World Health Organization: case definitions
A. Patients with acute respiratory illness (i.e., fever and at least one sign/symptom of respiratory disease such as cough or shortness of breath) AND a history of travel to or residence in a location reporting community transmission of COVID-19 during the 14 days prior to symptom onset; OR
B. Patients with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to symptom onset; OR
C. Patients with severe acute respiratory illness (i.e., fever and at least one sign/symptom of respiratory disease such as cough or shortness of breath) AND requiring hospitalisation AND in the absence of an alternative diagnosis that fully explains the clinical presentation.
A. Suspect case for whom testing for the COVID-19 virus is inconclusive (inconclusive being the result of the test reported by the laboratory); OR
B. Suspect case for whom testing could not be performed for any reason.
Patients with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.
Definition of contact
A contact is a person who experienced any one of the following exposures during the 2 days before and the 14 days after the onset of symptoms of a probable or confirmed case:
Face-to-face contact with a probable or confirmed case within 1 metre (3 feet) and for more than 15 minutes
Direct physical contact with a probable or confirmed case
Direct care for a patient with probable or confirmed COVID-19 disease without using proper personal protective equipment
Other situations as indicated by local risk assessments.
Note: for confirmed asymptomatic cases, the period of contact is measured as the 2 days before through the 14 days after the date on which the sample was taken that led to confirmation.
Centers for Disease Control and Prevention: criteria to guide evaluation and laboratory testing for COVID-19
Clinicians should use their judgement to determine whether a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).
Priorities for testing
Symptomatic healthcare workers
Patients in long-term care facilities with symptoms
Patients 65 years of age and older with symptoms
Patients with underlying conditions with symptoms
First responders with symptoms
Critical infrastructure workers with symptoms
Individuals who do not meet any of the above categories with symptoms
Healthcare workers and first responders
Individuals with mild symptoms in communities experiencing high COVID-19 hospitalisations
Individuals without symptoms
Other considerations that may guide testing are epidemiologic factors such as the occurrence of local community transmission of COVID-19 infections in a jurisdiction. Clinicians are strongly encouraged to test for other causes of respiratory illness, including infections such as influenza.
Infectious Diseases Society of America (IDSA): COVID-19 prioritization of diagnostic testing
IDSA recommends a tiering system for prioritising patients given the current limited availability of near-patient or point-of-care testing. These recommendations will likely change as testing becomes more widely available.
Critically ill patients in the intensive care unit with unexplained viral pneumonia or respiratory failure, regardless of travel history or close contact with a suspected or confirmed COVID-19 patient.
Any person, including healthcare workers, with fever or signs/symptoms of a lower respiratory tract illness and close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset (including all residents of a long-term care facility that has a laboratory-confirmed COVID-19 case).
Any person, including healthcare workers, with fever or signs/symptoms of a lower respiratory tract illness and a history of travel within 14 days of symptom onset to geographical regions where sustained community transmission has been identified.
Individuals with fever or signs/symptoms of a lower respiratory tract illness who also are immunosuppressed (including patients with HIV), are older, or have underlying chronic health conditions.
Individuals with fever or signs/symptoms of a lower respiratory tract illness who are critical to pandemic response including healthcare workers, public health officials, and other essential leaders.
Hospitalised (non-intensive care unit) patients and long-term care facility residents with unexplained fever and signs/symptoms of a lower respiratory tract illness. The number of confirmed COVID-19 cases in the community should be considered.
As testing becomes more widely available, routine testing of hospitalised patients may be important for infection prevention and management at discharge.
Patients in outpatient settings who meet the criteria for influenza testing (e.g., older people and/or those with underlying health conditions). Testing in pregnant women and symptomatic children with similar risk factors for complications is encouraged. The number of confirmed COVID-19 cases in the community should be considered.
Community surveillance as directed by public health and/or infectious diseases authorities.
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