CShorten/CDC-COVID-FAQ huggingface dataset:
Category: Testing, Diagnosis, and Notification
Question: How do you diagnose and report a potential case of multisystem inflammatory syndrome in children (MIS-C)?
Answer: Patients with MIS-C have presented with a persistent fever and a variety of signs and symptoms including multiorgan (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic, neurologic) involvement and elevated inflammatory markers. Not all children will have the same symptoms. For children who may have MIS-C, further evaluation for signs of this syndrome may include (but are not limited to) chest radiograph, echocardiography, and blood testing to evaluate for evidence of inflammation. Healthcare providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local, state, or territorial health department. After hour phone numbers for health departments are available at the Council of State and Territorial Epidemiologists website.  For additional reporting questions, please contact CDC’s 24-hour Emergency Operations Center at 770-488-7100. For more information, including a full case definition, please visit MIS-C Information for Healthcare Providers.
Category: Treatment and Management
Question: Should post-exposure prophylaxis be used for people who may have been exposed to a person with COVID-19?
Answer: There is currently no FDA-approved post-exposure prophylaxis for people who may have been exposed to COVID-19. For information about registered clinical trials of investigational therapeutics for pre- or post-exposure prophylaxis of SARS-CoV-2 infection, visit ClinicalTrials.gov. For more information on movement restrictions, monitoring for symptoms, and evaluation after possible exposure to COVID-19, see Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or Community Settings and Interim U.S Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19). The National Institutes of Health recently published guidelines on prophylaxis use for COVID-19 and testing and management of COVID-19 patients. For more information, please visit: National Institutes of Health: Coronavirus Disease 2019 (COVID-19) Treatment Guidelines.
Category: Treatment and Management
Question: How are COVID-19 patients treated?
Answer: Not all patients with COVID-19 will require medical supportive care. Clinical management for hospitalized patients with COVID-19 is focused on supportive care for complications, including supplemental oxygen and advanced organ support for respiratory failure, septic shock, and multi-organ failure. Empiric testing and treatment for other viral or bacterial etiologies may be warranted. The National Institutes of Health has published interim guidelines for the medical management of COVID-19 prepared by the COVID-19 Treatment Guidelines Panel. For information on investigational therapies, see Therapeutic Options for Patients with COVID-19.
Category: Treatment and Management
Question: Do patients with confirmed or suspected COVID-19 need to be admitted to the hospital?
Answer: Not all patients with COVID-19 require hospital admission. Patients whose clinical presentation warrants in-patient clinical management for supportive medical care should be admitted to the hospital under appropriate Transmission-Based Precautions. Some patients with initial mild clinical presentation may worsen in the second week of illness. The decision to monitor these patients in the inpatient or outpatient setting should be made on a case-by-case basis. This decision will depend not only on the clinical presentation, but also on the patient’s ability to engage in self-monitoring, the feasibility of safe isolation at home, and the risk of transmission in the patient’s home environment. For more information, see Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in a Healthcare Setting and Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19). References related to hospitalization and outcomes among patients with COVID-19: Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 Among Children in China. Pediatrics 2020. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020.
Category: Treatment and Management
Question: When can patients with confirmed COVID-19 be discharged from the hospital?
Answer: Patients can be discharged from the healthcare facility whenever clinically indicated. Meeting criteria for discontinuation of Transmission-Based Precautions is not a prerequisite for discharge from a healthcare facility. Isolation should be maintained at home if the patient returns home before the time period recommended for discontinuation of hospital Transmission-Based Precautions. Decisions to discontinue Transmission-Based Precautions or in-home isolation should be made according to the following guidance: For hospitalized persons, see Discontinuation of Transmission-Based Precautions and Disposition of Patients with SARS-CoV-2 Infection in Healthcare Settings. For non-hospitalized persons, see Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for COVID-19 and Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: What do we know about detection of SARS-CoV-2 RNA after clinical recovery from COVID-19?
