This message is being sent on behalf of
Timothy Friel MD, FIDSA, Chair, Department of Medicine    

REVISED LVPG/LVHN Guidance for COVID-19 Testing
(Updated 4/5/2020)

(Please note – these recommendations reflect the current state and are based on evolving data, observations and availability of testing supplies. Recommendation will be updated if more formal recommendations become available.)

In light of continued regional and national shortages in test kits, we currently recommend COVID-19 testing ONLY for the following patients.

1. All hospitalized patients with symptoms suggestive of possible COVID-19 infection
2. Symptomatic healthcare workers
3. Symptomatic patients living in long-term care facilities
4. Symptomatic patients with higher risk of complications from COVID-19
5. Symptomatic pregnant women
6. Symptomatic first responders (for example, EMTs, firefighters, police, etc.)
7. Symptomatic household members of patients at high risk for complications of COVID-19* (only for first family member displaying symptoms; other symptomatic family members will be presumed to have COVID-19 if index patient positive).

*Individuals at higher risk of complications include the following:

1. Patients age 65 and older
2. Chronic lung disease and asthma
3. Significant heart disease
4. Immunosuppression
5. Diabetes
6. Morbid obesity
7. Chronic kidney disease
8. Chronic liver disease

The most commonly reported symptoms in patients with confirmed COVID-19 infection include the following:

1. Fever (now defined as temperature >100.0)
2. Cough
3. Shortness of breath or trouble breathing (above baseline for patients with chronic respiratory conditions)

To be considered “symptomatic,” patient must display at least one of the three symptoms listed above.

Other mild symptoms have been described at initial presentation, including fatigue, myalgias, gastrointestinal symptoms and changes in the perception of taste or smell. The presence of any of these mild symptoms – alone or in combination – should not prompt testing at this time.

Otherwise healthy patients with mild to moderate symptoms (those who will be managed at home) should no longer be tested. These patients can be presumed to have COVID-19 and should be encouraged to follow the same recommendations for infected individuals.

For patients who develop new symptoms AND currently live with someone with a confirmed diagnosis of COVID-19, testing is no longer recommended. These patients can be presumed to have COVID-19 and should be encouraged to follow the same recommendations for infected individuals.

Asymptomatic patients should NOT be tested. Current tests are only capable of making the diagnosis of active COVID-19. The test does NOT confirm or rule out a significant exposure.