Hospital Discharge Related Questions
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Frequently Asked Inpatient Questions Microchapter |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]Gurmandeep Singh Sandhu,M.B.B.S.[3]
Hospital Discharge Related Questions
Can patients who are no longer symptomatic but still test positive for COVID-19 be discharged
- As long as a patient is stable and no longer symptomatic, they can be discharged.
- Based on data and experience with other viral infections, most persons recovered from COVID-19 who test persistently or recurrently positive by RT-PCR are likely no longer infectious. Additionally, the magnitude and persistence of the immune response following recovery may vary among individuals, with factors such as age potentially influencing protection.
- Based on limited available data, determinations must be made on a case-by-case basis as to whether recovered persons with persistently detectable SARS-CoV-2 RNA are potentially infectious to others and should continue to be in-home isolation and excluded from work, school, or other group settings. Such determinations are typically made in consultation with infectious disease specialists and public health officials, after reviewing available information (e.g., medical history, time from an initial positive test, RT-PCR Ct values, and presence of COVID-19 signs or symptoms).
If after discharge a patient shows new symptoms of COVID-19, should they be isolated and tested again?
- Yes, they should be isolated and retested.
- Persons who test positive for SARS-CoV-2 by RT-PCR come out of isolation after meeting the criteria for the symptom-based or test-based strategy.
- We do not know the degree to which previous COVID-19 illness protects against subsequent SARS-CoV-2 infection or for how long persons are protected.
- Currently, serologic testing cannot be used to determine if this person may be reinfected. A positive serologic test may be evidence of the prior infection, but it remains unknown to what degree persons with detectable anti-SARS-CoV-2 antibodies are immune to reinfection. Contact tracing for the second period of symptoms (new case investigation) may be warranted.
I recently recovered from COVID-19, can I donate convalescent plasma?
- COVID-19 convalescent plasma must only be collected from recovered individuals if they are eligible to donate blood.
- Individuals must have had a prior diagnosis of COVID-19 documented by a laboratory test and meet other laboratory criteria.
- Individuals must have fully recovered from COVID-19, with complete resolution of symptoms for at least 14 days before donation of convalescent plasma. You can ask your local blood center if there are options to donate convalescent plasma in your area.
If after discharge, close contacts of a patient test positive, should they self-isolate again?
- Yes, they should follow quarantine recommendations for contacts. We do not know to what degree or duration persons are protected against reinfection with SARS-CoV-2 following recovery from COVID illness.
- A positive serologic test may be evidence of prior infection, but it remains unknown whether persons with detectable anti-SARS-CoV-2 antibodies are immune to reinfection.
After discharge, should patients continue to wear a face mask?
- Yes. It is recommended that almost all persons 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.
- Fabric face coverings may also offer the wearer some protection against re-exposure to SARS-CoV-2, provide reassurance to others in public settings, and act as 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.
- Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.[1]
How soon after discharge can patients return to thier jobs?
- After discharge, patients can resume work as soon as they feel well enough to. They should adhere to strict social distancing, frequent hand washing, face-covering, and other recommended safety measures
Can discharged patients use public places and transportation?
- Patients can use public places and transportation. However, they should adhere strictly to recommended safety measures or guidelines.