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Covid-19: transfer delay of Covid-19 patients towards follow-up care service or a retirement home

The HCSP updates its recommendations on the delay to respect before transferring Covid-19 patients in follow-up care and rehabilitation services (SSR) or in accommodation facilities for dependent elderly people (Ehpad in french).

This delay depends on the clinical severity of the disease in the patient as well as on whether or not the patient is immunocompromised.

  • For mild cases in non-immunocompromised patients, transfer is possible at least 7 days after the onset of clinical signs or 7 days after the date of sampling for SARS-CoV-2 by RT-PCR, and at least 48 hours after the resolution of symptoms (fever and respiratory signs), provided that protective measures are maintained for the following 7 days (physical distance, hand hygiene, wearing of masks).
  • For immunocompromised patients or those with severe Covid-19, transfer is possible at least 10 days after the onset of clinical signs or 10 days after the date of sampling for SARS-CoV-2 by RT-PCR, and at least 48 hours after the resolution of symptoms (fever and respiratory signs), provided that protective measures (physical distance, hand hygiene, wearing a mask) are maintained for the following 14 days.
  • In the event of a positive test in an asymptomatic hospitalized patient, protective measures must be observed for the next 7 days after the date of the first positive SARS-CoV-2 RT-PCR test, or 14 days if the patient is immunocompromised.

After this period, protective measures (hand hygiene, masks, physical distancing) can be lifted and RT-PCR test on nasopharyngeal swab is not recommended. However, in case of transfer occurring before the above delays, the determination of the CT value (cycle threshold) during the RT-PCR test can guide the course of action: indeed, a CT of less than or equal to 33 contraindicates the transfer.

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