A simplified alternative diagnostic algorithm for SARS-CoV-2 suspected symptomatic patients and confirmed close contacts (asymptomatic): A consensus of Latin American experts
The algorithm is divided into 3 parts by time since symptoms onset or close contact.
•
Real-time reverse transcription- polymerase chain reaction advised in first 14 days.
•
Antigen detection tests may be used as an alternative.
•
Antibody detection assays advised 14 days after symptoms onset or close contact.
•
Testing for other respiratory diseases should be considered.
Abstract
Introduction
Latin America accounts for one-quarter of global COVID-19 cases and one-third of deaths. Inequalities in the region lead to barriers to the best use of diagnostic tests during the pandemic. There is a need for simplified guidelines that consider the region’s limited health resources, international guidelines, medical literature, and local expertise.
Methods
Using a modified Delphi method, 9 experts from Latin American countries developed a simplified algorithm for COVID-19 diagnosis on the basis of their answers to 24 questions related to diagnostic settings, and discussion of the literature and their experiences.
Results
The algorithm considers 3 timeframes (≤7 days, 8–13 days, and ≥14 days) and presents diagnostic options for each. SARS-CoV-2 real- time reverse transcription-polymerase chain reaction is the test of choice from day 1 to 14 after symptom onset or close contact, although antigen testing may be used in specific circumstances, from day 5 to 7. Antibody assays may be used for confirmation, usually after day 14; however, if clinical suspicion is very high, but other tests are negative, these assays may be used as an adjunct to decision-making from day 8 to 13.
Conclusion
The proposed algorithm aims to support COVID-19 diagnosis decision-making in Latin America.
