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COVID-19 (Novel Coronavirus)

Clinicians should consult with their local Medical Health Officer with questions, concerns or for guidance related to cases suspected of COVID-19 infection.

Surveillance case definitions are intended for public health surveillance and reporting purposes and may not apply to clinical practice. 

Case definitions

Confirmed case

A person with confirmation of infection with SARS-CoV-2 documented by:

  • The detection of at least one specific gene target by a validated laboratory-based nucleic acid amplification test (NAAT) assay (e.g. real-time PCR or nucleic acid sequencing) performed at a community, hospital, or reference laboratory (the National Microbiology Laboratory or a provincial public health laboratory) 
OR
  • The detection of at least one specific gene target by a validated point-of-care (POC) nucleic acid amplification test (NAAT) that has been deemed acceptable to provide a final result (i.e. does not require confirmatory testing)

OR
  • Seroconversion or diagnostic rise (at least four-fold or greater from baseline) a in viral specific antibody titre in serum or plasma using a validated laboratory-based serological assay for SARS-CoV-2

Probable - lab case

A person who:

1.

  •  Has symptoms b compatible with COVID-19
  • Had a high-risk exposure with a confirmed COVID-19 case (i.e. close contact) OR was exposed to a known cluster or outbreak of COVID-19

AND

  • Has had a laboratory-based NAAT assay for SARS-CoV-2 and the result is inconclusive

OR

  • Had SARS-CoV-2 antibodies detected in a single serum, plasma, or whole blood sample using a validated laboratory-based serological assay for SARS-CoV-2 collected within 4 weeks of symptom onset

OR

2. Had a POC NAAT or POC antigen test for SARS-CoV-2 completed and the result is preliminary (presumptive) positive c

OR

3. Had a validated POC antigen test for SARS-CoV-2 completed and the result is positive 

Probable - epi-linked case

A person who:

  • Has symptoms b compatible with COVID-19
AND

  • Had a high-risk exposure with a confirmed d COVID-19 case (i.e. close contact) OR was exposed to a known cluster or outbreak of COVID-19

 AND

  • Has not had a laboratory-based NAAT assay for SARS-CoV-2 completed e

    Notes

a.       A diagnostic rise in antibody titre can be established using paired acute and convalescent sera taken 2-4 weeks apart and tested using by an end-point enzyme immunoassay (EIA), quantitative EIA, or neutralizing antibody titres (e.g., plaque reduction neutralization (PRN)).

Note: At this time, serology testing should not be used for classification of cases who have been previously diagnosed with COVID-19, who have received a SARS-CoV-2 vaccination, for screening, or the routine diagnosis of acute infection.

b.       Symptoms compatible with COVID-19 include any 1 or more of the following:

    • Fever or chills
    •  Cough
    • Loss of sense of smell or taste
    • Difficulty breathing
    • Sore throat
    • Loss of appetite
    • Extreme fatigue or tiredness
    • Headache
    • Body aches
    • Nausea or vomiting
    • Diarrhea 
  1. A positive POC result should be considered as preliminary (presumptive) positive when reporting occurs prior to completion of POC validation or testing occurs in a non-licenced setting.
  2. Cases who had a high-risk exposure with a probable COVID-19 case that had a positive result to validated POC antigen test for SARS-CoV-2 where confirmatory testing was not required (as per the provincial guidelines for POC test in Rural, Remote and Indigenous Communities) should also be considered probable – epi-linked.
  3. For negative results from a compromised sample or if NAAT testing is delayed (e.g. >10-14 days following symptom onset), such persons remain as Probable - epi-linked.

For more information on laboratory tests, please refer to the Laboratory Comments available within the Public Health Agency of Canada's COVID-19 case definition document.

SOURCE: COVID-19 (Novel Coronavirus) ( )
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