Hüfner A, Kiefl D, Baacke M, Zöllner R, Loza Mencía E, Schellein O, Avan N, Pemmerl S
Zentrale Notaufnahme, Caritas-Krankenhaus St. Josef, Landshuter Straße 65, 93053, Regensburg, Deutschland.
Klinik für Interdisziplinäre Notfallmedizin, Sana Klinikum Offenbach, Offenbach, Deutschland.
Med Klin Intensivmed Notfmed. 2020 Dec;115(Suppl 3):132-138. doi: 10.1007/s00063-020-00754-4. Epub 2020 Nov 6.
The clinical manifestation of COVID-19 is nonspecific and varies greatly, which makes it more difficult to discriminate from other (virus) infections. Neither individual findings nor combinations of findings are specific enough to be able to diagnose COVID-19 with a high degree of certainty. The goal was to identify patients in the emergency department, who are at risk for COVID-19 disease, early by using a score, so that they could be isolated pre-emptively.
Development and implementation of a symptom-based COVID-19 score based on a multicentric retrospective evaluation in three German emergency departments from 9 March until 30 April 2020 of patients suspected of having COVID-19 and subsequent SARS-CoV‑2 PCR testing.
The study population included 697 patients and 9.4% of these patients were diagnosed with COVID-19 infection. A COVID-19 score of ≥5 points was associated with a significantly increased likelihood of illness. The sensitivity of the score was 98.4% with a moderate specificity of 48.3%.
The score, which is easy to obtain during the initial assessment, supports the assessment of the pretest probability for a COVID-19 infection as part of the risk stratification and can influence the treatment pathway in terms of pre-emptive isolation, PCR testing and other treatment options at an early stage. Due to the nonspecific symptoms of the disease; however, it must be accepted that the goal of high sensitivity results in a relatively low specificity of the score.
新型冠状病毒肺炎（COVID-19）的临床表现不具有特异性，且差异很大，这使得它比其他（病毒）感染更难鉴别。无论是单个症状还是症状组合都不足以特异性地确诊COVID-19。目标是通过使用一种评分系统，在急诊科早期识别出有患COVID-19疾病风险的患者，以便对他们进行预防性隔离。
基于对2020年3月9日至4月30日德国三个急诊科疑似患有COVID-19的患者进行多中心回顾性评估，并进行后续严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）检测，开发并实施了一种基于症状的COVID-19评分系统。
研究人群包括697例患者，其中9.4%的患者被诊断为COVID-19感染。COVID-19评分≥5分与患病可能性显著增加相关。该评分系统的敏感性为98.4%，特异性为中等水平，为48.3%。
该评分系统在初始评估时易于获得，作为风险分层的一部分，有助于评估COVID-19感染的预检概率，并可在早期通过预防性隔离、PCR检测和其他治疗选择影响治疗途径。然而，由于该疾病症状不具有特异性，必须承认高敏感性的目标导致该评分系统的特异性相对较低。
