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. 2020 Jun 10;129:104502. doi: 10.1016/j.jcv.2020.104502

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© 2020 Elsevier B.V. All rights reserved.

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Fig. 1 — Value of a predictive COVID-19 rule-out tool in improving utilization of health care resources during a pandemic. Example contains a cohort comprising 1000 hypothetical patients with respiratory symptoms presenting to emergency departments across a region and assumes 8% COVID-19 prevalence, a highly accurate SARS-CoV-2 test, and 600 of a limited hospital resource (e.g. SARS-CoV-2 tests, personal protective equipment). (Panel A) If patients are randomly tested or randomly allocated a hospital resource during the wait for results, many patients with COVID-19 patients may not get tested or allocated the resource. (Panel B) With availability of a predictive tool of high sensitivity and negative predictive value based on readily available routine test results, utilization of limited confirmatory SARS-CoV-2 testing or other resources is reserved for those patients more likely to have COVID-19, with a 33 % improvement (48/80 to 74/80) in resource allocation. COVID19 +ve: COVID-19 positive patients; COVID19 -ve: COVID-19 negative patients; Pred + ve: predicted positive; Pred -ve: predicted negative.