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

K.R.C. Hensgens*, I.H.T. van Rensen, A.W. Lekx, F.H.M. van Osch, L.H.H. Knarren, C.E. Wyers, J.P. van den Bergh, D.G. Barten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Web of Science)

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.
Original languageEnglish
Article number9271
Number of pages11
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number17
DOIs
Publication statusPublished - 1 Sep 2021

Keywords

  • emergency department
  • COVID-19
  • pandemic
  • pre-triage screening
  • triage

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