Sarawak General Hospital, Department of Medicine, Infectious Disease Unit, Kuching, Sarawak, Malaysia.
Sarawak General Hospital, Clinical Research Centre, Kuching, Sarawak, Malaysia.
Med J Malaysia. 2022 Mar;77(2):237-240.
Isolation of SARS-CoV-2-infected individuals is an important COVID-19 pandemic control measure. While most cases have uncomplicated infection, a small proportion of them has developed life-threatening disease. We set up a retrospective study to determine preadmission triaging tool to predict the development of severe COVID-19.
A retrospective study was conducted from 1 October 2020 to 31 January 2021 with enrolment of all SARS-CoV-2 PCR-confirmed persons aged ≥13 years. The disease severity was assessed on admission and daily throughout the hospitalisation. Test-positive individuals were considered as having "severe COVID-19" if they had ≥1 of the following: room air oxygen saturation 30 breaths/minute, signs of severe respiratory distress, or received mechanical ventilation and/or vasopressor therapy. Uni- and multi-variate analyses using SPSS Statistics Ver. 26 were performed.
We showed that age ≥ 60 years, BMI ≥ 30.0, presentation on days 7-12 of illness, and ≥1 comorbidity were associated with development of severe COVID-19. A scoring system based on the four variables is a useful COVID-19 risk assessment tool. A total score ≥2 had a sensitivity of 60.9%, specificity of 88.2%, positive predictive value of 37.8% and negative predictive value of 95.0%.
Development of preadmission triaging tool can help health care providers (HCPs) decide on the placement of test-positive individuals to appropriate isolation facilities according to the risk of developing severe COVID-19.
对 SARS-CoV-2 感染者进行隔离是 COVID-19 大流行控制的重要措施。虽然大多数病例感染较轻，但仍有一小部分患者会发展为危及生命的疾病。我们进行了一项回顾性研究，旨在确定入院前的分诊工具，以预测 COVID-19 的严重程度。
本回顾性研究于 2020 年 10 月 1 日至 2021 年 1 月 31 日进行，纳入所有年龄≥13 岁、SARS-CoV-2 PCR 检测阳性的患者。入院时及住院期间每日对疾病严重程度进行评估。若患者符合以下任意一项标准，即被认为患有“严重 COVID-19”：静息状态下血氧饱和度<93%、呼吸窘迫明显、需要机械通气和/或血管升压药物治疗。采用 SPSS Statistics Ver. 26 进行单变量和多变量分析。
我们发现，年龄≥60 岁、BMI≥30.0、疾病第 7-12 天出现症状以及存在≥1 种合并症与发展为严重 COVID-19 相关。基于这四个变量的评分系统是一种有用的 COVID-19 风险评估工具。总分≥2 分的敏感性为 60.9%，特异性为 88.2%，阳性预测值为 37.8%，阴性预测值为 95.0%。
入院前分诊工具的制定有助于医疗保健提供者根据发展为严重 COVID-19 的风险，将检测阳性患者安置到适当的隔离设施。
