Evaluation of the Criteria Adopted to Identify Suspected Cases of COVID-19 in the Emergency Department Service of a Referral Palliative Oncology Care Unit

Abstract

Due to the need for isolation of inpatients with suspected COVID-19, accuracy in identifying these cases in Emergency Department (ED) has great relevance, especially in Palliative Oncology Care Unit (PCU). To evaluate the efficiency of clinical criteria adopted to identify suspected cases of COVID-19 by the ED in PCU. All patients admitted to PCU between April and June 2020 from ED were included. The clinical criteria adopted to identify suspected COVID-19 cases were: being in contact with a suspected or confirmed case less than 14 days ago and / or presenting fever with no defined focus and / or respiratory symptoms not explained by oncological disease and / or suggestive image in radiological examination (if necessary). All suspected cases were submitted to deep nasal and throat swab for SARS COV-2 investigation by Reverse Transcription Polymerase Chain Reaction Test, adopted as gold standard. Inpatients hospitalized by ED, without suspicion, and then diagnosed with COVID-19 within 10 days of hospitalization were considered as false-negative cases. During the period, 327 patients were admitted from ED. Of these, 69 (21%) were considered suspects, of whom 34 (49%) tested positive for COVID-19. The sensitivity of the clinical criterion to identify suspected cases was 87%, specificity was 88%, positive predictive value was 49%, negative was 98% and accuracy was 88%. The clinical criteria adopted to identify suspected cases of COVID-19 at ED proved to be efficient, with low risk of spreading in-hospital infection, avoiding unnecessary isolation of patients.