Alliance for Pandemic Preparedness

June 17, 2020

Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases

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  • A scoping review of the accuracy of diagnostic approaches for COVID-19 in emergency department settings  included 87 studies through May 5, 2020. The review concluded that report of fever and loss of smell and taste were the most helpful features to distinguish COVID-19 patients from those with similar illnesses and that a low white blood cell count is the most common lab abnormality. Sensitivity of testing by rRT-PCR in the emergency department was 60%-78%.  
  • CT scanning may increase the sensitivity of rRT-PCR prior to seroconversion, but guidelines to identify patients most likely to benefit from CT scanning are still emerging.  
  • The authors report that current studies do not adhere to accepted diagnostic accuracy reporting standards and anticipate significantly biased results if the same tests were applied to emergency department patients with suspected COVID-19.  

Carpenter et al. (June 2020). Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases. Academic Emergency Medicine. https://doi.org/10.1111/acem.14048