使用逆转录聚合酶链反应(RT-PCR)是诊断SARS-CoV-2感染的金标准实验室测试。然而,它的缺点是周转时间和成本长。尼日利亚疾病控制中心(NCDC)为COVID-19制定了病例定义。我们试图确定14项的效用,根据NCDC病例定义改编的点加权临床筛查问卷,用于确定更有可能患有该疾病的患者。这是为了帮助及时的临床决策。
UNASSIGNED:我们回顾性地回顾了在拉各斯大学教学医院急症室(A和E)就诊的113名非手术患者的资料,拉各斯,尼日利亚。根据筛查评分将患者分层为低(0-2),中等(3-5)和高(6)预测试类别。低分和高分≥6分的患者分别进入A、E和COVID-19病房,分别,而中度组进行了胸部计算机断层扫描以帮助进一步的决策,等待RT-PCR结果的结果。与RT-PCR测试结果相比,计算了分诊评分的有效性,并利用kappa评分的一致性来评估两个分诊评分之间的一致性。还根据最大Younden指数获得了最佳截止分数。
未经评估:低频,中等和高测试前分数为34(30%),43(38.1%)和36(31.9%),分别。总的来说,RT-PCR阳性38.1%(43/113)。RT-PCR阳性占26.5%(9/34),筛选得分低,55.8%(24/43)得分中等,27.8%(10/36)得分高。高分6的敏感性和特异性分别为25%和92.86%,而低得3分的敏感性和特异性分别为62.5%和58.6%,分别。
UNASSIGNED:筛选工具在其初始设计中显示出高特异性,这表明任何使用此工具得分低的人都有很高的可能性测试为阴性。我们建议使用当前筛查工具的4分(A分)或6分(B分),以增加鉴定COVID-19患者进行RT-PCR检测的机会。
The use of reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard laboratory test for diagnosing SARS-CoV-2 infection. However, it has the disadvantage of a long turnaround time and cost. The Nigeria Centre for Disease Control (NCDC) formulated a case definition for COVID-19. We sought to determine the utility of a 14-item, point-weighted clinical screening questionnaire adapted from the NCDC case definition in identifying patients more likely to have the disease. This was to aid prompt clinical decision-making.
UNASSIGNED: We retrospectively reviewed the data of 113 non-surgical patients presenting to the Accident and Emergency Department (A and E) of Lagos University Teaching Hospital, Lagos, Nigeria. Patients were stratified based on screening scores into low (0-2), moderate (3-5) and high (6) pre-test categories. Patients with low and high scores ≥6 were admitted to the A and E and the COVID-19 holding ward, respectively, while the moderate group had chest computed tomography scans to aid further decision-making, pending the outcome of their RT-PCR results. The validity of the triage score as compared to the RT-PCR test result was calculated and the kappa score of agreement was utilised to evaluate the concordance between two triage scores. The optimum cut-off score was also obtained based on the maximal Younden\'s index.
UNASSIGNED: The frequencies of low, moderate and high pre-test scores were 34 (30%), 43 (38.1%) and 36 (31.9%), respectively. Overall, 38.1% (43/113) were RT-PCR positive. RT-PCR was positive in 26.5% (9/34) with low screening scores, 55.8% (24/43) with moderate scores and 27.8% (10/36) with high scores. The sensitivity and specificity of a high score of 6 were 25% and 92.86%, while the lower score of 3 had sensitivity and specificity of 62.5% and 58.6%, respectively.
UNASSIGNED: The screening tool showed a high specificity in its initial design, which suggests that anyone with a low score using this tool has a high probability of testing negative. We recommend a cut-off score of 4 (score A) or 6 (score B) of the current screening tool be used to increase the chances of identifying persons with COVID-19 for RT-PCR testing.