Sort and Sieve: Pre-Triage Screening of Patients with Suspected COVID-19 in the Emergency Department

Kirsten R.C. Hensgens, Inge H.T. van Rensen, Anita W. Lekx, Frits H.M. van Osch, Lieve H.H. Knarren, Caroline E. Wyers, Joop P. van den Bergh and Dennis G. Barten
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Kirsten R.C. Hensgens: VieCuri Medical Centre, Department of Emergency Medicine, 5912 BL Venlo, The Netherlands
Inge H.T. van Rensen: VieCuri Medical Centre, Department of Emergency Medicine, 5912 BL Venlo, The Netherlands
Anita W. Lekx: VieCuri Medical Centre, Department of Emergency Medicine, 5912 BL Venlo, The Netherlands
Frits H.M. van Osch: VieCuri Medical Centre, Department of Clinical Epidemiology, 5912 BL Venlo, The Netherlands
Lieve H.H. Knarren: VieCuri Medical Centre, Department of Internal Medicine, T5912 BL Venlo, The Netherlands
Caroline E. Wyers: School of Nutrition and Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands
Joop P. van den Bergh: School of Nutrition and Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands
Dennis G. Barten: VieCuri Medical Centre, Department of Emergency Medicine, 5912 BL Venlo, The Netherlands

IJERPH, 2021, vol. 18, issue 17, 1-11

Abstract: Introduction. To reduce the risk of nosocomial transmission, suspected COVID-19 patients entering the Emergency Department (ED) were assigned to a high-risk (ED) or low-risk (acute medical unit, AMU) area based on symptoms, travel and contact history. The objective of this study was to evaluate the performance of our pre-triage screening method and to analyse the characteristics of initially undetected COVID-19 patients. Methods. This was a retrospective, observational, single centre study. Patients ? 18 years visiting the AMU-ED between 17 March and 17 April 2020 were included. Primary outcome was the (correct) number of COVID-19 patients assigned to the AMU or ED. Results. In total, 1287 patients visited the AMU-ED: 525 (40.8%) AMU, 762 (59.2%) ED. Within the ED group, 304 (64.3%) of 473 tested patients were COVID-19 positive, compared to 13 (46.4%) of 28 tested patients in the AMU group. Our pre-triage screening accuracy was 63.7%. Of the 13 COVID-19 patients who were initially assigned to the AMU, all patients were ?65 years of age and the majority presented with gastro-intestinal or non-specific symptoms. Conclusion. Older COVID-19 patients presenting with non-specific symptoms were more likely to remain undetected. ED screening protocols should therefore also include non-specific symptoms, particularly in older patients.

Keywords: emergency department; COVID-19; pandemic; pre-triage screening; triage (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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