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. 2020 Dec 7:7:605689.
doi: 10.3389/fmed.2020.605689. eCollection 2020.

Correlation Between the COVID-19 Respiratory Triage Score and SARS-COV-2 PCR Test

Ahmad Aldobyany  1 , Abdelfattah Touman  1 , Nabil Ghaleb  1 , Rajaa Alsaggaf  1 , Noureen Murtaza  1 , Adel Hamada  1 , Moataz Alknawy  1 , Amr S Albanna  2   3 , Eid Alqurashi  1
Affiliations

Correlation Between the COVID-19 Respiratory Triage Score and SARS-COV-2 PCR Test

Ahmad Aldobyany et al. Front Med (Lausanne). .

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; respiratory triage; screening for COVID-19; viral pneumonia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Percentage of negative and positive COVID-19 PCR test results at each value of COVID-19 Triage Score and the performance characteristics (sensitivity and specificity) of these values.
Figure 2
Figure 2
The Receiver operating characteristic (ROC) of COVID-19 Triage Score using the COVID-19 PCR testing as a Reference Value.
See this image and copyright information in PMC

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