Background: COVID-19 clinical presentation is usually non-specific and includes commonly encountered symptoms like fever, cough, nausea, and vomiting. It has been reported that COVID-19 patients can potentially transmit the disease to others before developing symptoms. Thus, extensive surveillance and screening of individuals at risk of the disease is required to limit SARS-COV-2 spread. The COVID-19 respiratory triage score has been used for patient screening. We aimed to determine its diagnostic performance characteristics, which have not been adequately studied before. Methodology: This is a retrospective observational study involving all patients screened for COVID-19 at a tertiary care facility. Patients were tested using nasopharyngeal swab for SARS-COV-2 PCR. The Saudi CDC COVID-19 respiratory triage score was measured for all subjects. The sensitivity, specificity, positive predictive value, and negative predicted value of COVID-19 respiratory triage score were measured with reference to SARS-COV-2 PCR test. Multivariate regression analysis was done to identify factors that can predict a positive SARS-COV-2 PCR test. Result: A total of 1,435 subjects were included. The COVID-19 respiratory triage score provided a marginal diagnostic performance with a receiver-operating characteristics (ROC) area under the curve value of 0.60 (95% CI: 0.57–0.64). A triage score of 5 provided the best cut-off value for the combined sensitivity and specificity. Clinical characteristics that independently predicted positive COVID-19 PCR test include male sex (adjusted OR: 1.47; p = 0.034), healthcare workers and their family members (adjusted OR: 1.99; 95%; p = 0.016), fever (adjusted OR: 2.98; p < 0.001), and moderate disease severity (adjusted OR: 5; p < 0.001). Conclusion: The current COVID-19 respiratory triage score has marginal diagnostic performance characteristics. Its performance can improve by including additional predictors to the respiratory symptoms in order to avoid missing COVID-19 patients with atypical presentation and to limit unnecessary SARS-COV-2 PCR testing.
【저자키워드】 COVID-19, SARS-CoV-2, Viral pneumonia, respiratory triage, screening for COVID-19, 【초록키워드】 severity, diagnostic, risk, Symptom, cough, Symptoms, healthcare worker, Spread, Nasopharyngeal swab, sensitivity, specificity, PCR testing, PCR, Positive predictive value, Characteristics, ROC, Surveillance, Sensitivity and specificity, CDC, clinical, Fever, Patient, predictor, PCR test, Care, multivariate regression analysis, predict, non-specific, retrospective, Male sex, Atypical, COVID-19 patient, Factor, moderate disease, subject, all subjects, individual, nausea, respiratory symptom, cut-off value, vomiting, positive, positive COVID-19, limit, IMPROVE, was measured, tested, predicted, identify, include, reported, the disease, required, provided, screened, adjusted, determine, were measured, was done, their family member, 【제목키워드】 Test, Triage, PCR, respiratory, score,