TY - JOUR T1 - Admission COVID-19 clinical risk assessment for guiding patient placement and diagnostic testing strategy JF - Clinical Medicine JO - Clin Med DO - 10.7861/clinmed.2020-0519 SP - clinmed.2020-0519 AU - Nick K Jones AU - Isobel Ramsay AU - Elinor Moore AU - Jonathan Fuld AU - Chris Adcock AU - Edward Banham-Hall AU - Judith Babar AU - Effrossyni Gkrania-Klotsas AU - Hoi Ping Mok Y1 - 2021/02/04 UR - http://www.rcpjournals.org/content/early/2021/02/03/clinmed.2020-0519.abstract N2 - Introduction Without universal access to point-of-care SARS-CoV-2 testing, many hospitals rely on clinical judgement alone for identifying cases of COVID-19 early.Methods Cambridge University Hospitals NHS Foundation Trust introduced a ‘traffic light’ clinical judgement aid to the COVID-19 admissions unit in mid-March 2020. Ability to accurately predict COVID-19 was audited retrospectively across different stages of the epidemic.Results One SARS-CoV-2 PCR positive patient (1/41, 2%) was misallocated to a ‘green’ (non-COVID-19) area during the first period of observation, and no patients (0/32, 0%) were mislabelled ‘green’ during the second period. 33 of 62 (53%) labelled ‘red’ (high risk) tested SARS-CoV-2 PCR positive during the first period, while 5 of 22 (23%) ‘red’ patients were PCR positive in the second.Conclusion COVID-19 clinical risk stratification on initial assessment effectively identifies non-COVID-19 patients. However, diagnosing COVID-19 is challenging and risk of overcalling COVID-19 should be recognised, especially when background prevalence is low. ER -