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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.
  • +13
  • Fernando Anschau,
  • Paulo Worm,
  • Luciane Kopittke,
  • Luis Humberto de Mello Villwock,
  • Marcos Luiggi Lemos Sartori,
  • Sandro Pinheiro,
  • Jéferson Cardoso do Rosário,
  • José Francisco Secorun Inácio,
  • Maicon Diogo Much,
  • Eduardo Marckmann,
  • João Ricardo Nickenig Vissoci,
  • Wagner de Lara Machado,
  • Dalton Breno Costa,
  • Daniel Klug,
  • Juliane Martin Prestes,
  • Fabiano Hessel
Fernando Anschau
Grupo Hospitalar Conceição

Corresponding Author:fernando.anschau@pucrs.br

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Paulo Worm
Grupo Hospitalar Conceição
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Luciane Kopittke
Grupo Hospitalar Conceição
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Luis Humberto de Mello Villwock
Pontifícia Universidade Católica do Rio Grande do Sul
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Marcos Luiggi Lemos Sartori
Pontifícia Universidade Católica do Rio Grande do Sul
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Sandro Pinheiro
Pontifícia Universidade Católica do Rio Grande do Sul
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Jéferson Cardoso do Rosário
Pontifícia Universidade Católica do Rio Grande do Sul
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José Francisco Secorun Inácio
Pontifícia Universidade Católica do Rio Grande do Sul
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Maicon Diogo Much
Pontifícia Universidade Católica do Rio Grande do Sul
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Eduardo Marckmann
Pontifícia Universidade Católica do Rio Grande do Sul
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João Ricardo Nickenig Vissoci
Duke University
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Wagner de Lara Machado
Pontifícia Universidade Católica do Rio Grande do Sul
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Dalton Breno Costa
Pontifícia Universidade Católica do Rio Grande do Sul
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Daniel Klug
Grupo Hospitalar Conceição
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Juliane Martin Prestes
Grupo Hospitalar Conceição
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Fabiano Hessel
Pontifícia Universidade Católica do Rio Grande do Sul
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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
16 Mar 2021Submitted to International Journal of Clinical Practice
18 Mar 2021Submission Checks Completed
18 Mar 2021Assigned to Editor
22 Mar 2021Reviewer(s) Assigned
14 May 2021Review(s) Completed, Editorial Evaluation Pending
14 Jun 20211st Revision Received
16 Jun 2021Submission Checks Completed
16 Jun 2021Assigned to Editor
16 Jun 2021Review(s) Completed, Editorial Evaluation Pending
16 Jun 2021Reviewer(s) Assigned
02 Jul 2021Editorial Decision: Revise Minor
05 Jul 20212nd Revision Received
06 Jul 2021Submission Checks Completed
06 Jul 2021Assigned to Editor
06 Jul 2021Review(s) Completed, Editorial Evaluation Pending
06 Jul 2021Editorial Decision: Accept