Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25510
Title: COVID-MATCH65-A prospectively derived clinical decision rule for severe acute respiratory syndrome coronavirus 2.
Austin Authors: Trubiano, Jason A ;Vogrin, Sara;Smibert, Olivia C ;Marhoon, Nada ;Alexander, Adrian A;Chua, Kyra Y L ;James, Fiona L;Jones, Nicholas R L;Grigg, Samuel E ;Xu, Cecilia L H ;Moini, Nasreen;Stanley, Sam R;Birrell, Michael T ;Rose, Morgan T ;Gordon, Claire L ;Kwong, Jason C ;Holmes, Natasha E 
Affiliation: Department of Medicine (St Vincent's Hospital), University of Melbourne, Fitzroy, Australia
Department of Infectious Diseases and The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
General Medicine
Data Analytics Research and Evaluation (DARE) Centre
Electronic Medical Record and Information and Communications Technology Services, Austin Health, Heidelberg, Australia
Infectious Diseases
Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
Medicine (University of Melbourne)
Issue Date: Dec-2020
metadata.dc.date: 2020-12
Publication information: PloS one 2020; 15(12): e0243414
Abstract: We report on the key clinical predictors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and present a clinical decision rule that can risk stratify patients for COVID-19. A prospective cohort of patients assessed for COVID-19 at a screening clinic in Melbourne, Australia. The primary outcome was a positive COVID-19 test from nasopharyngeal swab. A backwards stepwise logistic regression was used to derive a model of clinical variables predictive of a positive COVID-19 test. Internal validation of the final model was performed using bootstrapped samples and the model scoring derived from the coefficients, with modelling performed for increasing prevalence. Of 4226 patients with suspected COVID-19 who were assessed, 2976 patients underwent SARS-CoV-2 testing (n = 108 SARS-CoV-2 positive) and were used to determine factors associated with a positive COVID-19 test. The 7 features associated with a positive COVID-19 test on multivariable analysis were: COVID-19 patient exposure or international travel, Myalgia/malaise, Anosmia or ageusia, Temperature, Coryza/sore throat, Hypoxia-oxygen saturation < 97%, 65 years or older-summarized in the mnemonic COVID-MATCH65. Internal validation showed an AUC of 0.836. A cut-off of ≥ 1.5 points was associated with a 92.6% sensitivity and 99.5% negative predictive value (NPV) for COVID-19. From the largest prospective outpatient cohort of suspected COVID-19 we define the clinical factors predictive of a positive SARS-CoV-2 test. The subsequent clinical decision rule, COVID-MATCH65, has a high sensitivity and NPV for SARS-CoV-2 and can be employed in the pandemic, adjusted for disease prevalence, to aid COVID-19 risk-assessment and vital testing resource allocation.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25510
DOI: 10.1371/journal.pone.0243414
ORCID: 0000-0002-5111-6367
0000-0002-4480-4911
PubMed URL: 33296409
Type: Journal Article
Subjects: COVID-19
Appears in Collections:Journal articles

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