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VOLUME 6 , ISSUE 1 ( January-April, 2021 ) > List of Articles


Impact of Triaging for COVID-19 Patients in a Tertiary Care Hospital in West India: A Retrospective Analysis of a Case Series

Srishti S. Jain, Anchin Kalia, Pallaavi Goel, Nimish Mathur, Puneet Rijhwani

Keywords : Biomarkers, Capacity management, COVID-19, Point-of-care testing, Radiological imaging, Triaging

Citation Information : Jain SS, Kalia A, Goel P, Mathur N, Rijhwani P. Impact of Triaging for COVID-19 Patients in a Tertiary Care Hospital in West India: A Retrospective Analysis of a Case Series. J Mahatma Gandhi Univ Med Sci Tech 2021; 6 (1):5-9.

DOI: 10.5005/jp-journals-10057-0145

License: CC BY-NC 4.0

Published Online: 31-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Introduction: Assessing the clinical severity of coronavirus disease-2019 (COVID-19) and triaging to appropriate levels of care is certainly one of the key elements in the success of managing COVID-19 patients. During the concluded wave of the pandemic, cases were categorized and cared for with set criteria prescribed by authorities. Other triaging criteria were included in contemporary international guidelines, but this hypothesis was never tested if anyone set is ever better than the other. Materials and methods: This is a case series of 165 deceased patients of COVID-19. All patients were categorized as per clinical disease severity and admitted to the designated care area after confirmation of SARS-CoV-2 infection as decided by the admitting doctors. We collected retrospective data from patient medical records and analyzed for medical history, comorbidity profiles, hematology investigations, organ function tests, computed tomography of the thorax, and point-of-care biomarker test (D-dimer, procalcitonin, NT-proBNP, Trop-T). These data were analyzed to compare the differences between the variables of ward and ICU patients by using XLstat software. Results: In this analysis of deceased patients’ case series, we found that there was no significant difference among the patients admitted to ward and ICU for initial demographic and biomarker variables and risk factors. Diabetes was the most commonly found comorbidity. The mortality rate among the ward and ICU (5.89 vs 6.67%, p value: 0.44) was also similar among both the cohorts. Conclusion: In this case series, we could conclude that both the cohorts were comparable at admission on demographic and laboratory parameter profile. Clinical significance: This analysis led us to the conclusion that our existing “triage criteria” for COVID-19 patients will need appropriate modification before the second wave sets in the region.

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  1. WHO Coronavirus Disease (COVID-19) Dashboard [Internet]. [cited 2021 Mar 1]. Available from:
  2. Macera M, De Angelis G, Sagnelli C, et al. Clinical presentation of COVID-19: case series and review of the literature. Int J Environ Res Public Health 2020;17(14):5062. DOI: 10.3390/ijerph17145062. Available from:
  3. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061. DOI: 10.1001/jama.2020.1585. Available from:
  4. Xu X-W, Wu X-X, Jiang X-G, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020. m606. Available from:
  5. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020;8(5):475–481. DOI: 10.1016/S2213-2600(20)30079-5. Available from:
  6. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet Lond Engl. 2020;395(10229):1054–1062. DOI: 10.1016/S0140-6736(20)30566-3.
  7. UpdatedClinicalManagementProtocolforCOVID19dated03072020.pdf [Internet]. [cited 2021 Mar 1]. Available from: ProtocolforCOVID19dated03072020.pdf.
  8. Clinical Spectrum [Internet]. COVID-19 Treatment Guidelines. [cited 2021 Mar 1]. Available from:
  9. Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost JTH 2020;18(6):1324–1329. DOI: 10.1111/jth.14859.
  10. Chen H, Li X, Marmar T, et al. Cardiac troponin I association with critical illness and death risk in 726 seriously ill COVID-19 patients: a retrospective cohort study. Int J Med Sci 2021;18(6):1474–1483. DOI: 10.7150/ijms.53641.
  11. Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol 2020;92(7):856–862. DOI: 10.1002/jmv.25871.
  12. Investigation of novel SARS-CoV-2 variant - Variant of Concern 202012/01. [cited 2021 Mar 1];19. Available from:
  13. Wise J. COVID-19: new coronavirus variant is identified in UK. BMJ 2020;371:m4857. DOI: 10.1136/bmj.m4857. Available from:
  14. Risk of spread of new SARS-CoV-2 variants of concern in the EU/EEA - first update. 2021; 29. Available from
  15. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020;323(13):1239–1242. DOI: 10.1001/jama.2020.2648.
  16. Richards-Belle A, Orzechowska I, Gould DW, et al. COVID-19 in critical care: epidemiology of the first epidemic wave across England, Wales and Northern Ireland. Intensive Care Med 2020;46(11):2035–2047. Available from: 10.1007/s00134-020-06267-0.
  17. Wang Y, Lu X, Li Y, et al. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am J Respir Crit Care Med 2020;201(11):1430–1434. Available from:
  18. Gupta S, Hayek SS, Wang W, et al. Factors associated with death in critically Ill patients with coronavirus disease 2019 in the US. JAMA Intern Med 2020;180(11):1436. DOI: 10.1001/jamainternmed.2020.3596Available from:
  19. Abdeen Y, Kaako A, Alnabulsi M, et al. The prognostic effect of brain natriuretic peptide levels on outcomes of hospitalized patients with COVID-19. Avicenna J Med 2021;11(1):20–26. DOI: 10.4103/ajm.ajm_169_20.
  20. Berger JS, Kunichoff D, Adhikari S, et al. Prevalence and outcomes of D-Dimer elevation in hospitalized patients with COVID-19. Arterioscler Thromb Vasc Biol 2020;40(10):2539–2547. DOI: 10.1161/ATVBAHA.120.314872.
  21. Tyrrell CSB, Mytton OT, Gentry SV, et al. Managing intensive care admissions when there are not enough beds during the COVID-19 pandemic: a systematic review. Thorax 2021;76(3):302–312. DOI: 10.1136/thoraxjnl-2020-215518. Available from:
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