COVID Disease — Recovered Patient/Re-Testing with New Symptoms — Clinical Pathway: All Settings

Active COVID-19, Clinical Pathway — All Settings

Recovered Patient/Re-Testing with New Symptoms

COVID-Recovered Patients are Defined as Follows

Previously Symptomatic COVID-19 patients with laboratory-confirmed PCR testing of respiratory source that meet the following criteria:

  • Mild-Moderate Illness
    • At least 10 days have passed since symptoms first appeared; and
    • At 24 hours have passed since last fever without the use of fever-reducing medications and symptoms (e.g., cough, shortness of breath) have improved
  • Severe to Critical Illness or Severe Immunocompromise
    • At least 20 days have passed since symptoms first appeared and
    • At least 24 hours have passed since last fever w/o using fever-reducing medications and symptoms (e.g., cough, shortness of breath) have improved

Previously Asymptomatic COVID-19 patients with laboratory-confirmed PCR testing of respiratory source that meet the following criteria:

  • Mild-Moderate Illness
    • At least 10 days have passed since the date of their first positive viral diagnostic test
  • Severe to Critical Illness or Severe Immunocompromise
    • At least 10 days have passed since the date of their first positive viral diagnostic test

Note

There is currently insufficient evidence to make a COVID-19 diagnosis based on serologic studies and these should NOT be used to confirm previous infection.

  • Asymptomatic patients who are considered COVID-recovered by the criteria above do not need:
    • Repeat admission testing for a period of 3 months from their date of clearance.
    • Repeat pre-procedural testing for a period of 3 months from their date of clearance.
  • Patients who have been cleared can be placed on the medical or surgical unit best suited to their needs, and do not need to be admitted to the SIU or PSTU.
  • These guidelines will also apply even if the patient has had a recent repeat POSITIVE PCR test performed for other reasons, such as placement in a rehab or behavioral health facility.

Questions regarding patient placement, patient clearance and appropriate PPE can be directed to the COVID hotline or Infection Prevention and Control at 42096.

Re-testing for COVID-19 should be considered in the following instances:

  1. New infectious symptoms ≥ 90 days since first/most recent SARS-CoV-2 infection
  2. New infectious symptoms without alternate etiology 31–89* days since first/most recent SARS-CoV-2 infection (Outpatient, use rapid antigen test)
  3. New infectious symptoms with close contact with a person known to have laboratory confirmed COVID-19 infection 31–89* days since first SARS-CoV-2 infection (Outpatient, use rapid antigen test)
  4. The patient requires transfer to a congregate care setting with testing required as per the protocol for patient acceptance

*Between 31-44 days, the inpatient team can call the Lab for Cycle Time and can order a rapid antigen (LumiraDx) test if there is desire to determine if the patient has re-infection versus a residual positive test from prior infection