COVID-19 symptom checkers can delay treatment

Digital symptom checkers in the US and UK missed several severe illnesses in an international study.

Digital COVID-19 symptom checkers may be causing some patients to not receive prompt treatment for serious illness.

According to a news release, an international case simulation study published in the online journal BMJ Health & Care Informatics found that both the US and UK symptom checkers repeatedly failed to identify symptoms of severe COVID-19, bacterial pneumonia, and sepsis and often advised patients showing these symptoms to stay home.

These symptom checkers are becoming more available and used on a national scale to pick up COVID-19 infections. The task of identifying COVID-19 cases that require treatment can be difficult because the disease mimics common conditions which rarely require treatment and a lack of clear clinical signs and symptoms that will reliably predict which patients will progress to severe disease, the release says.

There is “hardly any evidence” that these symptom checkers, which combine a series of set questions and pre-determined responses, are effective or safe for prioritizing treatment during the pandemic, according to the release.

The researchers looked at symptom checkers from the US, UK, Singapore, and Japan. The checkers in Singapore and Japan triaged twice as many cases for direct clinical assessment as those in the US and UK. Singapore had the highest referral rate with 88 percent, while the US had the least with 38 percent, the release says.

Of the simulated cases not referred, the US and UK symptom checkers triaged a significant number that would have required early clinical assessment to stay home. The US system in particular frequently triaged cases with possible severe COVID-19 infection, bacterial pneumonia, and sepsis to stay home, while advising possible neutropenic sepsis to seek medical attention within 24 hours.

Both the US and UK systems "are likely to delay presentations of serious medical conditions to appropriate care, and as such, are likely to confer an increased risk of morbidity and mortality," the researchers warn in the release.