Simple, fast and affordable triaging pathway for COVID-19

Abstract

Coronavirus disease 2019 has caused a global pandemic. The majority of patients will experience mild disease, but others will develop a severe respiratory infection that requires hospitalisation. This is causing a significant strain on health services. Patients are presenting at emergency departments with symptoms of dyspnoea, dry cough and fever with varying severity. The appropriate triaging of patients will assist in preventing health services becoming overwhelmed during the pandemic. This is assisted through clinical assessment and various imaging and laboratory investigations, including chest X-ray, blood analysis and identification of viral infection with SARS-CoV-2. Here, a succinct triaging pathway that aims to be fast, reliable and affordable is presented. The hope is that such a pathway will assist health services in appropriately combating the pandemic.

Keywords: chest imaging; health economics; infectious diseases; molecular diagnostics; pathology; public health.

Figure 1

Pathway to triage patients with COVID-19 from initial presentation. Decision points are discussed in more detail in the main text. (1) Viral swab collection; (2) initial assessment; (3) further investigations. ABG, arterial blood gas; A+E, Accident and Emergency; CXR, chest X-ray; NEWS2, National Early Warning Score 2; PoCT, point-of-care test; PPE, personal protective equipment; RT-PCR, Reverse-Transcriptase PCR; URT, upper respiratory tract.