Discontinuation of In-Home Isolation for Immunocompromised Persons with COVID-19 (Interim Guidance)
CDC guidance for COVID-19 may be adapted by state and local health departments to respond to rapidly changing local circumstances.
Who this is for: Healthcare providers and public health officials managing immunocompromised persons with coronavirus disease 2019 (COVID-19) under home isolation.
Limited information is available to characterize the spectrum of clinical illness, transmission efficiency, and the duration of viral shedding for immunocompromised persons with novel coronavirus disease (COVID-19). Experience from other respiratory viral infections, in particular influenza, suggests that persons with COVID-19 may shed detectable viral material and potentially infectious virus for an extended period of time after recovery.
Where there is concern that immunocompromised persons (e.g., medical treatment with immunosuppressive drugs, bone marrow or solid organ transplant recipients, inherited immunodeficiency, poorly controlled HIV) may continue to shed virus after recovery, jurisdictions may wish to consider the utility of a test-based strategy. However, a test-based strategy is contingent on the availability of ample testing supplies and laboratory capacity as well as convenient access to testing and in the absence of these conditions may not be feasible.
Possible Strategy to Discontinue Home Isolation For Immunocompromised Persons with COVID-19 When A Test-Based Strategy is Feasible and Desired:
Maintain home isolation until:
- Resolution of fever without the use of fever-reducing medications and
- Improvement in respiratory symptoms (e.g., cough, shortness of breath) and
- Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens). See Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for 2019 Novel Coronavirus (2019-nCoV).
When a test-based strategy is not feasible or desired, healthcare providers and public health officials should follow the non-test-based strategy outlined in the guidance for non-immunocompromised persons.
For Non-Immunocompromised Persons, see Interim Guidance on Discontinuation of Home Isolation for Persons with COVID-19
For Hospitalized Patients, see (Interim Guidance for Discontinuation of Transmission-Based Precautions Among Hospitalized Patients with COVID-19).