Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, United States of America.
Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States of America.
PLoS One. 2022 Mar 16;17(3):e0264220. doi: 10.1371/journal.pone.0264220. eCollection 2022.
Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic.
An observational single-center study of prospective cohort of patients presenting to the ED during the early COVID-19 pandemic with respiratory symptoms and a CBC drawn within 4.5 hours of initial vital signs. A sample of this blood was aliquoted for performance of the ISI, and patients were followed for clinical outcomes. The study required no patient-centered activity beyond standard of care and treating clinicians were unaware of study enrollment and ISI test results.
282 patients were included. The ISI ranges 0.1 to 10.0, with three interpretation bands indicating risk of adverse outcome: low (green), 0.1-4.9; intermediate (yellow), 5.0-6.2; and high (red), 6.3-10.0. Of 193 (68.4%) tested for SARS-CoV-2, 96 (49.7%) were positive. The ISI resulted in 182 (64.5%) green, 54 (18.1%) yellow, and 46 (15.6%) red band patients. Green band patients had a 1.1% (n = 2) 3-day mortality, while yellow and red band had 3.7% (n = 2, p > .05) and 10.9% (n = 5, p < .05) 3-day mortalities, respectively. Fewer green band patients required admission (96 [52.7%]) vs yellow (44 [81.5%]) and red (43 [93.5%]). Green band patients had more hospital free days (median 23 (Q1-Q3 20-25) than yellow (median 22 [Q1-Q3 0-23], p < 0.05) and red (median 21 [Q1-Q3 0-24], p < 0.01). SOFA increased with interpretation band: green (2, [Q1-Q3 0-4]) vs yellow (4, [Q1-Q3 2-5], p < 0.001) and red (5, [Q1-Q3 3-6]) p < 0.001).
The ISI rapidly risk-stratifies patients presenting to the ED during the early COVID-19 pandemic with signs or suspicion of respiratory infection.
评估 IntelliSep Index（ISI）在大流行期间因 COVID-19 呼吸道症状而就诊于急诊科的患者的风险分层。
对大流行早期因 COVID-19 呼吸道症状和在初始生命体征后 4.5 小时内抽取的全血细胞计数（CBC）而就诊于急诊科的患者进行前瞻性队列观察性单中心研究。对该血液样本进行了 ISI 检测，并对患者进行了临床结局随访。该研究除了标准护理外不需要患者参与，并且治疗医生不知道研究入组和 ISI 检测结果。
共纳入 282 例患者。ISI 范围为 0.1 至 10.0，有三个解释带表示不良结局的风险：低（绿色），0.1-4.9；中（黄色），5.0-6.2；高（红色），6.3-10.0。在 193 例接受 SARS-CoV-2 检测的患者中，96 例（49.7%）呈阳性。ISI 结果为 182 例（64.5%）为绿色带，54 例（18.1%）为黄色带，46 例（15.6%）为红色带。绿色带患者的 3 天死亡率为 1.1%（n=2），而黄色带和红色带的 3 天死亡率分别为 3.7%（n=2，p>.05）和 10.9%（n=5，p<.05）。需要住院治疗的绿色带患者（96 [52.7%]）少于黄色带（44 [81.5%]）和红色带（43 [93.5%]）。绿色带患者的住院天数（中位数 23 [Q1-Q3 20-25]）多于黄色带（中位数 22 [Q1-Q3 0-23]，p<.05）和红色带（中位数 21 [Q1-Q3 0-24]，p<.01）。SOFA 随解释带增加：绿色（2，[Q1-Q3 0-4]）与黄色（4，[Q1-Q3 2-5]，p<.001）和红色（5，[Q1-Q3 3-6]，p<.001）。
在大流行早期因 COVID-19 呼吸道症状就诊于急诊科的患者中，ISI 可快速对患者进行风险分层。
