COVID-19 scoring
DOI:
https://doi.org/10.18203/2349-3933.ijam20204528Keywords:
COVID-19, TRACE-SLIP score, TriageAbstract
Background: Triaging of COVID-19 patients. Coronavirus disease 2019 (COVID-19) pandemic has posed a threat both to lives of common people as well as to the existing overburdened healthcare system. There has been dearth of hospital beds which has lead to chaos. In such a situation triaging of patients is of utmost importance to avoid unnecessary hospital admission which results in both anxiety in patients and increases load on hospitals. We hereby propose a scoring system which incorporates all the points that must be seen in suspected and tested positive COVID-19 patients and gives a score following which patients can be divided into different stages as per severity namely mild, moderate and severe. Mild cases can be advised for home quarantine/isolation with warning signs explained and this reduces unnecessary admissions. Moderate and severe cases which requires admission can be triaged with respect to ward and intensive care unit (ICU) admissions. This prevents unnecessary ICU admissions as well as prevents delay in ICU shifting of moderate cases on deterioration.
Methods: We have conducted a cross-sectional study on 500 suspected and real time-polymerase chain reaction (RT-PCR) tested positive COVID-19 patients using this scoring system in order to triage them.
Result: Out of 500 patients including both suspected and positive COVID-19 patients only 373 required admissions whereas 127 admissions were successfully avoided as they could be sent for home quarantine/isolation.
Conclusion: Triaging of patients, especially during a pandemic where the case load is immense, is very important. Presence of a concise score which incorporate all important points serves the purpose.
Metrics
References
Coronavirus. Who.int. 2020. https://www.who.int/healthtopics/coronavirus/coronavirus. Accessed on 10 July, 2020.
Gandhi R, Lynch J, del Rio C. Mild or Moderate Covid-19. New England Journal of Medicine. 2020.
Berlin D, Gulick R, Martinez F. Severe Covid-19. New England Journal of Medicine. 2020.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.
Government Management Protocol for COVID-19, Department of Health and Family Welfare. Accessed on 10 July, 2020.
Wu J, Leung K, Bushman M, Kishore N, Niehus R, de Salazar P et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nature Medicine. 2020;26(4):506-10.
Arnett DK, Blumenthal RS, Albert MA. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2019;74:e177-232.
Shah SJ, Stafford RS. Current trends of hypertension treatment in the United States. Am J Hypertens. 2017;30:1008-14.
Bunyavanich S, Do A, Vicencio A. Nasal gene expression of angiotensin-converting enzyme 2 in children and adults. JAMA. 2020;323(23):2427-9
Wang Z, Chen Z, Zhang L. Status of hypertension in China: results from the China Hypertension Survey, 2012-2015. Circulation. 2018;137:2344-56.
Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone system inhibitors in patients with Covid-19. N Engl J Med. 2020;382:1653-9.
Tikellis C, Wookey PJ, Candido R, Andrikopoulos S, Thomas MC, Cooper ME. Diabetes. 2004;53(4):989-97.
Carlsson PO, Berne C, Jansson L. Angiotensin II and the endocrine pancreas: effects on islet blood flow and insulin secretion in rats. Diabetologia. 1998;41:127-33.
Kuno A, Yamada T, Masuda K, Ogawa K, Sogawa M, Nakamura S et al. Angiotensin-converting enzyme inhibitor attenuates pancreatic inflammation and fibrosis in male Wistar Bonn/Kobori rats. Gastroenterol. 2003;124:1010-9.
Hajra A, Mathai S, Ball S, Bandyopadhyay D, Veyseh M, Chakraborty S et al. Management of Thrombotic Complications in COVID-19: An Update. Drugs. 2020.
Revised National Clinical Management Guidelines of COVID-19, Government of India, Ministry of Health & Family Welfare. Accessed on 10 July, 2020.
Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduction and Targeted Therapy. 2020;5(33).
Radiologyassistant.nl. 2020. The Radiology Assistant: COVID-19 Imaging Findings. https://radiologyassistant.nl/chest/covid-19/covid19-imaging-findings. Accessed on 10 July, 2020.
Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631-7.
