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

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==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
*#*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}}

Latest revision as of 21:09, 18 January 2022

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