Coronavirus Diagnostic Criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]


Diagnosis of coronaviruses causing infection in humans is based on combination of clinical and epidemiological criteria. Close contact with infected individuals, travel to endemic area and detection of viral RNA in the patient's serum are the most important criteria for confirmation of diagnosis.

Diagnostic Criteria


Patients in the United States who meet the following criteria should be evaluated as in association with the outbreak of 2019-nCoV in Wuhan City, China.

Clinical Features & Epidemiologic Risk
Fever and symptoms of lower respiratory illness (e.g., cough, difficulty breathing) and In the last 14 days before symptom onset, a history of travel from Wuhan City, China.

– or –

In the last 14 days before symptom onset, close contact2 with a person who is under investigation for 2019-nCoV while that person was ill.

Fever or symptoms of lower respiratory illness (e.g., cough, difficulty breathing) and In the last 14 days, close contact2 with an ill laboratory-confirmed 2019-nCoV patient.


Criteria for diagnosis of MERS-CoV RNA: a positive result for at least one of the following:

  • Positivity for at least two MERS-CoV-specific gene targets (upE, ORF1a, ORF1b, N) by real-time RT-PCR (recommended)
  • Positivity on RT-PCR result for at least one MERS-CoV-specific gene target [ORF1b (RdRp), N], AND confirmation by base sequence analysis of the PCR product
  • Diagnosis by serological tests: a) Seroconversion using two serum specimens collected at an interval of at least 14 days b) The screening test with ELISA or IFA, and the confirmatory neutralization test


Cinical Criteria Laboratory Criteria Epidemiological Criteria
Fever > 38C and respiratory illness Antibody to SARS-CoV ( > 28 days or acute) Travel history (10 days) to SARS endemic area
Radiological findings Detection of SARS-CoV RNA by RT-PCR and confirmation by PCR assay Close contact with SARS infected patient
Autopsy findings Isolation of virus