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Thoracic CT can be useful for managing patients with a high clinical suspicion of COVID-19 who test negative for SARS-CoV-2, researchers from the UK report.
Dr. Samanjit S. Hare and colleagues at the Royal Free London NHS Foundation Trust propose an algorithm for the infection-control management of inpatients with a negative initial SARS-CoV-2 RT-PCR result in a report in Thorax.
• Patients at low clinical suspicion of COVID-19 who have an admission chest x-ray reported as normal or another diagnosis can be de-isolated and considered not to have COVID-19.
• Patients at high clinical suspicion of COVID-19 with an admission chest x-ray reported as normal, indeterminate, or others should continue to be isolated and undergo repeat chest x-ray and SARS-CoV-2 testing.
• Patients whose repeat chest x-ray is "classical for COVID-19" or whose SARS-CoV-2 result is positive should continue to be isolated and managed according to guidelines, the authors say.
• Patients whose repeat chest x-ray is normal, indeterminate, or other and whose repeat SARS-CoV-2 testing is negative should be scheduled for thoracic CT and then be managed according to its results.
• If the findings are consistent with COVID-19, isolation should be continued and the patient should be managed according to guidelines.
• If the findings are not consistent with COVID-19, patients can be de-isolated, according to the report.
Source: https://thorax.bmj.com/content/early/2020/06/09/thoraxjnl-2020-214916
Dr. Samanjit S. Hare and colleagues at the Royal Free London NHS Foundation Trust propose an algorithm for the infection-control management of inpatients with a negative initial SARS-CoV-2 RT-PCR result in a report in Thorax.
• Patients at low clinical suspicion of COVID-19 who have an admission chest x-ray reported as normal or another diagnosis can be de-isolated and considered not to have COVID-19.
• Patients at high clinical suspicion of COVID-19 with an admission chest x-ray reported as normal, indeterminate, or others should continue to be isolated and undergo repeat chest x-ray and SARS-CoV-2 testing.
• Patients whose repeat chest x-ray is "classical for COVID-19" or whose SARS-CoV-2 result is positive should continue to be isolated and managed according to guidelines, the authors say.
• Patients whose repeat chest x-ray is normal, indeterminate, or other and whose repeat SARS-CoV-2 testing is negative should be scheduled for thoracic CT and then be managed according to its results.
• If the findings are consistent with COVID-19, isolation should be continued and the patient should be managed according to guidelines.
• If the findings are not consistent with COVID-19, patients can be de-isolated, according to the report.
Source: https://thorax.bmj.com/content/early/2020/06/09/thoraxjnl-2020-214916
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