Last updated on October 14th, 2024 at 09:46 am
Symptoms of COVID-19
Note these can be symptoms of flu as well as other common respiratory infections.
- new onset continuous cough
- high temperature, fever or chills
- loss of, or change in, normal sense of taste or smell
- shortness of breath
- unexplained tiredness, lack of energy
- muscle aches or pains that are not due to exercise
- loss of appetite
- headache that is unusual or longer lasting than usual
- sore throat
- a blocked or runny nose
- diarrhoea
- feeling sick or being sick
Emergency admissions
Patients with symptoms/signs of COVID-19/flu/respiratory viral illness:
If a patient has clinical features of COVID-19 on admission or develops these after admission, do the following immediately:
- Isolate patient in a single room with respiratory precautions (if no side room is available, patient can be cared for in a bay).
- Minimise number of staff entering the room.
- Wear the appropriate PPE: Click here to see a summary of PPE to be worn
- Send samples for PCR testing, in addition to usual investigations appropriate to the patient’s clinical condition, as per GOV.UK guidance. COVID-19 test can be requested on CareFlow (under the test name COVID-19 Novel Coronavirus PCR and on the ‘Test required’ drop down, select ‘SYMPTOMATIC patient test [COVIDS]’.
When prevalence of other respiratory viruses is high (e.g. during the winter season), extended PCR testing for influenza A/B and RSV (respiratory syncytial virus) in addition to SARS CoV-2/COVID-19 for patients with symptoms of COVID-19/influenza will be carried out automatically by the laboratory for patients with symptoms of COVID-19. During low prevalence of influenza/RSV symptomatic patients will be tested for SARS CoV2/COVID-19 only with the exception of ICU and haematology patients who will still be tested automatically for an extended virus panel and children aged ≤5 years who will also be tested automatically for RSV. If testing for additional respiratory viruses is clinically indicated on any other patients, please discuss with the Microbiology Laboratory on extension 1837 on a case by case basis.
Testing of asymptomatic patients for COVID-19:
There is no longer a requirement to test all asymptomatic patients requiring inpatient admission (i.e. at least admission overnight) for COVID-19 except for the following groups of patients who must still be tested for COVID-19 on admission even if they are asymptomatic:
All inpatient admissions to wards 2A, 4D and 4E on admission to those wards (patient do not need to await a COVID result before being admitted into these areas) – for these patients, even if the patient does not have any symptoms of COVID-19 detailed above, send samples for COVID-19 testing, in addition to usual investigations appropriate to the patient’s clinical condition.
The test must be carried out without delay at the point where decision to admit is made.
For asymptomatic patients, a COVID-19 test can be requested on CareFlow (under test name COVID-19 Novel Coronavirus PCR and on the ‘Test required’ drop down, select ‘Asymptomatic admission screen [COVA]’).
Patients who are tested on admission but do not have clinical features of COVID-19 do NOT need isolation in side rooms (unless they also have another reason to require this e.g. another infectious disease requiring isolation precautions or infection alert such as MRSA/VRE/CPE).
Elective admissions (including Day Surgery admissions and other elective attendances)
Testing of asymptomatic patients for COVID-19 prior to elective admission is no longer recommended.
Repeat testing of patients after admission
There is no longer a need for patients to be routinely tested repeatedly for COVID-19 after admission unless they fulfil one of the criteria for testing stated above, as a part of outbreak screening advised by the Infection Prevention Team or for the purposes of discharge to a care home.
Discharges
All asymptomatic patients being discharged to a care home, hospice and, in some situations, when a patient is being discharged with a package of care (essentially if the care providers request it) should be tested up to 48 hours prior to discharge using LFD (not PCR) arranged via the Discharge Co-ordinator. Please see the discharge pathways for further details. Patients with symptoms must still be tested using PCR.
Requesting COVID-19 Tests
SARS-CoV-2/COVID-19, Flu and RSV Testing
From Monday 14th October 2024, for the winter/influenza season, the laboratory will be providing PCR testing for influenza A/B and RSV (respiratory syncytial virus) in addition to SARS CoV-2/COVID-19 for patients with symptoms of COVID-19/influenza/respiratory viral illness.
The tests done will be determined by clinical details provided on the request form hence it is important that the correct details are selected on CareFlow under COVID-19 Novel Coronavirus PCR:
- For patients with symptoms/clinical features of respiratory viral infection – select ‘SYMPTOMATIC patient test [COVIDS]’ on the CareFlow dropdown menu.
- For patients with no clinical features/symptoms of respiratory viral infection – select the other appropriate option from the CareFlow drop down menu as below.
| Indication | Careflow drop down option | Flu/RSV test included | Rapid test |
| Any patient (new admission or existing inpatient) with clinical features of COVID-19/flu/respiratory viral illness | SYMPTOMATIC patient test COVIDS | Yes | No |
| Screening of all asymptomatic patients on admission to wards 2A/4D or 4E | Asymptomatic admission screen COVA | No | No |
| For testing previously COVID-19 positive severely immunocompromised inpatients or inpatients who have received ICU care during the current admission prior to stepping down infection prevention precautions | Clearance swab COVIDX | No | No |
All hand written requests must clearly state the following:
- THREE patient identifiers on form and sample.
- Clinical details i.e. COVIDS if symptomatic or if asymptomatic, COVA, to ensure the correct tests are performed.
- Date and time of sample collection.
Routine test results will be available within 24 hours from receipt in laboratory.
Urgent test results will be available within 2 – 4 hours from receipt in laboratory.
There is only a limited availability of rapid/urgent tests for COVID-19. Extremely exceptional requests (i.e. where the result will make an immediate and significant difference to patient management compared with routine non-rapid testing of which results are available within 24 hours), must be discussed on a case by case basis with the laboratory: please contact the laboratory and provide name, DOB and reason for requiring an urgent test. The laboratory telephone numbers can be found towards the end of the page.
Sample Transport
Samples MUST be transported to the laboratory as soon as possible. Ideally within 15 minutes. Please use the POD: 444 or 555.
Note: urgent samples must be hand delivered to specimen reception and staff should be notified this is an urgent sample.
Results
All results can be viewed on CareFlow and the COVID-19 dashboard.
Note that for symptomatic patients, where tested, results of all 3 tests (i.e. SARS CoV-2, flu A/B and RSV) will be reported under a single investigation ‘COVID-19 Novel Coronavirus PCR’ on CareFlow rather than separately.
The laboratory will NO longer telephone positive influenza A, B or RSV results to the requesting location. It is the responsibility of the clinical teams to view the results on CareFlow and action as appropriate.
COVID-19, influenza A, B and RSV result turnaround times are as follows:
- Accident and Emergency – within 4 hours.
- All other departments – within 24 hours.
If the results are not available on CareFlow after the time above, please telephone the laboratory on 0151 430 1837/1830 (available 24/7).
Laboratory Contact Information
Microbiology
0151 430 1652 / 1837
Open 24/7
Please note guidance related to COVID-19 is updated regularly hence always refer to the most up to date version of the guidance online at https://covid.sthk.nhs.uk/