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Clinical criteria for COVID-19
Common symptoms of COVID-19 are similar to those found with colds or influenza. A person may have one or more of the following common symptoms
- new or worsening cough
- sneezing and runny nose
- temporary loss of smell or altered sense of taste
- sore throat
- shortness of breath
- fatigue/feeling of tiredness.
Less common symptoms of COVID-19 may include diarrhoea, headache, muscle aches, nausea, vomiting, malaise, chest pain, abdominal pain, joint pain, or confusion/irritability. These almost always occur with one or more of the common symptoms.
Symptoms tend to arise around two to five days after a person has been infected but can take longer to show. The virus can be passed to others before they know they have it-from up to two days before symptoms develop,
Other conditions that require urgent assessment and management should always be considered as possible diagnoses alongside COVID-19.
A case that has laboratory definitive evidence.
Laboratory definitive evidence requires at least one of the following:
- detection of SARS-CoV-2 from a clinical specimen using a validated NAAT (PCR). Very weak positive results will only be labelled a confirmed case when the result is confirmed on a second sample.
- detection of coronavirus from a clinical specimen using pan-coronavirus NAAT (PCR) and confirmation as SARS-CoV-2 by sequencing
- significant rise in IgG antibody level to SARS-CoV-2 between paired sera.
- detection of SARS-CoV-2 from a clinical specimen using a validated laboratory multi-target NAAT (PCR) OR a validated single target point of care NAAT (PCR) test.
- A close contact of a confirmed case that has a high exposure history, meets the clinical criteria and for whom testing cannot be performed, or
- A close contact of a confirmed case that has a high exposure history, meets the clinical criteria, and has a negative PCR result but it has been more than 7 days since symptom onset before their first negative PCR test was taken.
- An individual with a positive result from a clinical specimen using a certified rapid antigen test (RAT), either supervised or self-tested who
- Has symptoms consistent with COVID-19 OR
- Is a close contact of a confirmed or positive case OR
- Is asymptomatic (in phase 3 only)
A confirmed case that is deemed to have recovered (no longer considered infectious) at the time of testing or a person with a positive NAAT(PCR) result with a high CT value, which is followed by a negative rapid antigen test (RAT).
Under investigation case
A case that has been notified where information is not yet available to classify it as confirmed, probable or not a case.
Not a case
An ‘under investigation’ case who:
- has a negative test and has been assessed as not a case;
- a person where SARS-CoV-2 has been detected, where the detection is determined to be due to a previous COVID-19 infection which has already been recorded either in New Zealand or overseas within the previous 28 days from release.
- a person who has detection of SARS-CoV-2 from a clinical specimen but, following further investigations such as serology, repeat testing, history, and symptoms, they are deemed to not be a case (eg, a likely false positive).
Guidance on testing
The COVID-19 Testing Plan for Aotearoa/New Zealand sets out how testing will support our COVID-19 response. The COVID-19 Testing Guidance provides testing advice to health care professionals.
With regards to testing in long Covid, current guidelines do not support any specific testing at this stage.
Taking a clinical specimen for COVID-19 and appropriate personal personal protective equipment (PPE) use
For guidance on how to take nasopharyngeal, and oropharyngeal + anterior nasal specimens for COVID-19, and the correct PPE to use see COVID-19: Infection prevention and control recommendations for health and disability care workers.
Information on rapid antigen testing below:
Notification of cases
Most people will upload their RAT results via My Covid Record. Attending medical practitioners should ensure that supervised RAT results are also uploaded. A GP can notify a positive RAT test via their Patient Management System (PMS), via My Covid Record or through the 0800 number. PCR results will be uploaded via Eclair.
Guidance on managing cases and contacts
This guidance for health practitioners provides information for assessing and managing COVID-19 cases and contacts
Guidance on long COVID
Most people who get COVID-19 recover fully, but some may go on to develop longer term symptoms from the virus. This is known as long COVID, or for recording purposes is described as:
- Ongoing symptomatic COVID-19: Signs and symptoms of COVID‑19 from 4 weeks up to 12 weeks
- Post-COVID-19 syndrome: Signs and symptoms that develop during or after an infection consistent with COVID‑19, continue for more than 12 weeks and are not explained by an alternative diagnosis.
A guideline for clinical rehabilitation for people with long COVID provides an evidence-based summary that describes a current understanding of post COVID symptoms.
Along with the full guideline there is a summary of the resources available for individuals and clinicians, and a symptom map to assist with clinical assessment of individuals presenting with long COVID symptoms.