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

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dc.contributor.authorLara, B.A.
dc.contributor.authorTorres, F.
dc.contributor.authorHolger, P.
dc.contributor.authorPerales, C.
dc.contributor.authorBasauri, S.
dc.contributor.authorClausdorff, H.
dc.contributor.authorEscobedo, E.
dc.contributor.authorAguilera, P.
dc.contributor.authorSaldias, F.
dc.contributor.authorSwadron, S.
dc.date.accessioned2024-01-10T14:22:42Z
dc.date.available2024-01-10T14:22:42Z
dc.date.issued2021
dc.description.abstract© 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.
dc.fuente.origenScopus
dc.identifier.doi10.5811/westjem.2020.12.49200
dc.identifier.eissn19369018
dc.identifier.issn19369018 1936900X
dc.identifier.pubmedidMEDLINE:34125032
dc.identifier.scopusidSCOPUS_ID:85108204207
dc.identifier.urihttps://doi.org/10.5811/westjem.2020.12.49200
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79987
dc.identifier.wosidWOS:000658363300020
dc.information.autorucFacultad de Medicina; Clausdorff Fiedler, Hans Jurgen; S/I; 172140
dc.issue.numero3
dc.language.isoen
dc.nota.accesocontenido completo
dc.pagina.final598
dc.pagina.inicio592
dc.publishereScholarship
dc.revistaWestern Journal of Emergency Medicine
dc.rightsacceso abierto
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleClinical prediction tool to assess the likelihood of a positive sars-cov-2 (covid-19) polymerase chain reaction test in patients with flu-like symptoms
dc.typeartículo
dc.volumen22
sipa.codpersvinculados172140
sipa.indexWos
sipa.indexScopus
sipa.indexPubmed
sipa.trazabilidadCarga SIPA;09-01-2024
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