• Ru Chen, Guilan Xu, Lihui Yang, Zelin Deng, Qing Hu, Hao Hu, and Zhen Wang.
• Neurological Department, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
• Intern Emerg Med. 2021 Jun 1; 16 (4): 925-932.

AbstractWe aimed at establishing a new COVID-19 risk scores, serving as a guide for rapidly screening the COVID-19 patients in order to reduce the risk of COVID-19 hospital-related transmission. As the COVID-19 disease is breaking out across the world, hospital-related transmission is one of the main factors accountable for the spread of COVID-19. For COVID-19 prevention it is urgent to establish a fast and efficient screening strategy for the COVID-19 patients. We analyzed 335 patients (including 124 patients with COVID-19). Five significant clinical attributes were selected as the components for establishing a COVID-19 risk score system, and every attribute was assigned a specific score according to their respective odds ratio values. We also compared three different screening schemes (Scheme I: temperature higher than 37.2 °C on admission, Scheme II: exposure to a source of transmission within 14 days in addition to fever, Scheme III: our new COVID-19 risk score) in terms of their respective receiver operating characteristic (ROC) curves, so as to evaluate their respective screening effectiveness. Five significant risk factors, which were exposed to a source of transmission (9 points), cluster onset (6 points), history of fever or temperature higher than 37.2 °C on admission (4 points), cough (1 point) and other atypical symptoms (1 point), were ultimately selected from many candidates to construct the new rapid COVID-19 screening program. Based on the screening scheme, the patients were quickly divided into three subgroups according to their respective COVID-19 risk scores: low risk (≤ 6 points, risk < 10%), medium risk (7-13 points) and high risk (≥ 14 points, risk > 80%). When the score of 10 points was selected as a cut-off point for differentiating the patients with COVID-19 from all of the other patients, the sensitivity was 93.6%, with a specificity of 86.3%. The area under the ROC curve (AUC) of COVID-19 risk score system was 0.96 (P = 0.000), much higher than the AUCs of Scheme I (0.56, P = 0.000) and Scheme II (0.85, P = 0.000), respectively. Our COVID-19 risk score system can help the clinicians effectively and rapidly identify and differentiate the patients with COVID-19 infections, to be mainly used in those areas where COVID-19 still exhibits epidemiological characteristics.

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