mteb/FeedbackQARetrieval huggingface dataset:
Clinical Questions about COVID-19: Questions and Answers
Obstetrical Care
How should the use of N95 respirators be prioritized within obstetric healthcare settings during shortages?
During respirator shortages, care should be taken to ensure that N95
respirators are reserved for situations where respiratory protection is most
important, such as performance of aerosol-generating procedures on patients
with suspected or confirmed COVID-19 infection. In such shortage situations,
facemasks might be used for other types of patient care.
Alternatives to N95 respirators might be considered where feasible. These
include other classes of NIOSH-approved filtering facepiece respirators, half
facepiece or full facepiece elastomeric respirators, and powered air-purifying
respirators (PAPRs) where feasible. All of these alternatives will provide
equivalent or higher protection than N95 respirators when properly worn.
However, PAPRs and elastomeric respirators should not be used in surgical
settings due to concerns that exhaled air may contaminate the sterile field.
For more information please see: Strategies for Optimizing the Supply of N95
Respirators: Conventional Capacity
Strategies.
When respirator supplies are restored, the facility can switch back to use of
N95 respirators for all care of patients with known or suspected COVID-19
infection. For more information, please see Interim Infection Prevention and
Control Recommendations for Patients with Suspected or Confirmed Coronavirus
Disease 2019 (COVID-19) in Healthcare
Settings.
Clinical Questions about COVID-19: Questions and Answers
Testing, Diagnosis, and Notification
How do you diagnose and report a potential case of multisystem inflammatory syndrome in children (MIS-C)?
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.external
icon 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 the CDC Health Alert
Network. For guidance for
pediatric healthcare providers, visit Information for Pediatric Healthcare
Providers.
Clinical Questions about COVID-19: Questions and Answers
Patients with Liver Disease
Should vaccination of HBV-exposed infants continue during the COVID-19 pandemic?
Yes. Hepatitis B vaccination of all infants, especially those exposed to
hepatitis B virus, should occur according to the Advisory Committee on
Immunization Practices (ACIP) recommendations.
Labor and Delivery Care

Identify HBsAg status of all women presenting for delivery.
If a woman’s HBsAg status is positive, HBIG and single antigen hepatitis B vaccine should be administered to her infant within 12 hours of birth.
If a woman’s HBsAg status is unknown, single antigen hepatitis B vaccine should be administered to her infant within 12 hours of birth. Administration of HBIG should be determined per ACIP recommendations (see https://www.cdc.gov/mmwr/volumes/67/rr/rr6701a1.htm). Infants weighing <2,000 grams should receive HBIG if the mother’s HBsAg status cannot be determined within 12 hours of birth.
Provide the birth dose of hepatitis B vaccine to all other newborns within 24 hours of birth to prevent horizontal hepatitis B virus transmission from household or other close contacts.
Clinical Questions about COVID-19: Questions and Answers
Waste Management
What do waste management companies need to know about wastewater and sewage coming from a healthcare facility or community setting with either a known COVID-19 patient or person under investigation (PUI)?
Waste generated in the care of PUIs or patients with confirmed COVID-19 does
not present additional considerations for wastewater disinfection in the
United States. Coronaviruses are susceptible to the same disinfection
conditions in community and healthcare settings as other viruses, so current
disinfection conditions in wastewater treatment facilities are expected to be
sufficient. This includes conditions for practices such as oxidation with
hypochlorite (i.e., chlorine bleach) and peracetic acid, as well as
inactivation using UV irradiation.
Clinical Questions about COVID-19: Questions and Answers
COVID-19 Risk
Who is at risk for severe disease from COVID-19?
The available data are currently insufficient to clearly identify risk factors
for severe clinical outcomes. Based on limited data that are available for
COVID-19 patients, and data from related coronaviruses such as severe acute
respiratory syndrome coronavirus (SARS-CoV) and MERS-CoV, people who may be at
risk for more severe outcomes include older adults and persons who have
certain underlying chronic medical
conditions. Those
underlying chronic conditions include chronic lung disease, moderate to severe
asthma, cardiac disease with complications, diabetes, or immunocompromising
conditions. See also Interim Clinical Guidance for Management of Patients
with Confirmed Coronavirus Disease 2019
(COVID-19) and Information for Healthcare Professionals: COVID-19 and
Underlying Conditions.
