The CoLab-score rapidly and efficiently excludes COVID-19 at the emergency department without need for SARS-CoV-2 testing: a multicenter case-control study

Background
Rapid identification of emergency department (ED) patients with a possible COVID-19 infection is needed. PCR-testing all ED patients is neither feasible nor effective in most centers, therefore a rapid, objective, low-cost screening tool to triage ED patients is necessary.
Methods
Results from all routine lab tests from ED patients at the Catharina Hospital were collected from July 2019 to July 2020 and used in a statistical model to obtain the CoLab-score. The score was validated temporally and externally in three independent centers.
Results
The CoLab-score consists of 10 routine lab results and can be used to safely rule-out a COVID-19 infection in more than one third of ED presentations with a negative predictive value of 0.997 (95% CI: 0.994 – 0.999) .
Conclusions
The CoLab-score is a valuable tool to rule out COVID-19, guide PCR testing and is available to any center with access to routine laboratory tests. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial The study was reviewed by the Medical research Ethics Committees United (MEC-U) under study number W20.071, which confirmed that the Medical Research Involving Human Subjects Act (In Dutch: WMO) does not apply to this study. The study was thereafter reviewed and approved by the internal hospital review board. ### Funding Statement This was an investigator-initiated study and no funding was received for this study. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Medical research Ethics Committees United (MEC-U) https://www.mec-u.nl/ I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets used to fit the model cannot be released publicly due to the risk of patient re-identification through individual health record data. The authors will consider requests for data sharing as part of an (academic) collaboration after approval by the hospital board of directors and subject to ethical approval and data transfer agreements in accordance with the GDPR regulations. This applies to the development and temporal validation datasets.