When should asymptomatic individuals undergo coronavirus disease 2019 (COVID-19) diagnostic tests?

Updated: Apr 02, 2021
  • Author: James J Dunn, PhD, D(ABMM), MT(ASCP); more...
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Answer

Viral tests (nucleic acid or antigen) are recommended to diagnose acute infection of symptomatic and asymptomatic individuals. [4, 7]  The results can then be used to guide contact tracing, treatment options, and isolation requirements. Asymptomatic individuals who have had direct contact with a known or suspected case of COVID-19 while not wearing appropriate PPE can be tested, but testing is not recommended in asymptomatic, otherwise healthy, non-immunocompromised individuals seeking healthcare services in communities where the prevalence of COVID-19 is less than 2% (if they are not undergoing emergent surgery or aerosol-generating procedures). [4] In contrast, testing is recommended for these same patients if they are hospitalized in communities with a high prevalence (ie, ≥10%) of COVID-19.

Asymptomatic, immunosuppressed patients being admitted to the hospital or persons undergoing immunosuppressive procedures should be tested within 48-72 hours of admission.

The decision to test asymptomatic patients will often depend on the availability of testing resources and the timeliness of results. However, asymptomatic individuals requiring urgent surgery can be tested as close to the planned procedure as possible (eg, within 48-72 hours). The need for testing asymptomatic persons prior to aerosol-generating procedures will to some extent depend on the availability of appropriate PPE.


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