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Risk score app accurately classifies COVID-19 outpatients who do not require testing or imaging
Clinical Question
Can a simple risk score tool accurately predict outpatients with COVID-19 who do not subsequently require any laboratory testing or imaging?
Bottom line
A simple risk score derived by the authors uses only age, dyspnea, and comorbidity to accurately identify more than 60% of patients with the Omicron variant of COVID-19 as being at low risk — and does so without the burden of additional testing. The LOCH risk score is available online as a free app. 1b
Reference
Study design: Decision rule (validation)
Funding: Self-funded or unfunded
Setting: Population-based
Synopsis
These investigators previously developed 2 risk scoring tools to help identify outpatients with COVID-19 who are at risk of hospitalization. In this follow-up study, the investigators assessed all outpatients, 12 years or older, with a diagnosis of COVID-19 by polymerase chain reaction from December 20, 2021, to January 7, 2022, during the Omicron phase of the pandemic. This Omicron cohort consisted of 6138 patients with at least 2 weeks of follow-up and a 1.9% overall rate of hospitalization. The authors developed 4 logistic regression models, with each model classifying at least half the patients in a low-risk group. One risk score tool, the Lehigh Outpatient COVID Hospitalization (LOCH), maximally classified more than 60% of patients in the low-risk group and only required age, dyspnea, and any comorbidity, without the need for any laboratory testing or imaging. In addition, the LOCH tool does not require an in-person evaluation.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
Impact assessment
Very good
Couldnt find the app
I couldn't find the app to use it
Risk score app predicts which patients with COVID do not req
It would be helpful if the criteria for which patients with COVID who do not require testing or imaging were included in the INFOPoem.