Evaluation of visual triage for screening of Middle East respiratory syndrome coronavirus patients

S.H. Alfaraj (1) , J.A. Al-Tawfiq (2) , P. Gautret (3, 4) , M.G. Alenazi (1) , A.Y. Asiri (1) , Z.A. Memish (1)

1 Prince Mohammed Bin Abdulaziz Hospital
2 Johns Hopkins University School of Medicine [Baltimore]
3 VITROME - Vecteurs - Infections tropicales et méditerranéennes
4 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection

The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in September 2012 in Saudi Arabia had attracted the attention of the global health community. In 2017 the Saudi Ministry of Health released a visual triage system with scoring to alert healthcare workers in emergency departments (EDs) and haemodialysis units for the possibility of occurrence of MERS-CoV infection. We performed a retrospective analysis of this visual score to determine its sensitivity and specificity. The study included all cases from 2014 to 2017 in a MERS-CoV referral centre in Riyadh, Saudi Arabia. During the study period there were a total of 2435 suspected MERS cases. Of these, 1823 (75%) tested negative and the remaining 25% tested positive for MERS-CoV by PCR assay. The application of the visual triage score found a similar percentage of MERS-CoV and non-MERS-CoV patients, with each score from 0 to 11. The percentage of patients with a cutoff score of 4 was 75% in patients with MERS-CoV infection and 85% in patients without MERS-CoV infection (p 0.0001). The sensitivity and specificity of this cutoff score for MERS-CoV infection were 74.1% and 18.6%, respectively. The sensitivity and specificity of the scoring system were low, and further refinement of the score is needed for better prediction of MERS-CoV infection.

Keywords: Middle East respiratory syndrome coronavirus (MERS-CoV); Saudi Arabia; Scoring; Visual triage

Domains: Life Sciences [q-bio]; Microbiology and Parasitology; Virology; Life Sciences [q-bio]; Human health and pathology; Infectious diseases

S.H. Alfaraj, J.A. Al-Tawfiq, P. Gautret, M.G. Alenazi, A.Y. Asiri, et al.. Evaluation of visual triage for screening of Middle East respiratory syndrome coronavirus patients. New Microbes and New Infections, 2018, 26, pp.49-52. ⟨10.1016/j.nmni.2018.08.008⟩. ⟨hal-02100825⟩