According to IDSA guidelines on the diagnosis of COVID-19, a SARS-CoV-2 nucleic acid amplification test is recommended in symptomatic individuals suspected of having COVID-19, even when the clinical suspicion for COVID-19 is low.
The IDSA suggests collecting nasopharyngeal, mid-turbinate, or nasal swabs rather than oropharyngeal swabs or saliva alone for SARS-CoV-2 RNA testing in symptomatic individuals with upper respiratory tract infection or influenza-like illness suspected of having COVID-19.
The IDSA suggests initially obtaining an upper respiratory tract sample (eg, nasopharyngeal swab) rather than a lower respiratory sample for SARS-CoV-2 RNA testing in hospitalized patients with suspected COVID-19 lower respiratory tract infection. If the initial upper respiratory sample result is negative and suspicion for disease remains high, the IDSA suggests collecting a lower respiratory tract sample (eg, sputum, bronchoalveolar lavage fluid, tracheal aspirate) rather than collecting another upper respiratory sample.
The IDSA recommends repeat viral RNA testing when the initial test is negative (vs performing a single test) in symptomatic individuals with an intermediate or high clinical suspicion of COVID-19.
The IDSA recommends SARS-CoV-2 RNA testing in immunocompromised, asymptomatic individuals who are being admitted to the hospital, regardless of exposure to COVID-19.
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Cite this: Michael Stuart Bronze. Fast Five Quiz: COVID-19 Clinical Keys - Medscape - Oct 22, 2020.