Answer: Many recovered persons do not have detectable SARS-CoV-2 RNA in upper respiratory tract specimens. However, viral RNA can be persistently detected by reverse transcription polymerase chain reaction (RT-PCR) in respiratory tract samples in some persons after apparent clinical recovery.  In some persons, after testing negative by RT-PCR in two consecutive samples, later samples can test positive again. These persistent detections of viral RNA usually are associated with higher cycle threshold (Ct) values (i.e., fewer RNA copies) than Ct values found in RT-PCR results from samples collected shortly before or during clinical illness. Studies that have examined how long SARS-CoV-2 RNA can be detected in adults have demonstrated that, in some persons, it can be detected for weeks.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: Are clinically recovered persons infectiouso to others if they test persistently or recurrently positive for SARS-CoV-2 RNA?
Answer: Whether the presence of detectable but low concentrations of viral RNA after clinical recovery represents the presence of potentially infectious virus is unknown. Based on experience with other viruses, it is unlikely that such persons pose an important infectious risk to others. However, whether this is true for SARS-CoV-2 infection has not been definitively established. After the onset of illness, the detectable viral burden usually declines. After a week or more, anti-SARS-CoV-2 immunoglobulin becomes detectable and then antibody levels increase. Some of these antibodies may prevent the virus from infecting cells in cell culture. A decline in viral RNA is associated with a decreased ability to isolate live virus. For most patients with COVID-19, efforts to isolate live virus from upper respiratory tract specimens have been unsuccessful when specimens are collected more than 10 days after illness onset. Recovery of live virus between 10 and 20 days after symptom onset has been documented in some persons with severe COVID-19; in some cases, these persons were in an immunocompromised state. Persons who have tested persistently or recurrently positive for SARS-CoV-2 RNA have, in some cases, had their signs and symptoms of COVID-19 improve. When viral isolation in tissue culture has been attempted in such persons in South Korea and the United States, live virus has not been isolated. There is no evidence to date that clinically recovered persons with persistent or recurrent detection of viral RNA have transmitted SARS-CoV-2 to others. Despite these observations, it’s not possible to conclude that all persons with persistent or recurrent detection of SARS-CoV-2 RNA are no longer infectious. There is no firm evidence that the antibodies that develop in response to SARS-CoV-2 infection are protective. If these antibodies are protective, it’s not known what antibody levels are needed to  protect against reinfection. These data and experience with other viral respiratory infections indicate that most persons recovered from COVID-19 who test persistently or recurrently positive by RT-PCR are likely no longer infectious. Isolation and precautions may be discontinued for persons with COVID-19  10 days after symptom onset (the date on which symptoms first began, including non-respiratory symptoms), provided their fever has resolved for at least 24 hours, without the use of fever-reducing medications, and their other symptoms have improved. For some persons with severe or critical illness, or who are severely immunocompromised, isolation and precautions may be maintained for up to 20 days after symptom onset.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: Can cycle threshold (Ct) values be used to assess when a person is no longer infectious?
Answer: No. Although attempts to culture virus from upper respiratory specimens have been largely unsuccessful when Ct values are in high but detectable ranges, Ct values are not a quantitative measure of viral burden. In addition, Ct values are not standardized by RT-PCR platform nor have they been approved by FDA for use in clinical management. CDC does not endorse or recommend use of Ct values to assess when a person is no longer infectious. However, serial Ct values may be useful in the context of the entire body of information available when assessing recovery and resolution of infection.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: What further evidence is needed to be reassured that persistent or recurrent shedding of SARS-CoV-2 RNA after recovery does not represent the presence of infectious virus?
Answer: Prospectively collecting serial respiratory samples and attempting to isolate live virus in tissue culture from multiple persons testing positive by RT-PCR following illness recovery is needed. If repeated attempts to recover replication-competent virus in culture from such serial samples are unsuccessful, that data would be sufficient evidence that infectious virus is absent. Then we would be sure that persons continuing to test positive do not pose an infectious risk to others.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: Can viral culture be used to demonstrate that a person who had persistently or recurrently detectable viral RNA is not infectious to others?
Answer: Yes. However, viral culture is not widely performed for SARS-CoV-2. It must be conducted in Biosafety Level 3 (BSL-3) laboratories using BSL-3 practices by experienced virologists and culture results can take a week or more. Therefore, while persons whose specimens do not yield live virus are considered no longer infectious, the complexity of such testing and the time required to complete it mean that culture cannot be used routinely to guide management of infected persons.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: A person who previously tested positive by RT-PCR for SARS-CoV-2 and clinically recovered from COVID-19 is later tested again, for example, as part of a contract tracing investigation. If that person again tests positive by RT-PCR, should they be managed as potentially infectious to others, and isolated again for COVID-19?
