Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 14374,
    "title": "Clinical Prediction Tool to Assess the Likelihood of a Positive SARS-Cov-2 (COVID-19) Polymerase Chain Reaction Test in Patients with Flu-like Symptoms",
    "subtitle": null,
    "abstract": "Introduction: \nThe clinical presentation of coronavirus disease 2019 (COVID-19) overlaps with many other common cold and influenza viruses. Identifying patients with a higher probability of infection becomes crucial in settings with limited access to testing. We developed a prediction instrument to assess the likelihood of a positive polymerase chain reaction (PCR) test, based solely on clinical variables that can be determined within the time frame of an emergency department (ED) patient encounter.\nMethods:\n We derived and prospectively validated a model to predict SARS-CoV-2 PCR positivity in patients visiting the ED with symptoms consistent with the disease.\nResults:\n Our model was based on 617 ED visits. In the derivation cohort, the median age was 36 years, 43% were men, and 9% had a positive result. The median time to testing from the onset of initial symptoms was four days (interquartile range [IQR]: 2-5 days, range 0-23 days), and 91% of all patients were discharged home. The final model based on a multivariable logistic regression included a history of close contact (adjusted odds ratio [AOR] 2.47, 95% confidence interval [CI], 1.29-4.7); fever (AOR 3.63, 95% CI, 1.931-6.85); anosmia or dysgeusia (AOR 9.7, 95% CI, 2.72-34.5); headache (AOR 1.95, 95% CI, 1.06-3.58), myalgia (AOR 2.6, 95% CI, 1.39-4.89); and dry cough (AOR 1.93, 95% CI, 1.02-3.64). The area under the curve (AUC) from the derivation cohort was 0.79 (95% CI, 0.73-0.85) and AUC 0.7 (95% CI, 0.61-0.75) in the validation cohort (N = 379).\nConclusion:\n We developed and validated a clinical tool to predict SARS-CoV-2 PCR positivity in patients presenting to the ED to assist with patient disposition in environments where COVID-19 tests or timely results are not readily available.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "COVID19, polymerase chain reaction, prediction tool"
        }
    ],
    "section": "Endemic Infections",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8gz205xh",
    "frozenauthors": [
        {
            "first_name": "Barbara",
            "middle_name": "A.",
            "last_name": "Lara",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Francisco",
            "middle_name": "",
            "last_name": "Torres",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Patricia",
            "middle_name": "",
            "last_name": "Holger",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Claudia",
            "middle_name": "",
            "last_name": "Perales",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Sofia",
            "middle_name": "",
            "last_name": "Basauri",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Hans",
            "middle_name": "",
            "last_name": "Clausdorff",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Ernesto",
            "middle_name": "",
            "last_name": "Escobedo",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Fernando",
            "middle_name": "",
            "last_name": "Saldias",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Department of Respiratory Diseases, Santiago, Chile",
            "department": "None"
        },
        {
            "first_name": "Stuart",
            "middle_name": "",
            "last_name": "Swadron",
            "name_suffix": "",
            "institution": "Keck School of Medicine, Department of Emergency Medicine, University of Southern California, Los Angeles, California",
            "department": "None"
        },
        {
            "first_name": "Pablo",
            "middle_name": "",
            "last_name": "Aguilera",
            "name_suffix": "",
            "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile",
            "department": "None"
        }
    ],
    "date_submitted": "2020-07-25T05:15:54+01:00",
    "date_accepted": "2020-07-25T05:15:54+01:00",
    "date_published": "2021-03-24T17:04:23Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14374/galley/7379/download/"
        }
    ]
}