Some COVID Treatment Guidelines

NIH expert panel

https://www.nih.gov/news-events/news-releases/expert-us-panel-develops-nih-treatment-guidelines-covid-19

https://covid19treatmentguidelines.nih.gov/
https://covid19treatmentguidelines.nih.gov/introduction/

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Online guide via PUBMED
https://www.ncbi.nlm.nih.gov/books/NBK554776/ 

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MedScape (March 13)
https://www.medscape.com/viewarticle/926794

"We recommend obtaining baseline CBC with differential, basic metabolic panel, liver function tests, and procalcitonin. Clues for COVID-19 include leukopenia, seen in 30% to 45% of patients, and lymphocytopenia, seen in 85% of the patients in the case series from China," Tirupathi said.


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California Dept Public Health priority testing guideline
(received 4 22)

CDPH released guidance to help health care providers and laboratories determine prioritization of specific groups for COVID-19 testing.

The guidance sets forth the following list of priorities:

Priority 1:

·         Hospitalized patients

·         Symptomatic healthcare workers

·         Persons identified for testing by public health contact investigations and disease control activities in high risk settings, including both residents and staff

o    E.g., congregate living facilities, correctional facilities

Priority 2:

·         Screening of asymptomatic residents of congregate living facilities prior to admission or re-admission to congregate living facility

o    E.g., a hospitalized patient will be screened for COVID-19 prior to discharge to a congregate living facility

·         Screening of asymptomatic healthcare workers

o    E.g., skilled nursing facility workers, hospital workers

·         Symptomatic persons in essential health and public safety occupations

o    E.g., first responders, law enforcement, congregate living facility workers

·         Symptomatic persons >65 years of age or with chronic medical conditions

Priority 3:

·         Symptomatic persons in essential infrastructure occupations

o    E.g., utility workers, food supply workers, other public employees

Priority 4:

·         Community-based testing of all low-risk symptomatic persons

·         Surveillance testing of asymptomatic persons

From NIH guidelines quoting CDC

CDC has established a priority system for diagnostic testing for SARS-CoV-2 infection based on the availability of tests;14 the CDC testing guidance is updated periodically.

• Priority 1: Hospitalized patients and symptomatic health care workers (to reduce the risk of nosocomial infections and maintain the health care system).
• Priority 2: Individuals with symptoms who live in long-term care facilities, who are aged ≥65 years, or who have underlying conditions, and symptomatic first responders (to ensure those at highest risk of complications of infection are rapidly identified and triaged).
• Priority 3: In communities experiencing high COVID-19 hospitalizations, critical infrastructure workers and other individuals with symptoms, health care workers and first responders, and individuals with mild symptoms (to decrease community spread and ensure the health of essential workers).

Of note, false-negative test results can occur. In people with a high likelihood of infection based on exposure history and/or clinical presentation, a single negative test does not completely exclude SARS-CoV-2 infection, and testing should be repeated.