Answer: For persons who remain asymptomatic following recovery from COVID-19, retesting (e.g., as part of a contact tracing investigation) is not necessary during the first 3 months after the date of symptom onset. When a positive test occurs less than 3 months after the person’s symptom onset of their most recent illness, it is possible that the positive test represents a new infection or a persistently positive test associated with the previous infection. If a positive test occurs more than 3 months after a person’s symptom onset, clinicians and public health authorities should consider the possibility of reinfection. Until we have more information, the determination of whether a patient with a positive test in these situations is contagious to others should be made on a case-by-case basis. Consider consultation with infectious diseases specialists and public health authorities to review all available information (e.g., medical history, time from initial positive test, RT-PCR Ct values, and presence of COVID-19 signs or symptoms).  Persons who are determined to be potentially infectious should undergo evaluation and remain isolated until they again meet criteria for discontinuation of isolation or discontinuation of transmission-based precautions, depending on their circumstances.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: If a previously infected person has clinically recovered but later experiences symptoms consistent with COVID-19, should the person be isolated again and tested for SARS-CoV-2?
Answer: If a previously infected person experiences new symptoms consistent with COVID-19 3 months or more after the date of the previous illness onset (or date of last positive viral diagnostic test [RT-PCR or antigen test] if the person never experienced symptoms), the person should undergo repeat viral diagnostic testing. However, serologic testing should not be used to establish the presence or absence of SARS-COV-2 infection or reinfection. These people who have a positive test result should be considered infectious and remain isolated until they again meet criteria for discontinuation of isolation or of transmission-based precautions. Contact tracing during the person’s second episode of symptoms is warranted. For persons who have recovered from laboratory-confirmed SARS-CoV-2 infection and who experience new symptoms consistent with COVID-19 within 3 months since the date of symptom onset of the previous illness episode (or date of last positive viral diagnostic test if the person never experienced symptoms), repeating viral diagnostic testing may be warranted if alternative etiologies for the illness cannot be identified. If reinfection is suspected and retesting is undertaken, the person should follow isolation recommendations for cases of COVID-19 pending clinical evaluation and testing results. Results of repeat testing should also be interpreted in consultation with an infectious disease specialist with consideration of cycle threshold values (if available) and clinical presentations. The determination of whether a patient with a subsequently positive test is contagious to others should be made on a case-by-case basis, in consultation with infectious diseases specialists and/or public health authorities, after review of available information (e.g., medical history, time from initial positive test, RT-PCR Ct values, and presence of COVID-19 signs or symptoms). Note: Serologic testing should not be used to establish the presence or absence of SARS-CoV-2 infection or reinfection.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: If an infected person has clinically recovered and then later is identified as a contact of another person with COVID-19, do they need to be quarantined?
Answer: If a person has clinically recovered from SARS-CoV-2 infection and is then identified as a contact of a new case 3 months or more after the date of symptom onset of their previous illness episode (or date of positive viral diagnostic test [RT-PCR or antigen test] if the person never experienced symptoms), then they should follow general quarantine recommendations for contacts and undergo repeat viral diagnostic testing. The following applies to a person who has clinically recovered from  SARS-CoV-2 infection that was confirmed with a viral diagnostic test and then, within 3 months since the date of symptom onset of the previous illness episode (or date of positive viral diagnostic test if the person never experienced symptoms), is identified as a contact of a new case.  If the person remains asymptomatic since the new exposure, then they do not need to be retested for SARS-CoV-2 and do not need to be quarantined. However, if the person experiences new symptoms consistent with COVID-19 and an evaluation fails to identify a diagnosis other than SARS-CoV-2 infection (e.g., influenza), then repeat viral diagnostic testing may be warranted, in consultation with an infectious disease specialist and public health authorities for isolation guidance.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: If an infected person has clinically recovered using the symptom-based strategy, do they need a test to show they are not infectious?
Answer: No. The symptom-based strategy is intended to replace the need for repeated testing.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: If an infected person has clinically recovered, should the person continue to wear a cloth face covering in public?