Clinical Questions about COVID-19: Questions and Answers
Patients with Asthma
Are any changes recommended to the asthma treatment plan if my patient with asthma has COVID-19?
Patients can be referred to CDC’s recommendations for caring for themselves
or someone else at home sick with COVID-19.
If nebulizer use at home is necessary for patients with asthma who have
symptoms or a diagnosis of COVID-19, use of the nebulizer in a location that
minimizes and preferably avoids exposure to any other members of the
household, and preferably a location where air is not recirculated into the
home (like a porch, patio, or garage) is recommended by national professional
organizations, including the American College of Allergy, Asthma & Immunology
(ACAAI) by the ACAAI and the Allergy & Asthma Network (AAN). Limiting the
number of people in the room or location where the nebulizer is used is also
recommended by the Asthma & Allergy Foundation of America (AAFA). Nebulizers
should be used and cleaned according to the manufacturer’s instructions.
If nebulizer use in a healthcare setting is necessary for patients who have
either symptoms or a diagnosis of COVID-19, use CDC’s recommended precautions
when performing aerosol-generating procedures
(AGPs).
Clinical Questions about COVID-19: Questions and Answers
Transmission
Can people who recover from COVID-19 be re-infected with SARS-CoV-2?
The immune response, including duration of immunity, to SARS-CoV-2 infection
is not yet understood. Patients with MERS-CoV are unlikely to be re-infected
shortly after they recover, but it is not yet known whether similar immune
protection will be observed for patients with COVID-19.
Clinical Questions about COVID-19: Questions and Answers
Obstetrical Care
Is use of high-flow oxygen considered an aerosol-generating procedure for respirator prioritization during shortages?
Based on limited data, high-flow oxygen use is not considered an aerosol-
generating procedure for respirator prioritization during shortages over
procedures more likely to generate higher concentrations of infectious
respiratory aerosols (such as bronchoscopy, intubation, and open suctioning).
Patients with known or suspected COVID-19 should receive any interventions
they would normally receive as standard of care. When respirator supplies are
restored, as with all clinical care activities for patients with known or
suspected COVID-19, respirators (or facemasks if a respirator is not
available), eye protection, gloves, and gowns should be used by HCP for the
care of pregnant patients with known or suspected COVID-19. For more
information please see: Healthcare Infection Prevention and Control
FAQs
Clinical Questions about COVID-19: Questions and Answers
COVID-19 Risk
Are there work restrictions recommended for HCP with underlying health conditions who may care for COVID-19 patients? What about for pregnant HCP?
Adherence to recommended infection prevention and control practices is an
important part of protecting HCP and patients in healthcare settings. All HCP
who care for confirmed or suspected COVID-19 patients should adhere to
standard and transmission based
precautions.
To the extent feasible, healthcare facilities could consider prioritizing HCP
who are not at higher risk of developing severe illness from COVID-19 or who
are not pregnant to care for confirmed or suspected COVID-19 patients.
If staffing shortages make this challenging, facilities could consider
restricting HCP at higher risk for severe illness from COVID-19 or who are
pregnant from being present for higher risk procedures (e.g., aerosol-
generating procedures)
on COVID-19 patients. Find more information for facilities on mitigating HCP
staffing shortages.
HCP who are concerned about their individual risk for severe illness from
COVID-19 due to underlying medical conditions while caring for COVID-19
patients can discuss their concerns with their supervisor or occupational
health services.
People 65 years and older and people of all ages with serious underlying
health conditions — like serious heart conditions, chronic lung disease, and
diabetes — seem to be at higher risk of developing severe illness from
COVID-19.
Information on COVID-19 in pregnancy is limited. Pregnant women are not
currently considered at increased risk for severe illness from COVID-19.
However, pregnant women have had a higher risk of severe illness when infected
with viruses from the same family as COVID-19 and other viral respiratory
infections, such as influenza. Find more information on
pregnancy and risk for severe illness from COVID-19.
Clinical Questions about COVID-19: Questions and Answers
Treatment and Management
How are COVID-19 patients treated?
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.
Corticosteroids are not routinely recommended for treatment of viral
pneumonia or ARDS, due to the potential for prolonging viral replication, as
has been observed with MERS coronavirus and influenza. Corticosteroids should
be avoided unless they are indicated for another reason (e.g., COPD
exacerbation or refractory septic shock following the Surviving Sepsis
Campaign Guidelinesexternal iconexternal
icon).
For information on investigational therapies, see Therapeutic Options for
Patients with COVID-19.
