Clinical Decision Support Tool and Rapid Point-of-Care Platform for Determining Disease Severity in Patients with COVID-19

Michael P McRae; Glennon W Simmons; Nicolaos J Christodoulides; Zhibing Lu; Stella K Kang; David Fenyo; Timothy Alcorn; Isaac P Dapkins; Iman Sharif; Deniz Vurmaz; Sayli S Modak; Kritika Srinivasan; Shruti Warhadpande; Ravi Shrivastav; John T McDevitt

The 2019-20 pandemic of coronavirus disease 2019 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1 was first reported in Wuhan, Hubei, China, in December 2019. 2 On March 11, 2020, the World Health Organization (WHO) declared the outbreak a pandemic. 3 Although there is expected to be a substantial under-reporting of cases (particularly of persons with milder symptoms, asymptomatic cases, and in countries with low testing volume), as of April 4, 2020 over 1M cases have been confirmed with approximately 60,000 deaths from the disease globally and major outbreaks in the US, Italy, China, and Spain. 4 Symptoms of COVID-19 are non-specific, and infected individuals may develop fever, cough, fatigue, shortness of breath, or muscle aches with further disease development leading to severe pneumonia, acute respiratory distress syndrome (ARDS), myocardial injury, sepsis, septic shock, and death. 5, 6 The median incubation period is approximately five days, and 97.5% of those who develop symptoms will do so within 11.5 days. 7 A larger analysis of 2449 patients reported hospitalization rates of 20 to 31 percent and ICU admission rates of 4.9 to 11.5 percent. 8 This large number of patients requiring intensive care threatens to overwhelm healthcare systems around the world. There is a need for a COVID-19 disease severity test to prioritize care for patients at elevated risk of mortality and manage low risk patients in outpatient settings or at home through self-quarantine.