Optimisation of COVID-19 diagnostic pathways in acute hospital admissions to prevent nosocomial transmission.
Clin Respir J
; 16(9): 618-622, 2022 Sep.
Article
in English
| MEDLINE | ID: covidwho-1968080
ABSTRACT
INTRODUCTION:
In the management of acute hospital admissions during the COVID-19 pandemic, safe patient cohorting depends on robust admission diagnostic strategies. It is essential that screening strategies are sensitive and rapid, to prevent nosocomial transmission of COVID-19 and maintain patient flow.METHODS:
We retrospectively identified all COVID-19 positive and suspected cases at our institution screened by reverse transcription polymerase chain reaction (RT-PCR) between 4 April and 28 June 2020. Using RT-PCR positivity within 7 days as our reference standard, we assessed sensitivity and net-benefit of three admission screening strategies single admission RT-PCR, composite admission RT-PCR and CXR and repeat RT-PCR with 48 h.RESULTS:
RT-PCR single-test sensitivity was 91.5% (87.8%-94.4%) versus 97.7% (95.4%-99.1%) (p = 0.025) for RT-PCR/CXR composite testing and 95.1% (92.1%-97.2%) (p = 0.03) for repeated RT-PCR. Net-benefit was 0.83 for single RT-PCR versus 0.89 for RT-PCR/CXR and 0.87 for repeated RT-PCR at 0.02% threshold probability.CONCLUSION:
The RT-PCR/CXR composite testing strategy was highly sensitive when screening patients at the point of hospital admission. Real-world sensitivity of this approach was comparable to repeat RT-PCR testing within 48 h; however, faster facilitating improved patient flow.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cross Infection
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Clin Respir J
Year:
2022
Document Type:
Article
Affiliation country:
Crj.13530
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