Author/Authors :
Fugazzola, Paola General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Favi, Francesco General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Tomasoni, Matteo General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Zaghi, Claudia General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Casadei, Chiara General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Prosperi, Enrico General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Sermonesi, Giacomo General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy , Corbella, Davide Intensive Care Unit - ASST Papa Giovanni XXIII - Bergamo, Italy , Coccolini, Federico Emergency Surgery Unit - State University of Pisa - Cisanello Hospital - Pisa, Italy , Pratico, Beniamino Internal Medicine Unit - Bufalini Hospital - Cesena, Italy , Agnoletti, Vanni Intensive Care Unit - Bufalini Hospital - Cesena, Italy , Ansaloni, Luca General and Emergency Surgery Department - Bufalini Hospital - Cesena, Italy
Abstract :
Background: The Coronavirus Disease 2019 (COVID-19) pandemic has necessitated the alteration of the organization of entire hospitals
to try to prevent them from becoming epidemiological clusters. The adopted diagnostic tools lack sensitivity or specificity.
Objectives: The aim of the study was to create an easy-to-get risk score (Ri.S.I.Co., risk score for infection with the new coronavirus)
developed on the field to stratify patients admitted to hospitals according to their risk of COVID-19 infection.
Methods: In this prospective study, we included all patients who were consecutively admitted to the suspected COVID-19 department
of the Bufalini Hospital, Cesena (Italy). All clinical, radiological, and laboratory predictors were included in the multivariate
logistic regression model to create a risk model. A simplified model was internally and externally validated, and two score thresholds
for stratifying the probability of COVID-19 infection were introduced.
Results: From 11th March to 5th April 2020, 200 patients were consecutively admitted. A Ri.S.I.Co lower than 2 showed a higher
sensitivity than SARS-Cov-2 nucleic acid detection (96.2% vs. 65.4%; P < 0.001). The presence of ground-glass pattern on the lung-CT
scan had a lower sensitivity than a Ri.S.I.Co lower than 2 (88.5% vs. 96.2%; P < 0.001) and a lower specificity than a Ri.S.I.Co higher
than 6 (75.0% vs. 96.9%; P < 0.001).
Conclusions: We believe that the Ri.S.I.Co could allow to stratify admitted patients according to their risk, preventing hospitals
from becoming the main COVID-19 carriers themselves. Furthermore, it could guide clinicians in starting therapies early in severeonset
cases with a high probability of COVID-19, before molecular SARS-CoV-2 infection is confirmed.
Keywords :
Early Diagnosis , Score , Mass Casualty Incidents , Pandemic
