Difference between revisions of "COVID-19: Testing and surveillance"

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#REDIRECT[[COVID-19]]
==Viral Testing Background (Reverse Transcriptase PCR)==
 
*Internationally the WHO has distributed kits<ref>Sheridan, Cormac . "Coronavirus and the race to distribute reliable diagnostics". Nature Biotechnology https://www.nature.com/articles/d41587-020-00002-2</ref>
 
*In the United States, the US Centers for Disease Control (CDC) is distributing testing to public health labs<ref>https://www.internationalreagentresource.org/</ref>
 
**Testing is currently coordinated through [https://www.cste.org/page/EpiOnCall state] or [https://www.naccho.org/membership/lhd-directory local] health departments or private labs
 
** See [http://publichealth.lacounty.gov/acd/ncorona2019/checklist.htm Example testing checklist from LA County DPH]
 
*BIOFIRE Respiratory Panel Corona Virus assay does NOT detect this COVID-19 subtype
 
 
 
===Who to Test (Persons Under Investigation)===
 
*Patients should be carefully evaluated to determine if they meet Persons Under Investigation (PUI) criteria
 
*Due to a lack of available tests, non-PUI patients (including the worried well) should not have testing performed
 
*Clinicians are strongly encouraged to test for other causes of respiratory illness (e.g. [[influenza]], [[RSV]])
 
**In many systems, testing algorithms assume patients do not have COVID-19 if influenza or RSV positive
 
 
 
;CDC PUI Guidance<ref>Criteria to Guide Evaluation and Laboratory Testing for COVID-19.  Updated March 20, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html</ref>
 
''<u>Your local PUI testing guidelines may be different, depending on test availability and local epidemiology; see [https://www.cste.org/page/EpiOnCall state] or [https://www.naccho.org/membership/lhd-directory local] health departments and internal hospital resources</u>''
 
*"Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested."
 
*Priorities for testing include:
 
*#Optimize care for hospitalized patients and lessen risk of nosocomial infections
 
*#*Hospitalized patients
 
*#*Symptomatic healthcare workers
 
*#Identify highest risk of complications
 
*#*Symptomatic patients in long-term care facilities
 
*#*Symptomatic patients ≥ 65 with symptoms
 
*#*Symptomatic patients with chronic medical conditions and/or an immunocompromised state
 
*#*Symptomatic first responders
 
*#Decrease community spread
 
*#*Symptomatic critical infrastructure workers
 
*#*Healthcare workers and first responders
 
*#*Any symptomatic individual
 
*#Non-priority
 
*#*Any individual without symptoms
 
 
 
===Clinical Sample Collection<ref>Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19). March 19, 2020 Revision. https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html</ref>===
 
''Testing can be done in ambulatory setting if absolutely needed (see [[Prevention of COVID-19 transmission in the healthcare setting|precautions]])''
 
#Upper respiratory tract specimen
 
#* Nasopharyngeal (NP) swab
 
#**Some systems allow sending both [[flu]]/[[RSV]] and [[COVID-19]] test on the same swab to conserve testing supplies
 
#Additionally include lower tract specimen, if available
 
#*''CDC does NOT recommend inducing sputum (because aerosol generating)''
 
#* For productive cough patients: collect sputum
 
#*For patients for whom it is clinically indicated (e.g., those receiving invasive mechanical ventilation): collect lower respiratory tract aspirate or bronchoalveolar lavage sample
 
#* May include in same testing tube as upper respiratory track specimen (i.e. send as a single test) in some systems
 
 
 
 
 
==See Also==
 
{{Special:Prefixindex/COVID-19 |hideredirects=1}}
 
 
 
==References==
 
 
 
 
 
[[Category:COVID-19]]
 

Latest revision as of 21:09, 18 January 2022

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