Abstract
Background: After the outbreak of the COVID-19 pandemic, emergency departments (ED) are starting to receive more and more non-COVID-19 patients. Thus, a way to quickly discriminate ED patients with potential COVID-19 infection from non-COVID-19 patients is needed in order to keep potentially contagious patients isolated while awaiting second-level testing. In this paper, we present the derivation and validation of the LCL (LDH-CRP-Lymphocyte) score, a simple, practical, and cheap score that could be helpful to rule out COVID-19 among ED patients with suspicious symptoms.
Methods: The LCL score was derived from a cohort of 335 patients coming to the ED of Cuneo Hospital (Piedmont, Italy) from March 16th to April 1st, 2020 with symptoms suspicious for SARS-CoV-2 infection. It was then retrospectively validated in a similar cohort of 173 patients admitted to our ED during April. The score is based on blood values of lactate dehydrogenase, C-reactive protein, and lymphocyte count.
Results: COVID-19 prevalence was 57% in the derivation cohort and 41% in the validation one. The LCL score performed well both in the derivation and in the validation cohorts, with an AUC respectively of 0.81 (95% CI: 0.77 – 0.86) and of 0.71 (95% CI: 0.63 – 0.78). An LCL score equal to 0 had a negative predictive value of 0.92 in the derivation cohort and of 0.81 in the validation cohort, with a negative likelihood ratio respectively of 0.08 and 0.36 for COVID-19 exclusion.
Conclusion: The LCL score is a derived and validated simple score that could constitute a useful tool to help physicians managing patients in the ED.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA906.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021