TY - JOUR VL - 11 TI - Utility of the FebriDx point-of-care assay in supporting a triage algorithm for medical admissions with possible COVID-19: an observational cohort study Y1 - 2021/08/09/ IS - 8 EP - 9 KW - Science & Technology KW - Life Sciences & Biomedicine KW - Medicine KW - General & Internal KW - General & Internal Medicine KW - COVID-19 KW - molecular diagnostics KW - infection control A1 - Houston, H A1 - Deas, G A1 - Naik, S A1 - Shah, K A1 - Patel, S A1 - Dottori, MG A1 - Tay, M A1 - Filson, SA A1 - Biggin-Lamming, J A1 - Ross, J A1 - Vaughan, N A1 - Vaid, N A1 - Rao, GG A1 - Amin, AK A1 - Gupta-Wright, A A1 - John, L PB - BMJ PUBLISHING GROUP JF - BMJ Open N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. UR - https://doi.org/10.1136/bmjopen-2021-049179 ID - discovery10133522 AV - public N2 - Objective: To evaluate a triage algorithm used to identify and isolate patients with suspected COVID-19 among medical patients needing admission to hospital using simple clinical criteria and the FebriDx assay. Design:: Retrospective observational cohort. Setting Large acute National Health Service hospital in London, UK. Participants: All medical admissions from the emergency department between 10 August 2020 and 4 November 2020 with a valid SARS-CoV-2 RT-PCR result. Interventions: Medical admissions were triaged as likely, possible or unlikely COVID-19 based on clinical criteria. Patients triaged as possible COVID-19 underwent FebriDx lateral flow assay on capillary blood, and those positive for myxovirus resistance protein A (a host response protein) were managed as likely COVID-19. Primary outcome measures: Diagnostic accuracy (sensitivity, specificity and predictive values) of the algorithm and the FebriDx assay using SARS-CoV-2 RT-PCR from nasopharyngeal swabs as the reference standard. Results: 4.0% (136) of 3443 medical admissions had RT-PCR confirmed COVID-19. Prevalence of COVID-19 was 46% (80/175) in those triaged as likely, 4.1% (50/1225) in possible and 0.3% (6/2033) in unlikely COVID-19. Using a SARS-CoV-2 RT-PCR reference standard, clinical triage had sensitivity of 96% (95% CI 91% to 98%) and specificity of 61.5% (95% CI 59.8% to 63.1%), while the triage algorithm including FebriDx had sensitivity of 93% (95% CI 87% to 96%) and specificity of 86.4% (95% CI 85.2% to 87.5%). While 2033 patients were deemed not to require isolation using clinical criteria alone, the addition of FebriDx to clinical triage allowed a further 826 patients to be released from isolation, reducing the need for isolation rooms by 9.5 per day, 95%?CI 8.9 to 10.2. Ten patients missed by the algorithm had mild or asymptomatic COVID-19. Conclusions: A triage algorithm including the FebriDx assay had good sensitivity and was useful to ?rule-out? COVID-19 among medical admissions to hospital. SN - 2044-6055 ER -