Updated Symptom List and Testing Guidance For Use When Evaluating Patients for COVID-19
April 29, 2020
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- Be familiar with updated CDC list of symptoms for which COVID-19 should be considered.
- Be familiar with new Washington DOH guidelines for COVID-19 testing to include all patients with COVID-19 symptoms when adequate testing capacity is available.
COVID-19 Symptoms (CDC)
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.
- Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).
- Other symptoms may include: Chills (and/or repeated shaking with chills), muscle pain, headache, sore throat, and, new loss of taste or smell.
- Have an increased index of suspicion for patients residing in long term care facilities and others with chronic co-morbidities associated with immune system compromise who may present with subtle and/or atypical symptoms.
Testing guidance for Washington state (Please review complete guidance at website below)
- Healthcare providers should test all patients with new onset of symptoms consistent with COVID-19, regardless of their age or health status.
- Symptoms of COVID-19 include:
- Cough, or shortness of breath or difficulty breathing OR
- At least two of:
- Repeated shaking with chills
- Muscle pain
- Sore throat
- New loss of taste or smell
- Other patients should be tested per clinical judgment.
- Rapidly testing all patients with symptoms consistent with COVID-19 is critical to identifying and isolating cases, quarantining their contacts, and suppressing community spread.
- While this guidance expands the groups of persons eligible for testing, prioritizing testing of certain symptomatic persons may be necessary when adequate test supplies are not available.
- Prioritize the following symptomatic patients for COVID-19 testing when necessary:
- Hospitalized patients with severe lower respiratory illness
- Workers in healthcare facilities, congregate living settings, critical infrastructure and public safety/first responders
- Residents in long-term care facilities or other congregate living settings, including prisons and shelters
- Persons identified through public health cluster and selected contact investigations
- Persons at higher risk of severe outcome
- Persons who are pregnant and in labor or scheduled for delivery
- Limit testing of asymptomatic persons to those with exposure
- Close contacts of a case (if a close contact tests negative, these individuals still need to remain in quarantine for 14 days after their last date of exposure)
- Individuals exposed to COVID-19 during an outbreak in a congregate setting (e.g., long term care facility, shelters, correctional settings, meat-packing plants, etc.)
- If adequate supplies are available, testing asymptomatic people can be considered for:
- Persons who are pregnant and present in labor
- People undergoing procedures that increase the risk of aerosolized particle spread
- People undergoing invasive surgical procedures (within 48 hours of procedure)
- Testing is not generally recommended for new asymptomatic admissions to a healthcare or long-term care facility, unless to a healthcare facility using the information for cohorting
- Clinicians are encouraged to test for other causes of respiratory illness in addition to testing for COVID-19