Smart Check - COVID-19 triage system: evaluation of the impact on the
screening time and identification of clinical manifestations of
SARS-CoV-2 infection in a public health service.
Abstract
Introduction: Most patients with COVID-19 have mild or moderate
manifestations, however, there is a wide spectrum of clinical
presentations and even more severe repercussions that require high
diagnostic suspicion. Vital sign acquisition and monitoring are crucial
for detecting and responding to patients with COVID-19. Objective: Thus,
we conducted this study to demonstrate the impact of using a tool called
Smart Check on the triage time of patients with suspected COVID-19 and
to identify the main initial clinical manifestations in these cases.
Methodology: We assessed triage times before and after the use of Smart
Check in 11,466 patients. In this group, we identified 211 patients for
the identification of COVID-19 clinical manifestations in a case-control
analysis. Results: Smart Check was able to decrease the triage time by
33 seconds on average, with 75% of the exams being performed within 5
minutes, whereas with the usual protocol these steps were performed
within 6 minutes. A range of clinical presentations made up the COVID-19
initial manifestations. Those with the highest frequency were dry cough
(46.8%), fever (41.3%), dyspnea (35.8%), and headache (32.1%). Loss
of appetite, fever, and ageusia were the manifestations that had a
statistically significant association with the SARS-CoV-2 presence.
Conclusions: Smart Check, a simple clinical evaluation tool, along with
the targeted use of rapid PCR testing, can optimize triage time for
patients with and without COVID-19. In triage centers, a number of
initial signs and symptoms should be cause for SARS-CoV-2 infection
suspicion, in particular the association of respiratory, neurological,
and gastrointestinal manifestations. Keywords: new coronavirus,
COVID-19, triage, clinical manifestations