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Article Dans Une Revue American Journal of Emergency Medicine Année : 2021

Clinical and operational impact of rapid point-of-care SARS-CoV-2 detection in an emergency department

Résumé

Study objective: Rapid point-of-care (POC) SARS-CoV-2 detection with Abbott ID NOW™ COVID-19 test has been implemented in our Emergency Department (ED) for several months. We aimed to evaluate the operational impact and potential benefits of this innovative clinical pathway. Methods: We conducted a prospective, descriptive, interventional, non-randomized study, before-after trial with the comparison of patient cohorts from two consecutive periods of seven weeks (observational pre-POC period vs interventional POC period). Results: In 2020, throughout weeks 37 to 50, 3333 patients were assessed for eligibility and among them 331 (9.9%) were positive for SARS-CoV-2 infections. Among the included patients, 136 (9.2%) were positive for SARS-CoV-2 infection in the pre-POC period and 195 (10.5%) in the POC period. Among positive patients for SARS-CoV-2 related infection in-hospital mortality rate was similar between the two groups but the hospitalization rate was higher in the POC group (81.6% vs. 65.4%; p < 0.001). More patients in the POC period were able to leave the ED within 6 h. We examined rates of antibiotic, anticoagulant, and corticosteroid prescriptions among patients tested for SARS-CoV-2 in the ED. Only the rate of prescribed anticoagulants was found to be higher in the POC period (40% vs. 24.2%; p < 0.003). Conclusion: We demonstrated that COVID-19 point-of-care testing speeds up clinical decision-making, improving use of recommended treatments for COVID-19, such as anticoagulants. Moreover, it improves the boarding time and significantly shortened the length of stay in the ED for patients requiring outpatient care.

Dates et versions

hal-04068192 , version 1 (13-04-2023)

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Camille Gerlier, Benoît Pilmis, Olivier Ganansia, Alban Le Monnier, Jean-Claude Nguyen Van. Clinical and operational impact of rapid point-of-care SARS-CoV-2 detection in an emergency department. American Journal of Emergency Medicine, 2021, 50, pp. 713-718. ⟨10.1016/j.ajem.2021.09.062⟩. ⟨hal-04068192⟩
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