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The National Institute of Public Health updated the COVID-19 case definitions on Friday, introducing a new term: probable case. The INSP explains what suspected case, probable case, confirmed case and contact mean.
Suspicious case
- anyone with sudden onset of fever and cough or anyone with sudden onset of 3 or more of the following signs and symptoms: fever, cough, asthenia, headache, myalgia, sore throat, coryza, dyspnea, anorexia / nausea /
- vomiting, diarrhea, deterioration of mental status;
- anyone with pneumonia, bronchopneumonia +/- pleurisy;
- anyone with a severe acute respiratory infection (SARI): fever or a history of fever and cough and shortness of breath (shortness of breath) and requiring overnight hospitalization.
According to the INSP, for children up to 16 years of age who have gastrointestinal symptoms (vomiting, diarrhea) not associated with food, a SARS-CoV-2 infection may be suspected.
Probable case
- a patient who meets the clinical criteria established in the suspected case and is in contact with a confirmed case or has an epidemiological link to an outbreak with at least one confirmed case;
- a suspicious case with a lung image suggestive of COVID-19:
- Pulmonary radiography: opaque opacity, often round, with less peripheral distribution;
- Pulmonary CT: multiple bilateral crushed-glass opacities, often round, with less peripheral distribution;
- lung ultrasound: thickened pleural lines, B lines (multifocal, discrete or confluent), consolidation patterns with or without
- bronchograms;
- a person with a recent onset of anosmia (loss of smell) or ageuzia (loss of taste) in the absence of an identified cause;
- an adult who died without explainable cause, with respiratory failure that preceded death and who was in contact with a confirmed case or who had an epidemiological link to an outbreak with at least one confirmed case.
Confirmed case you are a person with laboratory confirmation of SARS-CoV-2 infection, regardless of clinical signs and symptoms;
Direct contact:
- The person who lives in the same household with a COVID-19 patient;
- the person who had direct physical contact with a COVID-19 case (for example, handshake without subsequent hand hygiene);
- the person who has had direct unprotected contact with infectious secretions from a COVID-19 case (for example, by coughing, touching handkerchiefs with unprotected gloves);
- the person who had face-to-face contact with a COVID-19 case at a distance of less than 2 m and with a duration of at least 15 minutes;
- the person who was in the same room (for example, classroom, meeting room, hospital waiting room) with a COVID-19 case, for a minimum of 15 minutes and at a distance of less than 2 m;
- the person of the medical staff or other person who provides direct care to a patient with COVID-19 or a person of the laboratory staff who handles samples taken from a patient with COVID-19 without wearing the appropriate protective equipment.
Anyone who has worn appropriate protective equipment / masks and observed a physical distance is not considered direct contact.
A case of COVID-19 can be of community origin or associated with health care (IAAM), depending on:
- the number of days before the date of initiation or confirmation in the laboratory, after the date of admission to a health unit (hospital, dialysis center), residential center for long-term stay (day 1);
- the arguments of the epidemiological investigation on the community origin or IAAM (belonging of the case to outbreaks of infections with one or other of the origins).
There may be the following situations:
Community case COVID-19
- symptoms present on admission or at onset within the first 48 hours after admission;
- onset on days 3 to 7 after hospitalization and a strong suspicion of community transmission (pertaining to a community case outbreak);
COVID-19 case associated with healthcare (I AM)
- onset 48 hours after admission and a strong suspicion of transmission associated with medical care;
- cases of medical and auxiliary personnel, if there are no strong arguments in favor of community transmission;
Cases with onset in the first 14 days after discharge from a health unit can be:
- IAAM, if the onset occurs within the first 48 hours after discharge;
- of uncertain origin, in the case of onset 3-14 days after discharge, if there are no solid arguments in favor of a community origin or IAAM.
Patient death confirmed with COVID-19
Death from COVID-19 is defined as death in a patient confirmed with COVID-19, unless there is another clear cause of death that cannot be related to COVID-19 (e.g. trauma, severe acute bleeding). , etc.) and in
that there was no complete recovery period between illness and death.
Death in a patient confirmed with the new coronavirus cannot be attributed to a pre-existing disease (eg, cancer, hematological conditions, etc.) and COVID-19 must be reported as the cause of death, regardless of pre-existing medical conditions, which are It is suspected that they have favored a severe evolution of the SARS-CoV-2 infection.
COVID-19 must be mentioned on the death certificate as the cause of death for all deceased individuals whom COVID-19 caused or allegedly caused or contributed to death.
Confirmed cases of COVID resulting in death, in which dynamic RT-PCR tests on sputum / bronchial aspirate are negative (2 tests), may be considered death from SARS-CoV-2 infection if the doctor shows signs and symptoms highly suggestive and death is correlated with the clinical course of COVID.
If the cause of death needs to be clarified, RT-PCR examinations of lung tissue collected by the pathology / forensic specialist without necropsy are indicated.
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