101 Potential Solutions For Screening, Triage, And Severity Scoring Of Suspected COVID-19 Positive Patients In Low-Resource Settings: A Scoping Review

Study Objectives: Purposefully designed and validated screening, triage, and severity scoring tools are needed to reduce mortality of COVID-19 in low-resource settings (LRS). This review aimed to identify currently proposed and/or implemented methods of screening, triaging, and severity scoring suspected COVID-19 patients upon initial presentation to the health care system, and to evaluate the utility of these tools in LRS. A scoping review was conducted to identify studies describing acute screening, triage, and severity scoring of suspected COVID-19 patients published between 12 December, 2019 and 01 April, 2020. Extracted information included clinical features, use of laboratory and imaging studies, and relevant tool validation data. The initial search strategy yielded 15232 articles;124 met inclusion criteria. Results: Most studies were from China (n=41, 33.1%) or the United States (n=23, 18·5%). In total, 57 screening, 54 severity scoring, and 23 triage tools were described. A total of 23 tools–16 screening, four triage, and three severity scoring–were identified as feasible for use in LRS. A total of 37 studies provided validation data: four prospective and 33 retrospective, with none from low-income and lower-middle-income countries. Conclusions: This study identified a number of screening, triage, and severity scoring tools implemented and proposed for suspected COVID-19 patients. No tools were specifically designed and validated in LRS. A tool specific to resource limited context is crucial to reducing mortality in the current pandemic.