Browsing by Author "Swadron, S."

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    Clinical prediction tool to assess the likelihood of a positive sars-cov-2 (covid-19) polymerase chain reaction test in patients with flu-like symptoms
    (eScholarship, 2021) Lara, B.A.; Torres, F.; Holger, P.; Perales, C.; Basauri, S.; Clausdorff, H.; Escobedo, E.; Aguilera, P.; Saldias, F.; Swadron, S.
    © 2021 eScholarship. All rights reserved.Introduction: The clinical presentation of coronavirus disease 2019 (COVID-19) overlaps with many other common cold and influenza viruses. Identifying patients with a higher probability of infection becomes crucial in settings with limited access to testing. We developed a prediction instrument to assess the likelihood of a positive polymerase chain reaction (PCR) test, based solely on clinical variables that can be determined within the time frame of an emergency department (ED) patient encounter. Methods: We derived and prospectively validated a model to predict SARS-CoV-2 PCR positivity in patients visiting the ED with symptoms consistent with the disease. Results: Our model was based on 617 ED visits. In the derivation cohort, the median age was 36 years, 43% were men, and 9% had a positive result. The median time to testing from the onset of initial symptoms was four days (interquartile range [IQR]: 2-5 days, range 0-23 days), and 91% of all patients were discharged home. The final model based on a multivariable logistic regression included a history of close contact (adjusted odds ratio [AOR] 2.47, 95% confidence interval [CI], 1.29-4.7); fever (AOR 3.63, 95% CI, 1.931-6.85); anosmia or dysgeusia (AOR 9.7, 95% CI, 2.72- 34.5); headache (AOR 1.95, 95% CI, 1.06-3.58), myalgia (AOR 2.6, 95% CI, 1.39-4.89); and dry cough (AOR 1.93, 95% CI, 1.02-3.64). The area under the curve (AUC) from the derivation cohort was 0.79 (95% CI, 0.73-0.85) and AUC 0.7 (95% CI, 0.61-0.75) in the validation cohort (N = 379). Conclusion: We developed and validated a clinical tool to predict SARS-CoV-2 PCR positivity in patients presenting to the ED to assist with patient disposition in environments where COVID-19 tests or timely results are not readily available.
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    Consultas ambulatorias pediátricas atendidas en el Servicio de Urgencia de un hospital universitario
    (2014) Lara Hernández, Bárbara Alejandra; Aguilera Fuenzalida, Pablo René; Garrido, M.; Hirsch Birn, Tamara Eugenia; Swadron, S.; Saldías Peñafiel, Fernando