Evolving global and national criteria for identifying a suspected case of COVID-19

Abstract

Background The outbreak of coronavirus disease 2019 (COVID-19) began in December 2019 and continues to spread worldwide. Rapid and accurate identification of suspected cases is critical in slowing spread of the virus that causes the disease. We aimed to highlight discrepancies in the various criteria used by international agencies and highly impacted individual countries around the world. Methods We reviewed the criteria for identifying a suspected case of COVID-19 used by two international public health agencies and 10 countries across Asia, Europe, and North America. The criteria included information on the clinical causes of illness and epidemiological risk factors. Non-English language guidelines were translated into English by a co-author who is fluent in that particular language. Results Although most criteria are modifications of World Health Organization recommendations, the specific clinical features and epidemiological risks for triggering evaluation of patients with suspected COVID-19 differed widely among countries. The rationale for these differences may be related to each country’s resources, politics, experience with previous outbreaks or pandemics, health insurance system, COVID-19 outbreak severity, and other undetermined factors. Conclusion We found no consensus regarding the best diagnostic criteria for identifying a suspected case of COVID-19.

COVID-19 case definitions, diagnostic testing criteria, and surveillance across the pandemic’s 25 highest burden countries

“…6,26 National differences in testing eligibility criteria may also reflect resource limitations and differences in national health insurance coverage of tests. 12 A number of testing strategies proposed to target segments of the population believed to be at greatest risk of exposure to SARS-CoV-2. For example, some have proposed testing all symptomatic individuals and asymptomatic individuals with known or suspected contact with COVID-19 case for optimal NAAT testing.…”

“…Earlier evaluations of global COVID-19 case definitions do not reflect the latest changes to national case definitions and test eligibility criteria and do not target the full range of countries with the highest burden of disease. [12][13][14] In this study, we analyze (1) national COVID-19 case definitions from the 25 countries with the largest number of reported COVID-19 cases as of 1 October 2020 (collectively representing approximately 85% of the global cases at that time) and (2) specific criteria used to determine eligibility for SARS-CoV-2 diagnostic testing. The implications of inter-country differences on ongoing efforts to understand global disease burden and control the pandemic are also discussed.…”

Epidemiology and transmission of COVID-19 in cases and close contacts in Georgia in the first four months of the epidemic

“…Individuals were tested for COVID-19 for various reasons: symptoms according to the WHO standard definition, which were defined as: acute respiratory illness with fever and at least one other sign/symptom of respiratory disease, a history of travel to an area with local transmission or contact with a confirmed case; or severe acute respiratory infection requiring hospitalization and no other etiology that explains the clinical presentation 24 .…”

“…Individuals were tested for COVID-19 for various reasons: symptoms according to the WHO standard definition, which were defined as: acute respiratory illness with fever and at least one other sign/symptom of respiratory disease, a history of travel to an area with local transmission or contact with a confirmed case; or severe acute respiratory infection requiring hospitalization and no other etiology that explains the clinical presentation 24 . Non-symptomatic testing was conducted for contacts of confirmed cases; hospital patients or medical personnel with symptoms of respiratory disease; essential workers such as medical personnel, laboratory staff and transport/customs workers; beneficiaries and staff of care facilities for elderly and disabled; patients with early-stage tuberculosis (TB); and those in quarantine or self-isolation.…”

Pesquisas em saúde: relatos, experiências e perspectivas

“…Destaca-se ainda que em março de 2020 a infecção pelo vírus SARS-CoV-2 se apresentou de forma abrangente nas regiões brasileiras, onde se fez necessária a implementação de novas estratégias para o cuidado em saúde para minimizar a transmissão desse vírus (TONIN et al, 2020;SODER et al, 2020;ATSAWARUNGRUANGKIT et al, 2020).…”