The following is a summary of the interim guidance on evaluating and testing persons with COVID-19, which was updated by the Centers for Disease Control and Prevention (CDC) on March 24, 2020. View the complete guidance here.
Clinicians should continue to work with state and local health departments to coordinate COVID-19 testing. Clinical laboratories now have the option of offering testing under the Food & Drug Administration’s Emergency Use Authorization (EUA)—expanding testing options for symptomatic patients.
Clinicians should rely on clinical judgment to determine if a patient is symptomatic and in need of testing. The CDC noted that most COVID-19-positive patients developed a fever and/or symptoms of acute respiratory illness. Clinicians should also consider epidemiologic factors such as COVID-19 transmission in their community.
The CDC established three priorities for testing patients with suspected COVID-19 infection.
Ensure optimal care for hospitalized patients and reduce healthcare-associated infections.
Rapidly identify and triage symptomatic patients at the highest risk (e.g. elderly, underlying conditions, first responders, long-term care facility residents).
Expand testing to critical workers and patients with mild symptoms if resources allow.
If a patient is suspected of having COVID-19, clinicians should:
Notify infection control personnel at their healthcare facility; and
Notify state or local health department if a patient is classified as a person under investigation (PUI) for COVID-19
Testing and Specimen Collection
The CDC recommends collecting and testing upper respiratory tract specimens initially (nasopharyngeal swab). Lower respiratory tract specimens should be tested if available. Sputum should be collected and tested only if the patient develops a productive cough. A lower respiratory tract aspirate or bronchoalveolar lavage sample should be collected and tested as a lower respiratory tract specimen if clinically indicated. Specimens should be collected as soon as possible after a PUI is identified.