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Kettering Health Network Recommendations for Repeat SARS-CoV-2 Testing in Patients with a Documented Prior Infection

There is excellent data showing that while patients can remain positive on PCR testing for SARS-CoV-2, these patients do not harbor live virus after 10 days (mild/moderate disease or asymptomatic) or 20 days (severe disease or severely immunosuppressed). In addition, repeat infection with SARS-CoV-2 has only been documented once or twice worldwide.  For these reasons the usefulness of repeat test results is extremely limited. Finally, testing remains a resource where demand exceeds supply. As such, the network is following CDC recommendations on retesting.

For both inpatients and out patients:

• For persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 90 days after the date of symptom onset for the initial COVID-19 infection. This includes pre-operative patients.

• For persons who develop new symptoms consistent with COVID-19 during the 90 days after the date of initial symptom onset, if an alternative etiology cannot be identified by a provider, then the person may warrant retesting for SARS-CoV-2. For inpatients, isolation may be considered during this evaluation based on consultation with the campus infection control practitioner, especially in the event symptoms develop within 14 days after close contact with an infected person.

• For persons who never developed symptoms, the date of first positive RT-PCR test for SARS-CoV-2 RNA should be used in place of the date of symptom onset. Retesting is not recommended within 90 days after the date of the initial positive test. 

• Repeat testing is permissible for patients who will not be accepted into a congregate facility (SNF/LTACH/IPR) without a documented negative test).

September 21, 2020