Screening COVID-19 patients using safe practice score system in non-COVID radiology departments

Background: A prospective study was designed to evaluate the role of safe practice score system (SPSS) for targeted screening of patients in the non-COVID radiology department with the objective to (a) determine the incidence of COVID-19 in patients visiting non-COVID facilities, (b) to determine the sensitivity and specificity with predictive value of SPSS system to identify high-risk COVID patients undergoing ultrasound and echocardiographic examinations, (c) determination of relative risk (RR) estimation for health-care staff and other visiting patients and attendants, and (d) overall impact of the use of SPSS in the prevention of spread of the disease in the society. Methods: The study comprised a cohort of 688 patients who initially presented as non-COVID patients for ultrasound and echocardiography tests to a non-COVID health-care facility. Patients were divided into low-, moderate-, and high-risk COVID-19 probability groups based on SPSS screening scores of 0-3, 4-6, and more than 6, respectively. All high-risk patients with SPSS of more than 6 were advised real-time polymerase chain reaction (RT-PCR) or plain high-resolution computed tomography chest for the presence of COVID-19 before the diagnostic test could be done and all results were analyzed statistically. Results: Four hundred and forty-four low-risk patients had a median score of 3, and all underwent their radiological examinations. One hundred and forty patients were in the moderate-risk group and had a median score of 5. Thirty-six patients had a score of 6, out of which 12 patients were upgraded to score 6. One hundred and four patients were in the high-risk category group. Out of these, 20 patients were screened as RT-PCR negative and got their ultrasound examinations. The sensitivity and specificity of SPSS in categorizing patients into low and high risk were 100% and 95%, respectively, with false positive and negative of 4% and 0% with a positive and negative predictive value of 77% and 100%, respectively. The use of SPSS reduced the RR ratio for health-care workers and other staff from 7.9 to 2.6 (P = 0.001). The overall incidence of COVID-19 disease in patients visiting non-COVID hospitals was 12% during this time period. Screening and detection by the use of SPSS had a positive epidemiological impact and saved 33,000 people from getting infected when calculated by the susceptible-exposed-infectious-recovered (SEIR) pandemic model in this period of 90 days. Conclusion: SPSS categor