Sensitivity and specificity of a Middle East respiratory syndrome screening tool used in the emergency department

Background: Middle East respiratory syndrome coronavirus (MERS-CoV) infection becomes a global health issue because of its ability to spread rapidly, especially in healthcare settings. Improper triage of MERS-CoV-infected patients in the emergency department (ED) increases the risk of infection in healthcare providers and other patients. Having a good triage screening tool would improve early detection and isolation of suspected infected patients, thus preventing future outbreaks. Materials and Methods: This is a retrospective cohort study performed in a large urban, academic ED in a tertiary care center in Riyadh, Saudi Arabia. The aim of the study was to assess the accuracy of the triage screening tool used in the ED. A convenience sample of 734 patients visiting the ED during the 2015 MERS-CoV outbreak was included. Patients deemed positive were isolated and underwent MERS-CoV polymerase chain reaction (PCR) testing. Patients deemed negative were followed up via phone after two weeks of their ED visit. They were checked for the development of symptoms and whether the patients sought medical advice in another hospital or underwent MERS-CoV PCR testing. Results: The sensitivity of the screening tool for detecting PCR-positive MERS-CoV infection was 100% (95% confidence interval [CI]: 15.8–100), and the specificity was 78.2% (95% CI: 75.1–81.2). Conclusions: The ED triage screening tool used during the 2015 MERS-CoV outbreak is highly sensitive. It is effective for early detection of infection in the ED, thus allowing timely isolation of suspected patients.