What testing is recommended for persons with signs or symptoms consistent with coronavirus disease 2019 (COVID-19)?

Updated: Jun 16, 2020
  • Author: Medscape Drugs & Diseases; more...
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To test individuals with symptoms when there is a concern of potential coronavirus disease 2019 (COVID-19), the Centers for Disease Control and Prevention (CDC) recommends using authorized nucleic acid or antigen detection assays that have received a US Food and Drug Administration (FDA) Emergency Use Authorization (EUA). [3] Tests should be used in accordance with the authorized labeling; providers should be familiar with the tests’ performance characteristics and limitations.

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. [3]  Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (eg, cough), but some infected patients may also present with other symptoms.

Clinicians are encouraged to test for other causes of respiratory illness (eg, influenza) in addition to testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), depending on patient age, season, or clinical setting; detection of one respiratory pathogen (eg, influenza) does not exclude the potential for coinfection with SARS-CoV-2. [3]  These tests should not delay testing for SARS-CoV-2.

Symptoms and presentations may be different in the pediatric population; therefore, consider referencing the CDC guidelines for COVID in neonates and for multisystem inflammatory syndrome in children (MIS-C). [3]

The severity of symptomatic illness due to infection with SARS-CoV-2 may vary. [3, 4] Among persons with extensive and close contact to vulnerable populations (eg, healthcare personnel [HCP]), even mild signs and symptoms (eg, sore throat) of possible COVID-19 should prompt consideration for testing. [3] Additional information is available in CDC’s Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19.

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