Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting
<h4>Objective</h4> Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic. <h4>Methods</h4> An observational single-center study of prospective cohor...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926179/?tool=EBI |
| _version_ | 1818157595305705472 |
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| author | Hollis R. O’Neal Roya Sheybani Terrell S. Caffery Diana Hamer L. Mark Laperouse Mandi W. Musso Catherine S. O’Neal Henry T. K. Tse Ajay M. Shah Christopher B. Thomas |
| author_facet | Hollis R. O’Neal Roya Sheybani Terrell S. Caffery Diana Hamer L. Mark Laperouse Mandi W. Musso Catherine S. O’Neal Henry T. K. Tse Ajay M. Shah Christopher B. Thomas |
| author_sort | Hollis R. O’Neal |
| collection | DOAJ |
| description | <h4>Objective</h4> Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic. <h4>Methods</h4> An observational single-center study of prospective cohort of patients presenting to the ED during the early COVID-19 pandemic with respiratory symptoms and a CBC drawn within 4.5 hours of initial vital signs. A sample of this blood was aliquoted for performance of the ISI, and patients were followed for clinical outcomes. The study required no patient-centered activity beyond standard of care and treating clinicians were unaware of study enrollment and ISI test results. <h4>Main findings</h4> 282 patients were included. The ISI ranges 0.1 to 10.0, with three interpretation bands indicating risk of adverse outcome: low (green), 0.1–4.9; intermediate (yellow), 5.0–6.2; and high (red), 6.3–10.0. Of 193 (68.4%) tested for SARS-CoV-2, 96 (49.7%) were positive. The ISI resulted in 182 (64.5%) green, 54 (18.1%) yellow, and 46 (15.6%) red band patients. Green band patients had a 1.1% (n = 2) 3-day mortality, while yellow and red band had 3.7% (n = 2, p > .05) and 10.9% (n = 5, p < .05) 3-day mortalities, respectively. Fewer green band patients required admission (96 [52.7%]) vs yellow (44 [81.5%]) and red (43 [93.5%]). Green band patients had more hospital free days (median 23 (Q1-Q3 20–25) than yellow (median 22 [Q1-Q3 0–23], p < 0.05) and red (median 21 [Q1-Q3 0–24], p < 0.01). SOFA increased with interpretation band: green (2, [Q1-Q3 0–4]) vs yellow (4, [Q1-Q3 2–5], p < 0.001) and red (5, [Q1-Q3 3–6]) p < 0.001). <h4>Conclusions</h4> The ISI rapidly risk-stratifies patients presenting to the ED during the early COVID-19 pandemic with signs or suspicion of respiratory infection. |
| first_indexed | 2024-12-11T15:16:41Z |
| format | Article |
| id | doaj.art-168ea2fc08ae457db9bf4950158955a5 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T15:16:41Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-168ea2fc08ae457db9bf4950158955a52022-12-22T01:00:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department settingHollis R. O’NealRoya SheybaniTerrell S. CafferyDiana HamerL. Mark LaperouseMandi W. MussoCatherine S. O’NealHenry T. K. TseAjay M. ShahChristopher B. Thomas<h4>Objective</h4> Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic. <h4>Methods</h4> An observational single-center study of prospective cohort of patients presenting to the ED during the early COVID-19 pandemic with respiratory symptoms and a CBC drawn within 4.5 hours of initial vital signs. A sample of this blood was aliquoted for performance of the ISI, and patients were followed for clinical outcomes. The study required no patient-centered activity beyond standard of care and treating clinicians were unaware of study enrollment and ISI test results. <h4>Main findings</h4> 282 patients were included. The ISI ranges 0.1 to 10.0, with three interpretation bands indicating risk of adverse outcome: low (green), 0.1–4.9; intermediate (yellow), 5.0–6.2; and high (red), 6.3–10.0. Of 193 (68.4%) tested for SARS-CoV-2, 96 (49.7%) were positive. The ISI resulted in 182 (64.5%) green, 54 (18.1%) yellow, and 46 (15.6%) red band patients. Green band patients had a 1.1% (n = 2) 3-day mortality, while yellow and red band had 3.7% (n = 2, p > .05) and 10.9% (n = 5, p < .05) 3-day mortalities, respectively. Fewer green band patients required admission (96 [52.7%]) vs yellow (44 [81.5%]) and red (43 [93.5%]). Green band patients had more hospital free days (median 23 (Q1-Q3 20–25) than yellow (median 22 [Q1-Q3 0–23], p < 0.05) and red (median 21 [Q1-Q3 0–24], p < 0.01). SOFA increased with interpretation band: green (2, [Q1-Q3 0–4]) vs yellow (4, [Q1-Q3 2–5], p < 0.001) and red (5, [Q1-Q3 3–6]) p < 0.001). <h4>Conclusions</h4> The ISI rapidly risk-stratifies patients presenting to the ED during the early COVID-19 pandemic with signs or suspicion of respiratory infection.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926179/?tool=EBI |
| spellingShingle | Hollis R. O’Neal Roya Sheybani Terrell S. Caffery Diana Hamer L. Mark Laperouse Mandi W. Musso Catherine S. O’Neal Henry T. K. Tse Ajay M. Shah Christopher B. Thomas Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting PLoS ONE |
| title | Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting |
| title_full | Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting |
| title_fullStr | Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting |
| title_full_unstemmed | Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting |
| title_short | Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting |
| title_sort | assessment of a cellular host response test to risk stratify suspected covid 19 patients in the emergency department setting |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8926179/?tool=EBI |
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