AUTHOR=Aldobyany Ahmad , Touman Abdelfattah , Ghaleb Nabil , Alsaggaf Rajaa , Murtaza Noureen , Hamada Adel , Alknawy Moataz , Albanna Amr S. , Alqurashi Eid 

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

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.605689

DOI=10.3389/fmed.2020.605689

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methodology:</bold> 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.</p><p><bold>Result:</bold> 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; <italic>p</italic> = 0.034), healthcare workers and their family members (adjusted OR: 1.99; 95%; <italic>p</italic> = 0.016), fever (adjusted OR: 2.98; <italic>p</italic> &lt; 0.001), and moderate disease severity (adjusted OR: 5; <italic>p</italic> &lt; 0.001).</p><p><bold>Conclusion:</bold> 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.</p>