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 cohort o...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0264220 |
| _version_ | 1818365153735868416 |
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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 | 2024-12-13T22:15:44Z |
| format | Article |
| id | doaj.art-a2db1d342fb2455987eeeab4c0e29879 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T22:15:44Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-a2db1d342fb2455987eeeab4c0e298792022-12-21T23:29:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026422010.1371/journal.pone.0264220Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting.Hollis 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://doi.org/10.1371/journal.pone.0264220 |
| 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://doi.org/10.1371/journal.pone.0264220 |
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