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In regions where few people have received Covid-19 vaccines, health systems remain vulnerable to surges in SARS-CoV-2 infections. During the delta-wave of COVID-19 in India, for example, healthcare facilities and staff across the country struggled to cope with the surge in the number of cases of COVID-19 due to a shortage of hospital beds for people with severe cases, plus shortages of medicines and limited human resources.

Busy triage point outside the Emergency Department at the Christian Medial College, Vellore, Tamil Nadu, India © Ms Priyanka Gautam, Christian Medical College, Vellore, India

In a study published 21 March in Clinical Infectious Diseases, the PRIORITISE study team report the development and validation of three clinical prediction models that could help identify patients presenting with moderate Covid-19 who could safely be managed in the community. Identification of patients suitable for outpatient management could help decompress and protect health systems during current and future spikes in infections, especially in locations where capacity for inpatient monitoring is limited. The models, which contain three easily ascertainable clinical parameters (age, sex, SpO2) and one biomarker (IL-6, NLR or suPAR) measurable using a point-of-care test, would be readily implementable in many LMIC settings. The study was a collaboration between MSF India and MORU, in partnership with the teams at CMC Vellore and AIIMS Patna, supported by FIND, and funded by MSF and the Wellcome Trust.

The PRIORITISE team would like to hear from groups interested in collaborating to further validate the findings. This is important before the models can be recommended for use. Ideally this would happen before another surge in infections, so partners who already have baseline clinical data and bio-banked plasma from patients with moderate Covid-19, alongside data on clinical outcomes over the next 14-28 days, are encouraged to get in touch.

Please share and, if interested, kindly contact Arjun Chandna or Sakib Burza

Read the full publication 'Facilitating safe discharge through predicting disease progression in moderate COVID-19: a prospective cohort study to develop and validate a clinical prediction model in resource-limited settings' on the Clinical Infectious Diseases website

- Text courtesy of Arjun Chandna, on behalf of the PRIORITISE team, with thanks to Ms. Priyanka Gautam, Christian Medical College, Vellore, India for the photo.

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