COVID-19: Testing and surveillance
Revision as of 12:59, 16 January 2021 by Rossdonaldson1 (talk | contribs)
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[1]
Your local PUI testing guidelines may be different, depending on test availability and local epidemiology; see state or local health departments and internal hospital resources
- "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
- Optimize care for hospitalized patients and lessen risk of nosocomial infections
Clinical Sample Collection[2]
Testing can be done in ambulatory setting if absolutely needed (see precautions)
- Upper respiratory tract specimen
- 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
References
- ↑ 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
- ↑ 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