Table 1

Definition of suspicious COVID-19 cases, according to WHO, MOHME, and ECDC protocols.

ProtocolsCase definition
WHO6Suspected case of SARS-CoV-2 infection:
A person who meets the clinical AND epidemiological criteria:
Clinical criteria:
Acute onset of fever AND cough; OR · Acute onset of ANY THREE OR MORE of the following signs or symptoms: Fever, cough, general weakness/fatigue, headache, myalgia, sore throat, coryza, dyspnea, anorexia/nausea/vomiting, diarrhea, altered mental status.
Epidemiological criteria:
Residing or working in an area with high risk of transmission of virus: closed residential settings, humanitarian settings such as camp and camp-like settings for displaced persons; anytime within the 14 days prior to symptom onset; or · Residing or travel to an area with community transmission anytime within the 14 days prior to symptom onset; or · Working in any healthcare setting, including within health facilities or within the community; any time within the 14 days prior to symptom onset.
Probable case of SARS-CoV-2 infection:
  1. Patient who meets clinical criteria above AND is a contact of a probable or confirmed case, or linked to a COVID-19 cluster.

  2. Suspect case with chest imaging showing findings suggestive of COVID-19 disease.

  3. Person with recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any other identified cause.

  4. Death, not otherwise explained, in an adult with respiratory distress preceding death AND was a contact of a probable or confirmed case or linked to a COVID-19 cluster.


Confirmed case of SARS-CoV-2 infection:
  1. Person with a positive Nucleic Acid Amplification Test (NAAT).

  2. Person with a positive SARS-CoV-2 antigen-RDT AND meeting either the probable case definition or suspect criteria A or B.

  3. An asymptomatic person with a positive SARS-CoV-2 antigen-RDT who is a contact of a probable or confirmed case.

MOHME7Suspicious case
  1. A person with severe febrile respiratory disease who needs to be hospitalized due to fever, cough, etc, and another pathogen to justify his disease’s symptoms is not conceivable.


Which has at least one of the following characteristics:
  1. History of travel to endemic area within 14 days before the onset of symptoms

  2. Be one of the healthcare providers

  3. Despite appropriate pneumonia treatments, the clinical response is inadequate, and the clinical condition is unusual and unexpected.

ECDC8Clinical criteria
Any person with at least one of the following symptoms:
Cough
Fever
Shortness of breath
Sudden onset of anosmia, ageusia, or dysgeusia
Diagnostic imaging criteria: Radiological evidence showing lesions compatible with COVID-19
Laboratory criteria: Detection of COVID-19 nucleic acid in a clinical specimen
Epidemiological criteria
At least one of the following epidemiological links:
Close contact with a confirmed COVID-19 case in the 14 days before the onset of symptoms
Having been a resident or a staff member, in the 14 days before the onset of symptoms, in a residential institution for vulnerable people where ongoing COVID-19 transmission has been confirmed
Case classification
Possible case:
Any person meeting the clinical criteria
Probable case:
Any person meeting the clinical criteria with an epidemiological link
OR
Any person meeting the diagnostic criteria
  1. Confirmed case:


Any person meeting the laboratory criteria
  • COVID-19, coronavirus disease 2019; ECDC, European Centres for Disease Control; MOHME, Iranian Ministry of Health and Medical Education; RDT, rapid diagnostic test; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.