| Autor: |
Otrofanowei, Erereoghor, Akase, Iorhen Ephraim, Olopade, Bolaji Oluwarotimi, Akintan, Patricia E., Ima-Edomwonyi, Uyiekpen E., Akinbolagbe, Yeside Olubunmi, Agabi, Osigwe Paul, Nmadu, Danladi Abraham, Akinbode, Gbemileke O., Opawoye, Adefolarin, Olasope, C. Aramide, Ogundare, Adewale, Bolarinwa, B. Abiola, Awojumobi-Otokiti, Oluwakemi Elizabeth, Enajeroh, Precious. J., Karami, Moses, Esezobor, Christopher Imokhuede, Olorunfemi, Gbenga, Oshodi, Yewande O., Oluwole, Ayotunde Ayodeji |
| Předmět: |
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| Zdroj: |
Nigerian Postgraduate Medical Journal; Apr-Jun2022, Vol. 29 Issue 2, p96-101, 7p |
| Abstrakt: |
The use of reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard laboratory test for diagnosing SARS-CoV-2 infection. However, it has the disadvantage of a long turnaround time and cost. The Nigeria Centre for Disease Control (NCDC) formulated a case definition for COVID-19. We sought to determine the utility of a 14-item, point-weighted clinical screening questionnaire adapted from the NCDC case definition in identifying patients more likely to have the disease. This was to aid prompt clinical decision-making. Methods: We retrospectively reviewed the data of 113 non-surgical patients presenting to the Accident and Emergency Department (A and E) of Lagos University Teaching Hospital, Lagos, Nigeria. Patients were stratified based on screening scores into low (0-2), moderate (3-5) and high (6) pre-test categories. Patients with low and high scores ≥6 were admitted to the A and E and the COVID-19 holding ward, respectively, while the moderate group had chest computed tomography scans to aid further decision-making, pending the outcome of their RT-PCR results. The validity of the triage score as compared to the RT-PCR test result was calculated and the kappa score of agreement was utilised to evaluate the concordance between two triage scores. The optimum cut-off score was also obtained based on the maximal Younden's index. Results: The frequencies of low, moderate and high pre-test scores were 34 (30%), 43 (38.1%) and 36 (31.9%), respectively. Overall, 38.1% (43/113) were RT-PCR positive. RT-PCR was positive in 26.5% (9/34) with low screening scores, 55.8% (24/43) with moderate scores and 27.8% (10/36) with high scores. The sensitivity and specificity of a high score of 6 were 25% and 92.86%, while the lower score of 3 had sensitivity and specificity of 62.5% and 58.6%, respectively. Conclusion: The screening tool showed a high specificity in its initial design, which suggests that anyone with a low score using this tool has a high probability of testing negative. We recommend a cut-off score of 4 (score A) or 6 (score B) of the current screening tool be used to increase the chances of identifying persons with COVID-19 for RT-PCR testing. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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