Related Experiment Video
Updated: Dec 1, 2025
Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
[Risk stratification through implementation and evaluation of a COVID-19 score : A retrospective diagnostic study]
A Hüfner1, D Kiefl2, M Baacke3
1Zentrale Notaufnahme, Caritas-Krankenhaus St. Josef, Landshuter Straße 65, 93053, Regensburg, Deutschland. ahuefner@caritasstjosef.de.
Insights
A new COVID-19 score helps identify at-risk patients in emergency departments. This symptom-based tool aids in early isolation and treatment decisions for coronavirus disease 2019 (COVID-19).
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Clinical Diagnostics
Background:
- Clinical presentation of COVID-19 is often nonspecific, complicating differentiation from other viral infections.
- Diagnosing COVID-19 with high certainty based on individual or combined findings is challenging.
- Early identification of at-risk patients in emergency departments is crucial for pre-emptive isolation.
Purpose of the Study:
- To develop and validate a symptom-based score for early risk assessment of COVID-19 in emergency departments.
- To enable pre-emptive isolation and management of patients with suspected COVID-19.
- To improve the diagnostic pathway for coronavirus disease 2019.
Main Methods:
- A multicentric retrospective evaluation was conducted in three German emergency departments.
- Data from 697 patients with suspected COVID-19 were analyzed between March 9 and April 30, 2020.
- A symptom-based COVID-19 score was developed and validated against SARS-CoV-2 PCR testing.
Main Results:
- The study included 697 patients, with a 9.4% COVID-19 diagnosis rate.
- A COVID-19 score of ≥5 points significantly increased the likelihood of illness.
- The score demonstrated high sensitivity (98.4%) but moderate specificity (48.3%).
Conclusions:
- The developed COVID-19 score facilitates early risk stratification in emergency settings.
- It supports pre-emptive isolation, PCR testing, and treatment decisions.
- High sensitivity is achieved at the cost of moderate specificity due to nonspecific symptoms.
Background:
The clinical manifestation of COVID-19 is nonspecific and varies greatly, which makes it more difficult to discriminate from other (virus) infections. Neither individual findings nor combinations of findings are specific enough to be able to diagnose COVID-19 with a high degree of certainty. The goal was to identify patients in the emergency department, who are at risk for COVID-19 disease, early by using a score, so that they could be isolated pre-emptively.
Method:
Development and implementation of a symptom-based COVID-19 score based on a multicentric retrospective evaluation in three German emergency departments from 9 March until 30 April 2020 of patients suspected of having COVID-19 and subsequent SARS-CoV‑2 PCR testing.
Results:
The study population included 697 patients and 9.4% of these patients were diagnosed with COVID-19 infection. A COVID-19 score of ≥5 points was associated with a significantly increased likelihood of illness. The sensitivity of the score was 98.4% with a moderate specificity of 48.3%.
Discussion:
The score, which is easy to obtain during the initial assessment, supports the assessment of the pretest probability for a COVID-19 infection as part of the risk stratification and can influence the treatment pathway in terms of pre-emptive isolation, PCR testing and other treatment options at an early stage. Due to the nonspecific symptoms of the disease; however, it must be accepted that the goal of high sensitivity results in a relatively low specificity of the score.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:15Receiver Operating Characteristic Plot
01:29Bias in Epidemiological Studies
01:20Comparing the Survival Analysis of Two or More Groups
01:25Strategies for Assessing and Addressing Confounding
Confounding can be addressed at both the design phase of a study and through analytical methods after data...