Objective: To communicate recommendations for prioritizing diagnostic testing.
Due to limited availability of near-patient, or point-of-care, testing, Infectious Diseases Society of America (IDSA) has developed recommendations for diagnostic testing prioritization. These recommendations will probably change as testing becomes more widely available or as new information becomes available. IDSA continues to advocate for policies and investments to expand capacity of testing during coronavirus disease of 2019 (COVID-19):
Tier 1: Critically ill patients obtaining intensive care unit (ICU) level care with unexplained viral pneumonia or respiratory failure, irrespective of travel history or close contact with suspected or confirmed COVID-19 patients. Any person, including health care workers, with fever or signs/symptoms of a lower respiratory tract (LRT) illness and close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset should be tested.
Tier 2: Hospitalized (non-ICU) patients and long-term care residents with unexplained fever and signs or symptoms of LRT illness. Consider the number of confirmed COVID-19 cases in the community. With wide availability of testing, routine testing of hospitalized patients may be important for infection prevention and management at discharge.
Tier 3: Patients in outpatient settings who meet the criteria for influenza testing. This includes
- Individuals with co-morbid conditions including diabetes, chronic obstructive pulmonary disorder, congestive heart failure
- Age >50
- Immunocompromised hosts
- Encourage testing of pregnant women and symptomatic children with similar risk factors for complications.
Tier 4: Community surveillance as directed by public health and/or infectious diseases authorities.
Reference: IDSA. COVID-19 Prioritization of Diagnostic Testing. Available from: https://www.idsociety.org/globalassets/idsa/public-health/covid-19-prioritization-of-dx-testing.pdf Accessed on May 07, 2020.