![]() ![]() (23) Chest computed tomography (CT) images from patients with COVID-19 may demonstrate bilateral, peripheral ground glass opacities and consolidation. ( 21)Ĭhest radiographs of patients with severe COVID-19 may demonstrate bilateral air-space consolidation. ( 21) This study also noted that serum albumin, neutrophil to lymphocyte ratio, and red cell distribution width were each associated with disease severity. ( 22) One study that compared markers of inflammation in patients with and without COVID-19 observed modestly lower leukocyte, lymphocyte, and platelet counts and higher hemoglobin values in patients with COVID-19. (21,22) Studies found that hospitalized patients with COVID-19 may have coagulation abnormalities including increased D-dimer concentration, a modest decrease in platelet count, and a prolongation of the prothrombin time. ![]() Several markers of inflammation and abnormal coagulation are associated with severe COVID-19 illness. More information on coinfection and recommendations on antimicrobial stewardship or systematic approaches to using antimicrobials can be found on CDC’s Testing Guidance for Clinicians When SARS-CoV-2 and Influenza Viruses are Co-circulating webpage and the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network webpage. Testing for other causes of respiratory illness, in addition to testing for SARS-CoV-2, may be considered, depending on local pathogen co-circulation, patient age, underlying medical conditions, season, and clinical setting. ( 19,20) Detection of a different respiratory pathogen does not rule out COVID-19 infection. SARS-CoV-2 co-infection with another pathogen, including a respiratory virus, bacterium, or fungus has been documented, particularly in hospitalized patients. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) are available, see: FDA’s COVID-19 In Vitro Diagnostics EUAs, CDC’s Overview of Testing for SARS-CoV-2, CDC’s Interim Guidance for Antigen Testing for SARS-CoV-2, and the NIH’s Testing for SARS-CoV-2 Infection which describes testing recommendations, including guidance on the use of Ct values. Specific recommendations on testing strategies in various clinical situations and information on SARS-CoV-2 molecular and antigen assays (including COVID-19 self-tests) that have received U.S. For more information, see the Antigen Test Algorithm. A negative antigen test in persons with signs or symptoms of COVID-19 should be confirmed by NAAT. Antigen tests for SARS-CoV-2 use immunoassays to detect the presence of a specific viral antigen in respiratory specimens, and include point-of-care, laboratory-based, and self-tests. SARS-CoV-2 antigen tests typically provide rapid results and are less expensive than NAATs, but they are generally less sensitive than NAATs. Clinical RT-PCR tests for SARS-CoV-2 that determine the cycle threshold (Ct) value are not validated to estimate viral load, and the NIH recommends that Ct values may be considered only in consultation with an infectious disease expert. NAATs that use reverse transcription-polymerase chain reaction (RT-PCR) technology to detect SARS-CoV-2 ribonucleic acid (RNA) are highly sensitive and specific and detect SARS-CoV-2 RNA in respiratory specimens. Antibody tests (serology) are not indicated to diagnose a current infection. Viral tests, including NAAT and antigen tests, are used to diagnose COVID-19. Testing is important to identify and help reduce the spread of COVID-19 (see diagnostic tests for COVID-19).
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