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Coronavirus Disease 2019 A057
Current RMA Instruments
SOP bulletin information on new SOPs
- ICD-10-AM Codes: B97.29, U07.1
Coronavirus disease 2019 is a novel disease first detected in China in late 2019. It is a highly infectious condition that has gone on to cause a worldwide pandemic in 2020. It is transmitted by direct or close contact with an infected person or by touching objects or surfaces contaminated with the virus.
The incubation period is typically 2 to 14 days.
The spectrum of symptomatic acute infection ranges from mild to critical. Most infections are not severe and symptoms typically resolve within two to three weeks. Symptoms include fever, chills, cough, sore throat, headache, muscle pain, fatigue, shortness of breath, pneumonia and new loss of taste and smell. Individuals who experience mild illness may only require self-isolation at home (medical assistance not warranted). In older persons and those with underlying health conditions hospitalisation and intensive care with intubation and ventilation may be required. Individuals with severe disease have a longer recovery time (months). The most common persistent symptoms include cough, fatigue, shortness of breath and cognitive deficits. There is emerging data suggestive of ongoing respiratory and cardiac impairment. Death may occur in a small percentage of cases.
There is currently no accepted clinical diagnostic criteria for ‘long COVID’ but the definitions relating to the stages of COVID-19 recovery proposed by the CDC and WHO are widely used:
- Acute COVID-19: Symptoms of COVID-19 up to four weeks following the onset of illness
- Post COVID condition: Broad range of symptoms (physical and mental) which develop during or after COVID-19 that continues for 2 months or more, have an impact on the patient’s life and are not explained by an alternative diagnosis.
Risk of re-infection is possible with the emergence of new strains and variants of this virus.
Confirming the diagnosis
The diagnosis requires the presence of a clinical illness caused by infection with the SARS-CoV-2 virus. Presence of the virus is best demonstrated by:
- PCR testing (in a laboratory)
- Symptomatic person with suspected or probable SARS-CoV-2 virus infection PLUS a positive SARS-CoV-2 antigen test (RAT- rapid antigen test)
- Serology testing performed during or after the illness.
As a SARS-CoV-2 (rapid) antigen test is self-administered and self-assessed, additional information is required to confirm and date a positive result. This can include:
- Evidence of registration of positive Rapid Antigen Test results through the Department of Health
- Medical evaluation notes at the time of illness and documented acknowledgement of positive test result
- Workplace related evidence acknowledging the specific illness and positive test result (e.g. medical certificate)
Note that checking serology 3-4 weeks after the onset of symptoms optimizes the accuracy of the result. Test sensitivity beyond 5 weeks is uncertain. Some serologic tests cannot distinguish between prior infection and prior vaccination (i.e. a reactive result could indicate prior infection, prior vaccination or both). Clinical interpretation by the doctor ordering this test is required.
The diagnosis can be confirmed by a general practitioner.
The relevant medical specialist is a respiratory or infectious diseases physician.
Additional diagnoses covered by these SOPs
- Chronic COVID-19 or long COVID-19
Conditions not covered
- Asymptomatic infection with SARS-CoV-2
The clinical onset will be when relevant clinical symptoms first manifest.
There are no worsening factors except for inability to obtain appropriate clinical management. Therapy is mostly supportive, but there are drugs that have been reported to modify (lessen) the duration of disease and the likelihood of death from the disease.