Journal of Multidisciplinary Healthcare (Oct 2021)

COVID-19 Screening for Hospitalized Patients: The Role of Expanded Hospital Surveillance in a Low Prevalence Setting

  • Hsu JY,
  • Liu PY,
  • Tseng CH,
  • Liu CW,
  • Yang WT,
  • Huang WH,
  • Li SY,
  • Liao YC,
  • Wu MJ

Journal volume & issue
Vol. Volume 14
pp. 3027 – 3034

Abstract

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Jen-Yu Hsu,1 Po-Yu Liu,1 Chien-Hao Tseng,1 Chia-Wei Liu,1 Wan-Ting Yang,1 Wei-Hsuan Huang,1 Shu-Yuan Li,1 Ya-Chun Liao,1 Ming-Ju Wu2 1Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan; 2Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan & College of Medicine, National Chung Hsing University, Taichung, 402, TaiwanCorrespondence: Ming-Ju WuDepartment of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd, Xitun Dist, Taichung City, 407219, TaiwanTel +886-4-23592525Email [email protected]: The COVID-19 pandemic poses a serious threat to healthcare workers and hospitalized patients. Early detection of COVID-19 cases is essential to control the spread in healthcare facilities. However, real-world data on the screening criteria for hospitalized patients remain scarce. We aimed to explore whether patients with negative results of pre-hospital screening for COVID-19 should be rescreened after admission in a low-prevalence (less than 3% of the world average) setting.Patients and Methods: We retrospectively included patients in central Taiwan who were negative at the first screening but were newly diagnosed with pneumonia or had a body temperature above 38 degrees Celsius during their hospitalization. Each patient might be included as an eligible case several times, and the proportions of cases who were rescreened for COVID-19 and those diagnosed with COVID-19 were calculated. A logistic regression model was constructed to identify factors associated with rescreening. Reverse transcription-polymerase chain reaction tests were used to confirm the diagnosis of COVID-19.Results: A total of 3549 cases eligible for COVID-19 rescreening were included. There were 242 cases (6.8%) who received rescreening. In the multivariable analysis, cases aged 75 years or older, those with potential exposure to SARS-CoV-2, or patients visiting specific departments, such as the Cardiovascular Center and Department of Neurology, were more likely to be rescreened. None was diagnosed with COVID-19 after rescreening. There was no known cluster infection outbreak in the hospital or in the local community during the study period and in the following two months.Conclusion: In Taiwan, a country with a low COVID-19 prevalence, it was deemed safe to rescreen only high-risk hospitalized patients. This strategy was effective and reduced unnecessary costs.Keywords: fever, pneumonia, risk, SARS-CoV-2, screen

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