Clinical Questions about COVID-19: Questions and Answers
Obstetrical Care
Should intrapartum fever be considered as a possible sign of COVID-19 infection?
Clinicians should use their judgment to determine if a patient has signs and
symptoms compatible with COVID-19 and whether the
patient should be tested. Fever is the most commonly reported sign; most
patients with confirmed COVID-19 have developed fever and/or symptoms of acute
respiratory illness (cough, difficulty breathing).
Data regarding COVID-19 in pregnancy are limited; according to current
information, presenting signs and symptoms are expected to be similar to those
for non-pregnant patients, including the presence of fever.
Other considerations that may guide testing are epidemiologic factors such as
the occurrence of local community transmission of COVID-19 infections. As part
of evaluation, clinicians are strongly encouraged to test for other causes of
respiratory illness and peripartum fever. For more information please see:
Evaluating and Testing Persons for Coronavirus Disease 2019
(COVID-19)
Clinical Questions about COVID-19: Questions and Answers
Obstetrical Care
Does CDC recommend use of facemasks or respirators for healthcare personnel (HCP) caring for pregnant patients with known or suspected COVID-19 infection?
When available, respirators (or facemasks if a respirator is not available),
eye protection, gloves, and gowns should be used for the care of patients with
known or suspected COVID-19 infection, including women who are pregnant. For
more information, please see Interim Infection Prevention and Control
Recommendations for Patients with Suspected or Confirmed Coronavirus Disease
2019 (COVID-19) in Healthcare Settings.
Clinical Questions about COVID-19: Questions and Answers
Patients with Asthma
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?
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 guidelinesexternal
icon 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.
Clinical Questions about COVID-19: Questions and Answers
Waste Management
Should medical waste or general waste from healthcare facilities treating PUIs and patients with confirmed COVID-19 be handled any differently or need any additional disinfection?
Medical waste (trash) coming from healthcare facilities treating COVID-2019
patients is no different than waste coming from facilities without COVID-19
patients. CDC’s guidance states that management of laundry, food service
utensils, and medical waste should be performed in accordance with routine
procedures. There is no evidence to suggest that facility waste needs any
additional disinfection.
More guidance about environmental infection control is available in section 7
of CDC’s Interim Infection Prevention and Control
Recommendations for Patients with Confirmed COVID-19 or Persons Under
Investigation for COVID-19 in Healthcare Settings.
Clinical Questions about COVID-19: Questions and Answers
Transmission
Which body fluids can spread infection?
SARS-CoV-2 RNA has been detected in upper and lower respiratory tract
specimens, and SARS-CoV-2 virus has been isolated from upper respiratory tract
specimens and bronchoalveolar lavage fluid. SARS-CoV-2 RNA has been detected
in blood and stool specimens, and SARS-CoV-2 virus has been isolated in cell
culture from the stool of some patients, including a patient with pneumonia 15
days after symptom onset. The duration of SARS-CoV-2 RNA detection in upper
and lower respiratory tract specimens and in extrapulmonary specimens is not
yet known but may be several weeks or longer. Duration of several week or
longer has been observed in cases of MERS-CoV or SARS-CoV infection. While
viable, infectious SARS-CoV has been isolated from respiratory, blood, urine,
and stool specimens, viable, infectious MERS-CoV has only been isolated from
respiratory tract specimens. It is not yet known whether other non-respiratory
body fluids from an infected person including vomit, urine, breast milk, or
semen can contain viable, infectious SARS-CoV-2.
Clinical Questions about COVID-19: Questions and Answers
Patients with Liver Disease
Should management of infants born to HBV-infected women continue during the COVID-19 pandemic?
Yes. Management should continue to prevent mother-to-child transmission of
hepatitis B.
Pediatric Care of HBV-exposed Infants

Make every effort to ensure HBV-exposed infants complete the hepatitis B vaccine series following the ACIP recommendations (see https://www.cdc.gov/mmwr/volumes/67/rr/rr6701a1.htm). Providers using single-component vaccine who are experiencing immunization service disruption should administer hepatitis B vaccine as close to the recommended intervals as possible, including series completion at 6 months, and follow ACIP recommendations for post-vaccination serologic testing.
If post-vaccination serologic testing is delayed beyond 6 months after the hepatitis B series is completed, consider administering a “booster” dose of single antigen hepatitis B vaccine and then ordering post-vaccination serologic testing (HBsAg & antibody to HBsAg [anti-HBs]) 1-2 months after the “booster” dose.
