SCUBE-1: Shaping Triage Decisions in Ambulatory COVID-19 Care

SCUBE-1 sharpens outpatient triage for ambulatory COVID-19—offering an objective metric to guide hospitalization when clinical data are limited. This marker can supplement brief assessments in primary care and the ED and help clarify admission thresholds during rapid triage.

In the reported cohort, SCUBE-1 demonstrated sensitivity of 84.6% and specificity of 88.9% for hospitalization prediction. These performance characteristics support both rule-in and rule-out uses at the bedside: high values increase confidence to admit, while low values—when combined with clinical assessment—support safe observation. Overall, SCUBE-1 shifts triage toward more objective risk stratification.

Elevated SCUBE-1 correlated with higher neutrophil count, increased neutrophil-to-lymphocyte ratio (NLR), and longer hospital length of stay, indicating a graded relationship with disease severity. The pattern is consistent with thrombo-inflammatory activity linked to worse clinical trajectories without implying direct causation. Together, these associations position SCUBE-1 as a pragmatic severity signal for initial assessment.

The study used a prospective, single-center design with plasma sampling at emergency presentation and a commercial ELISA to quantify SCUBE-1; analysis included 84 patients total (59 PCR-positive: 37 managed at home and 22 hospitalized). Single-center enrollment and sample size limit immediate generalizability despite clear cohort delineation. Methodological strengths—prospective collection, blinded laboratory processing, and predefined clinical endpoints—support clinical translation.

Immediate implementation considerations include assay availability, validated thresholds, and integration with existing clinical scores. Research priorities include multicenter validation and development of rapid point-of-care platforms. Ultimately, reproducible thresholds and accessible assays will determine whether SCUBE-1 moves from a promising marker to a routine triage tool.

Key Takeaways:

• SCUBE-1 shows 84.6% sensitivity and 88.9% specificity for hospitalization prediction in the reported cohort.
• SCUBE-1 correlates with neutrophil count, NLR, and length of stay, indicating a severity signal useful for triage.
• Prospective collection and blinded ELISA analysis support clinical applicability, but multicenter validation and point-of-care assay development are needed.