Background Preventive strategies in the form of early identification and isolation of patients are the cornerstones in the control of COVID-19 pandemic. We have conducted this study to develop a clinical symptom-based scoring system (CSBSS) for the diagnostic evaluation of COVID-19. Methods In this study, 378 patients presenting to screening outpatient clinic with clinical suspicion of COVID-19 were evaluated for various clinical symptoms. Statistical associations between presenting symptoms and reverse transcription-polymerase chain reaction (RT-PCR) results were analysed to select statistically significant clinical symptoms to design a scoring formula. CSBSS was developed by evaluating clinical symptoms in 70% of the total patients. The cut-off score of the CSBSS was determined from ROC (receiver operating characteristics) curve analysis to obtain a cut-off for optimum sensitivity and specificity. Subsequently, developed CSBSS was validated in the external validation dataset comprising 30% of patients. Results Clinical symptoms like fever >100 0 F, myalgia, headache, cough and loss of smell had significant association with RT-PCR result. The adjusted odds ratios (95% confidence interval [CI]) for loss of smell, fever >100°F, headache, cough and myalgia were 5.00 (1.78-13.99), 2.05 (1.36-3.07), 1.31 (0.67-2.59), 1.26 (0.70-2.26) and 1.18 (0.50-2.78), respectively. The ROC curve and area under the curve of development and validation datasets were similar. Conclusion The presence of fever >100°F and loss of smell among suspected patients are important clinical predictors for the diagnosis of COVID-19. This newly developed CSBSS is a valid screening tool that can be useful in the diagnostic evaluation of patients with suspected COVID-19. This can be used for the risk stratification of the suspected patients before their RT-PCR results are generated.
【저자키워드】 COVID-19, Diagnosis, Screening, validation, score, 【초록키워드】 Clinical symptoms, COVID-19 pandemic, diagnostic, Symptom, cough, headache, RT-PCR, risk stratification, sensitivity, ROC, clinical, Fever, Patient, Isolation, dataset, predictor, patients, association, Analysis, ROC Curve, external validation, myalgia, presenting symptom, scoring system, outpatient clinic, Loss of Smell, adjusted odds ratio, 95% confidence interval, clinical symptom, clinical suspicion, cut-off, total patients, receiver operating characteristics, Result, develop, evaluated, conducted, analysed, can be used, was determined, statistically significant, presenting, 1.26, diagnosis of COVID-19, suspected patient, 【제목키워드】 clinical, development, Outpatient, Scoring, situation, Department, System,