RT Journal Article SR Electronic T1 Establishment of a novel triage system for SARS-CoV-2 among trauma victims in trauma centers with limited facilities JF Trauma Surgery & Acute Care Open JO Trauma Surg Acute Care Open FD BMJ Publishing Group Ltd SP e000726 DO 10.1136/tsaco-2021-000726 VO 6 IS 1 A1 Hossein Abdolrahimzadeh Fard A1 Roham Borazjani A1 Golnar Sabetian A1 Zahra Shayan A1 Shahram Boland Parvaz A1 Hamid Reza Abbassi A1 Shiva Aminnia A1 Maryam Salimi A1 Shahram Paydar A1 Ali Taheri Akerdi A1 Masome Zare A1 Leila Shayan A1 Salahaddin Mahmudi-Azer YR 2021 UL http://tsaco.bmj.com/content/6/1/e000726.abstract AB Objectives The triage of trauma patients with potential COVID-19 remains a major challenge given that a significant number of patients may be asymptomatic or pre-symptomatic. This study aimed to compare the specificity and sensitivity of available triage systems for COVID-19 among trauma patients. Furthermore, it aimed to develop a novel triage system for SARS-CoV-2 detection among trauma patients in centers with limited resources.Methods All patients referred to our center from February to May 2020 were enrolled in this prospective study. We evaluated the SARS-CoV-2 triage protocols from the WHO, the Iranian Ministry of Health and Medical Education (MOHME), and the European Centre for Disease Control and Prevention (ECDC) for their effectiveness in finding COVID-19 infected individuals among trauma patients. We then used these data to design a stepwise triage protocol to detect COVID-19 positive patients among trauma patients.Results According to our findings, the WHO protocol showed 100% specificity and 13.3% sensitivity. The MOHME protocol had 99% specificity and 23.3% sensitivity. While the ECDC protocol showed 93.3% sensitivity and 89.5% specificity, it did not prioritize patients based on traumatic injuries and unstable conditions. Our stepwise triage protocol, which prioritizes traumatic injuries, had 93.3% sensitivity and 90.3% specificity.Conclusion Our study shows that the triage protocols from the WHO, MOHME and ECDC are not best equipped to diagnose SARS-CoV-2 infected individuals among trauma patients. In our proposed stepwise triage system, patients are triaged according to their hemodynamic conditions, COVID-19 related clinical states, and COVID-19 related laboratory findings. Our triage model can lead to more accurate and resource-effective management of trauma patients with potential COVID-19 infection.Level of evidence Level Ⅲ.Data are available upon reasonable request. No free text required.