COVID-19

Overview

SARS-CoV-2 is the virus that causes COVID-19

  • Clinical criteria for diagnosis include:

    • At least two:  fever, chills, rigors, myalgia, headache, sore throat, difficulty breathing, new loss of taste/smell

    • At least one: cough, shortness of breath, difficulty breathing

    • Severe respiratory illness with pneumonia or acute respiratory distress syndrome (ARDS).

  • Detection of RNA virus via amplification is confirmatory evidence, while detection of specific antigen or antibody is presumptive evidence.

  • Epidemiologic linkage:

    • Close contact with confirmed/probably case of COVID-19 disease

    • Close contact with a person with compatible illness AND COVID-19 case linkage

    • Travel to or residence in an area with sustained community COVID-19 transmission

    • Member of a risk cohort as defined by public health authorities during an outbreak.

Tips for Documenting COVID-19

Confirmatory COVID-19 testing should be documented in the chart

  • Confirmatory testing not performed at DCMC must be obtained for patient’s DCMC record.

  • Document all associated conditions as “due to COVID-19”

  • If testing inconclusive or still pending upon discharge, write “presumptive positive” if the patient is undergoing management for COVID-19

  • A “probable” diagnosis:

    • Meets clinical criteria AND epidemiologic evidence with no confirmatory laboratory testing performed for COVID-19.

    • Meets presumptive laboratory evidence AND either clinical criteria OR epidemiologic evidence.

MIS-C

Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, conjunctivitis, or fatigue, and in severe cases, hypotension and shock. The cause of MIS-C is unknown, however, if testing clearly demonstrates COVID-19 positivity, this should be included and linked with MIS-C.