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2021-08-12

Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; School of Medicine, Imperial College London, London, UK.; Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Transformation Programme Director, London North West University Healthcare NHS Trust, London, UK.; Emergency Department, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Pathology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Microbiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Department of Medicine, Imperial College London, London, UK.; Department of Microbiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.; Institute for Global Health, University College London, London, UK a.gupta-wright@ucl.ac.uk.; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.; Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.

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