Evaluation of visual triage for screening of Middle East respiratory syndrome coronavirus patients

Alfaraj, S.H.; Al-Tawfiq, J.A.; Gautret, P.; Alenazi, M.G.; Asiri, A.Y.; Memish, Z.A.

Prince Mohammed bin Abdulaziz Hospital is a referral centre for MERS-CoV patients diagnosed in the central region based in Riyadh, Saudi Arabia. The visual triage form documents the institution, unit, healthcare worker involved in the triage with name and signature, and patient contact details (Fig. 1 ). It comprises nine items classified into two sections, with one related to the patient's symptoms and signs and presentation and the other section related to the patient's potential risk of exposure to MERS-CoV, each with a defined predetermined score (Fig. 1) . The patient's symptoms include fever, cough, shortness of breath, nausea, vomiting or diarrhea, sore throat or runny nose and the presence of underlying conditions including diabetes mellitus, chronic renal failure, coronary artery disease or heart failure. Any patient scoring 4 will need isolation and assessment by a physician before ruling out MERS-CoV. All admitted patients from 1 April 2014 to December 2017 who were tested for MERS-CoV were included in this study. MERS-CoV testing was done using nasopharyngeal swabs as described previously [4] . MERS-CoV diagnosis was based on positive real-time reversetranscriptase PCR as described previously [4, 16, 20] .