PLoS ONE (Jan 2022)

Assessment of a cellular host response test to risk-stratify suspected COVID-19 patients in the Emergency Department setting

  • 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

Journal volume & issue
Vol. 17, no. 3

Abstract

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Objective 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. Methods 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. Main findings 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 Conclusions The ISI rapidly risk-stratifies patients presenting to the ED during the early COVID-19 pandemic with signs or suspicion of respiratory infection.