Clinical Questions about COVID-19: Questions and Answers
Drugs and Investigational Therapies
Are empiric antibiotics recommended for patients suspected of having COVID-19?
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 iconexternal
icon.
Clinical Questions about COVID-19: Questions and Answers
Patients with Hypertension
Are patients with hypertension at higher risk for severe illness from COVID-19?
Although many patients with severe illness from COVID-19 have underlying
hypertension, it is unclear at this time if hypertension is an independent
risk factor for severe illness from COVID-19. Hypertension is common in the
United States. Hypertension is more frequent with advancing age and among men,
non-Hispanic blacks, and people with other underlying medical conditions such
as obesity, diabetes, and serious heart disease. At this time, people whose
only underlying medical condition is hypertension are not considered to be at
higher risk for severe illness from COVID-19.
Clinical Questions about COVID-19: Questions and Answers
Patients with Asthma
If my patient experiences an asthma exacerbation, should the exacerbation be treated any differently to reduce risk of COVID-19?
Selection of therapeutic options through guideline-recommended treatment of
asthma exacerbations has not been affected by what we currently know about
COVID-19.
Systemic corticosteroids should be used to treat an asthma exacerbation per
national asthma guidelinesexternal icon and current standards of
care, even if it is caused by COVID-19. Short-term use of systemic
corticosteroids to treat asthma exacerbations should be continued. There is
currently no evidence to suggest that short-term use of systemic
corticosteroids to treat asthma exacerbations increases the risk of developing
severe COVID-19, whereas there is an abundance of data to support use of
systemic steroids for moderate or severe asthma exacerbations.
Patients with asthma but without symptoms or a diagnosis of COVID-19 should
continue any required nebulizer for treatments, as recommended by national
professional organizations, including the American Academy of Allergy, Asthma
& Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology
(ACAAI). If healthcare providers need to be present during nebulizer use among
patients who have either symptoms or a diagnosis of COVID-19, use CDC’s
recommended precautions when performing aerosol-generating procedures
(AGPs).
Clinicians may be concerned that an asthma exacerbation is related to an
underlying infection with COVID-19. Clinicians can access laboratory testing
for COVID-19 through a network of state and local public health laboratories
across the country. Lists of states and territories with
laboratories that are
using COVID-19 viral tests are available. For more information, see Testing
in U.S. Clinicians
should direct testing questions to their
state
and localexternal icon
health departments.
Clinical Questions about COVID-19: Questions and Answers
Treatment and Management
Do patients with confirmed or suspected COVID-19 need to be admitted to the hospital?
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 isolation
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).
Clinical Questions about COVID-19: Questions and Answers
COVID-19 Risk
What is multisystem inflammatory syndrome in children (MIS-C) and who is at risk?
CDC is investigating reports of multisystem inflammatory syndrome in children
(MIS-C) associated with COVID-19. 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. CDC is
collaborating with domestic and international partners to better understand
this new syndrome, including how common it is and its risk factors, and to
begin tracking cases. For more information including a full case definition,
visit the CDC Health Alert
Network. For additional
clinical guidance, visit Information for Pediatric Healthcare
Providers.
Clinical Questions about COVID-19: Questions and Answers
Patients with Liver Disease
During the COVID-19 pandemic, should high-risk populations continue to be vaccinated for hepatitis A in response to the ongoing hepatitis A outbreaks?
Yes. People susceptible to hepatitis A virus (HAV) infection during the
current hepatitis A outbreaks should receive the hepatitis A vaccine when
possible. This includes:

people who use drugs (injection or non-injection)
people experiencing unstable housing or homelessness
men who have sex with men (MSM)
people who are or were recently incarcerated
people with chronic liver disease (including cirrhosis, hepatitis B, or hepatitis C) and living or working in areas where the hepatitis A outbreaks are ongoing

Vaccination in settings such as jails, other correctional facilities, and
homeless shelters should continue if already previously planned and organized
in a way that would adhere to infection control practices and where relevant
social distancing standards can be maintained. However, efforts should be made
to vaccinate people in non-congregate settings that allow for social
distancing. Whenever possible, vaccination efforts in non-congregate settings
should continue for people at highest risk of acquiring HAV infection or
developing serious complications from HAV infection, if social distancing
standards can be maintained.