Pandemic Triage Score in Patients With Known or Suspected Severe Acute Respiratory Syndrome (SARS) CoronaVirus (CoV) 2 Infection

Completed

Brief Summary: During this pandemic period, the goal of the health care system is to optimize the use of intensive care services for patients infected with SARS-CoV-2, given the frequency of complications that can lead to high mortality.

When patients with suspected or confirmed COVID-19 are admitted to hospital, whether or not they are symptomatic, there is currently no method to predict who will progress to complications requiring the use of intensive measures in 24-48 hours.

Detailed Description: The body undergoes a systemic adaptation response to severe illness. Elevated cortisol and systemic inflammation are two key responses. Along with hypotension, this triad can lead to end-organ failure and death in critical illness. In critical illness, serum cortisol is dissociated from its tissular activity. We have developed a formula that calculates tissular action of cortisol called the cortisol index. It correlates in chronic ambulatory illness, and acute illness such as myocardial infarction (manuscript pending). Elevated neutrophil to lymphocyte ration (NLR) is a marker of systemic inflammation and predictor of mortality on admission to the emergency department. We have confirmed this in a retrospective and prospective study (manuscript pending, data available upon request).

The purpose of this study is to evaluate a triage score (STC-19) based on patients' biological state at the time of diagnosis, to objectively determine which patients are most likely to require intensive medical services within 24-48 hours of presentation of the emergency department.

Recruitment & Eligibility

Inclusion Criteria

Patient with clinical signs of CoV-2-SARS infection
Complete blood count test and systolic blood pressure available at the time of diagnosis
Informed of the study.

Exclusion Criteria

Women beyond the 1st trimester of pregnancy
Persons under-the-age-of or legally-denied medical decision-making capacity by a judicial or administrative decision,
Persons of full age who are subject to a legal protection measure,
Persons unable to consent,
Persons who are not members of or beneficiaries of a social welfare program administered by the Republic of France
Patient's refusal to participate in the study.

Arm && Interventions

Group	Intervention	Description
Patient with COVID-19	STC-19 score	Patient with clinical signs of CoV-2-SARS infection and signs of severity

Primary Outcome Measures

Name	Time	Method
Number of Participants With Normal and Above Triage (STC-19) Score	Day 0	Correlation between the STC-19 score based on biological measures at the time of diagnosis and patient outcome (deceased or alive within 29 days of hospitalization) The STC-19 score is based on the genito-thyroid index (GTi) calculated from the neutrophil-to-lymphocyte ratio (NLR) and the cortisol index : Normal value for cortisol range from 3 to 7 Normal value for GTi range from 1.5 to 2.5

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Normal and Above Genito-thyroid Index (GTi) Value	Day 5	Correlation between the STC-19 score based on biological measures at the time of diagnosis and patient outcome (deceased or alive within 29 days of hospitalization) The genito-thyroid index (GTi) is calculated from the neutrophil-to-lymphocyte ratio (NLR). Normal value for GTi range from 1.5 to 2.5