Valid Covid19 Dx?

[Silver_Rik, ASN, BSN, RN]

SIAA - can a doctor make a valid Dx of Covid19 without a positive Coronavirus SARS-CoV-2 test? (Ie from S/S and lab values in the absence of a test or a negative test)?

[Wuzzie]

U07.2 COVID-19, virus not identified

Clinically-epidemiologically diagnosed COVID-19

Probable COVID-19

Suspected COVID-19

This is the valid ICD-10 code for suspected COVID so I would imagine that is what should be used. What is the context of your question?

[NRSKarenRN, BSN, RN]

4 hours ago, Silver_Rik said:

SIAA - can a doctor make a valid Dx of Covid19 without a positive Coronavirus SARS-CoV-2 test? (Ie from S/S and lab values in the absence of a test or a negative test)?

YES. As above

Quote

An emergency ICD-10 code of ‘U07.2 COVID-19, virus not identified’ is assigned to a clinical or epidemiological diagnosis of COVID-19 where laboratory confirmation is inconclusive or not available.

https://www.who.int/classifications/icd/covid19/en/

[Silver_Rik, ASN, BSN, RN]

I knew - at least pretty confident - that this was the case. I asked because in a Covid19 group for nurses on FB an ICU nurse who says the Covid19 statistics are being fraudulently exaggerated has been arguing with several of us that you can't make a valid diagnosis without a positive throat swab for the Coronavirus SARS-CoV-2. People have mentioned things like GGO on CXR, d-dimer, fibrinogen and she says all of those are caused by other conditions, and calling it Covid-19 is phony.

She says that for all other viral infections we only accept explicit testing for the presence of the virus.

[Uroboros, APRN]

Checkout some of the solid literature on "cytokine storm", which follows criteria many APP's were following before we had COVID PCR testing. The labs you mention are some of the precursors. In our testing center we have a similar protocol developed for patients with negative PCR's. And we have developed our own IgM IgG IgA antibody testing pending community approval.

Think about how many patients we commonly diagnose with influenza every season who have negative tests as well. COVID I suspect will eventually fall into a similar practice. Not true at all we only accept explicit POC testing for anything. Consider viral loading, which limits the sensitivity of these tests, however specific it may be remains a real mystery as many things still are with COVID. Of course the day may come when computers are able to collect quantifying data and simply spit out the corresponding ICD-10. But for now we tarry not in the art.

[Wuzzie]

1 hour ago, Silver_Rik said:

I asked because in a Covid19 group for nurses on FB an ICU nurse who says the Covid19 statistics are being fraudulently exaggerated has been arguing with several of us that you can't make a valid diagnosis without a positive throat swab for the Coronavirus SARS-CoV-2.

Well since it’s diagnosed with an NPH swab not a throat swab you can pretty much rule her out as an expert.

[Silver_Rik, ASN, BSN, RN]

13 hours ago, Uroboros said:

Checkout some of the solid literature on "cytokine storm", which follows criteria many APP's were following before we had COVID PCR testing. The labs you mention are some of the precursors. In our testing center we have a similar protocol developed for patients with negative PCR's. And we have developed our own IgM IgG IgA antibody testing pending community approval.

Think about how many patients we commonly diagnose with influenza every season who have negative tests as well. COVID I suspect will eventually fall into a similar practice. Not true at all we only accept explicit POC testing for anything. Consider viral loading, which limits the sensitivity of these tests, however specific it may be remains a real mystery as many things still are with COVID. Of course the day may come when computers are able to collect quantifying data and simply spit out the corresponding ICD-10. But for now we tarry not in the art.

Do you mind if I copy and repost this? If you do I can rewrite it

[Uroboros, APRN]

14 minutes ago, Silver_Rik said:

Do you mind if I copy and repost this? If you do I can rewrite it

Nothing has copyrights here my friend. Glad it helped.