Considering the impact the COVID-19 pandemic has had, particularly in low- and middle-income countries (LMICs), it becomes important to devise strategies for early diagnosis and management of people affected by the disease. Efficient triaging will assist with the timely diagnosis and management of these patients.

Hence, a single-center, cross-sectional, retrospective, observational study determined the adeptness of primary care physicians at a screening clinic to identify if a patient had COVID-19 or not, on the basis of their symptoms alone.

The study included subjects suspected to have COVID-19 who visited the center between August 1 and August 30, 2020. In all, 511 patients with at least one symptom pointing to COVID-19 visited the screening clinic. 

Main outcome measure- To ascertain if it is possible to predict the outcome of confirmatory test results just by history taking. 

Findings – 

• About 70.4% patients had fever and cough was present in 22%.
• Around 15% of the patients had shortness of breath and 11% had body aches.
• Nearly 20% patients presented only with fever.
• At a pre-test probability of 50%, trained doctors had a sensitivity of 74.7% in predicting positive cases on the basis of symptoms, while the specificity was 58.12%. With regular training, the doctors could predict the presence of infection in 74.7% cases just on the basis of clinical assessment.
• The doctors assessment had a positive predictive value of 67.87% and a negative predictive value of 66.02%. Positive predictive value refers to the probability that individuals with a positive screening test actually have the disease, while negative predictive value is the probability that individuals having a negative screening test actually dont have the disease. 

Conclusion –

Early triaging to diagnose COVID-19 can be done at a screening clinic, on the basis of history taking alone by trained physicians.

Source: Nayan N, Kumar MK, Nair RK, et al.Clinical Triaging in Cough Clinic Alleviates COVID-19 Overload in Emergency Department in India.SN Compr Clin Med. 2021 Jan 7 : 1–6.