Table 3.
The diagnosis criteria of suspected and confirmed cases with COVID-2019 published by NHC of PRC
| Trial edition (publication date) | Epidemiological history | Clinical manifestations | Suspected case | Confirmed case |
|---|---|---|---|---|
| First (January 16, 2020) | Within 2 weeks before the disease onset, there is a travel history or a direct/indirect contact history with markets in Wuhan, especially a market of farm produce |
(1) Fever (2) Radiographic evidence of pneumonia (3) Low or normal leukocyte count or low lymphocyte count during the early stage of disease (4) No improvement or worsening symptoms after 3–5 days of antimicrobial treatment per standard clinical guidelines |
Anyone who satisfies the epidemiological history and clinical manifestations can be diagnosed as a suspected case | The suspected case whose gene highly homologous to the known new coronavirus by whole-genome sequencing of the virus in respiratory specimens (sputum or throat swabs) is considered a confirmed case |
| Second (January 18, 2020) |
(1) Within 2 weeks before the disease onset, there is a travel history or living history in Wuhan (2) Within 2 weeks before the disease onset, there is a contact history with patients who had fever or respiratory symptoms from Wuhan (3) Clustering occurrence of cases |
(1) (2) (3) Same as above. Delete (4) |
Same as above |
The suspected case with one of the following evidences is reclassified as a confirmed case: (1) Positive results of nucleic acids of the new coronavirus by RT-PCR in respiratory specimens, such as sputum, throat swabs, and lower respiratory tract secretions (2) The viral gene sequence is highly homologous to the known new coronavirus |
| Third (January 22, 2020) | Same as above | Same as above | Same as above | Same as above |
| Fourth (January 27, 2020) |
(1) Within 2 weeks before the disease onset, there is a travel history or living history in Wuhan or other areas with local cases (2) Within 2 weeks before the disease onset, there is a contact history with patients who had fever or respiratory symptoms from Wuhan or other areas with local cases (3) Clustering occurrence of cases or epidemiologically associated with patients with new coronavirus pneumonia |
Same as above | Supplement: anyone with a positive epidemiological history and any 2 of the clinical manifestations is considered a suspected case | Add: blood specimens added to the RT-PCR or viral gene sequence test |
| Fifth (February 4, 2020) |
(1) Within 14 days before the disease onset, there is a travel history or living history in Wuhan and its surrounding areas or other communities with cases reported (2) Within 14 days before the disease onset, there is a contact history with patients with a positive result of the nucleic acid test of the new coronavirus (3) Within 14 days before the disease onset, there is a contact history with patients who had fever or respiratory symptoms from Wuhan and its surrounding areas or other communities with cases reported (4) Clustering occurrence of cases |
Supplement: (1) fever and/or respiratory symptoms; (2) (3) same as above |
Supplement: anyone with a positive epidemiological history and any 2 of the clinical manifestations or anyone without definite epidemiological history but with all the clinical manifestations is considered a suspected case Add: (2) in Hubei Province, anyone with/without an epidemiological history as well as with 2 clinical manifestations: “fever and/or respiratory symptoms, and low or normal leukocyte count or low lymphocyte count during the early stage of disease” can be considered a suspected case |
The confirmed cases’ diagnosis criteria are the same as above. Add: [2] In Hubei Province, suspected cases with imaging characteristics of pneumonia can be considered clinically diagnosed cases. |
| Sixth (February 18, 2020) | Same as above | Same as above | Delete: the diagnosis criteria of suspected case in Hubei Province | Delete: the diagnosis criteria of clinical diagnosis cases in Hubei Province |
| Seventh (March 3, 2020) |
(1) (2) (3) Same as above Supplement: (4) clustering occurrence of cases (within 2 weeks, 2 or more cases of fever and/or respiratory symptoms occurred in small areas such as homes, offices, and school classes) |
Same as above | Same as above |
(1) (2) same as above Add: (3) serum new coronavirus-specific IgM and IgG antibodies are positive; serum new coronavirus-specific IgG antibodies change from negative to positive or the IgG antibodies in the recovery period are 4 times or higher than in the acute period |
NHC National Health Commission, PRC People’s Republic of China