Japanese Society for Infection Prevention and Control-Online Journal

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Examination about the Triage of the Fever Outpatient: Symptoms Analysis of 1,004 Cases

Takanori ONODERA
Department of Nursing, Rakuwakai Marutamachi Hospital

Screening, surveillance, and early detection of coronavirus disease 2019 (COVID-19) cases are important components of outbreak management in healthcare facilities. At the beginning of the COVID-19 outbreak in March 2020, we set up an outpatient fever clinic aimed at streamlining screening testing for suspected patients arriving at the hospital to access routine healthcare services. Since then, identifying the appropriate screening strategy that is cost effective, robust, and effective has been an ongoing challenge. We initially screened all patients with any upper respiratory symptoms for COVID-19 regardless of their body temperature, which was an effective strategy considering that febrile status did not seem to impact the pretest probability at the start of the pandemic. This changed over time with fever being a significant predictor of a positive test result as different waves of COVID-19 variants hit throughout the country and the public's immunity status also changed. Our descriptive analysis and experience of screening 1,794 patients for COVID-19 at our fever clinic during the 2020-2021 pandemic demonstrate that healthcare facilities must adapt their screening strategy repeatedly over time in accordance with the evolving local context to run efficient screening programs with high sensitivity given the resource constraints.

Key words：coronavirus disease 2019, outpatient fever, triage, clinical symptoms

e-mail: onodera-takanori＠rakuwa.or.jp

Received: December 9, 2022
Accepted: March 9, 2023

38 (4)：209─214,2023