Answer: Yes. It is recommended that all persons, with a few exceptions, wear cloth face coverings in public.1 The primary purpose of cloth face coverings is to limit transmission of SARS-CoV-2 from infected persons who may be infectious but do not have clinical symptoms of illness or may have early or mild symptoms that they do not recognize. Cloth face coverings may provide reassurance to others in public settings and be a reminder of the need to maintain social distancing. However, cloth face coverings are not personal protective equipment (PPE) and should not be used instead of a respirator or a facemask to protect a healthcare worker. [1] Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.
Category: Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection
Question: What should I do if I suspect a potential case of reinfection?
Answer: Although current understanding of reinfection remains limited, CDC is working with its partners to characterize the clinical features, transmissibility, and immunological profile around reinfection with SARS-CoV-2. Therefore, the guidance remains the same to reinfections as to primary infection with SARS-CoV-2. To further our shared understanding of reinfection, CDC has released the Investigative Criteria for Suspected Cases of SARS-CoV-2 Reinfection as well as the Common Investigation Protocol for Investigating Suspected SARS-CoV-2 Reinfection. This protocol is to support public health investigations conducted by interested institutions and jurisdictions. Clinicians with available specimens for suspected cases of reinfection meeting the above investigative criteria are also invited to contact CDC at eocevent461@cdc.gov after consulting with their local health department to pursue investigations with CDC support.
Category: Drugs and Investigational Therapies
Question: Are empiric antibiotics recommended for patients suspected of having COVID-19?
Answer: Several patients with COVID-19 have been reported to present with concurrent community-acquired bacterial pneumonia. Decisions to administer antibiotics to COVID-19 patients should be based on the likelihood of bacterial infection (community-acquired or hospital-acquired), illness severity, and antimicrobial stewardship issues. For more information, see Diagnosis and Treatment of Adults with Community-acquired Pneumonia: An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of Americaexternal icon.
Category: Drugs and Investigational Therapies
Question: What antiviral drugs are available to treat COVID-19?
Answer: The National Institutes of Health (NIH) has published guidelines on testing and management of patients with COVID-19. For more information, please visit the NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. The recommendations are based on scientific evidence and expert opinion and are regularly updated as more data become available. Current clinical management of COVID-19 includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support when indicated. The U.S. Food and Drug Administration (FDA) has approved one drug, remdesivir (Veklury), for the treatment of COVID-19 in certain situations. Persons seeking information about registered clinical trials for COVID-19 in the United States can search for such information here: ClinicalTrials.gov. For more information on investigational therapies, see Therapeutic Options for Patients with COVID-19.​
Category: Drugs and Investigational Therapies
Question: Do nonsteroidal anti-inflammatory drugs (NSAIDs) worsen the course of disease for people with COVID-19?
Answer: CDC is currently not aware of scientific evidence establishing a link between NSAIDs (e.g., ibuprofen, naproxen) and worsening of COVID‑19. FDAexternal icon, the European Medicines Agency, the World Health Organization, and CDC are continuing to monitor the situation and will review new information on the effects of NSAIDs and COVID-19 disease as it becomes available. For those who wish to use treatment options other than NSAIDs, there are other over-the-counter and prescription medications approved for pain relief and fever reduction. Patients who rely on NSAIDs to treat chronic conditions and have additional questions should speak to their healthcare provider for individualized management. Patients should use NSAIDs, and all medications, according to the product labels and advice of their healthcare professional.
Category: Patients with Asthma
Question: If I have patients with asthma, do I need to make any changes to their daily asthma preventive management regimens to reduce their risk of getting sick with COVID-19?
Answer: People with moderate to severe asthma, particularly if not well controlled, might be at higher risk of getting very sick from COVID-19. Based on what we currently know about COVID-19, the selection of therapeutic options through guideline-recommended treatment of asthma has not been affected. National asthma guidelines are available. Continuation of inhaled corticosteroids is particularly important for patients already using these medications because there is no evidence of increased risk of COVID-19 morbidity with use of inhaled corticosteroids and an abundance of data showing reduced risk of asthma exacerbation with maintenance of asthma controller therapy. Patients with asthma but without symptoms or a diagnosis of COVID-19 should continue any required nebulizer treatments.