key: cord-314537-8a1vqale authors: Guo, Fuzheng; Du, Zhe; Wang, Tianbing title: An effective screening and management process in the outpatient clinic for patients requiring hospitalization during the COVID‐19 pandemic date: 2020-04-21 journal: J Med Virol DOI: 10.1002/jmv.25916 sha: doc_id: 314537 cord_uid: 8a1vqale We have described the screening and management process for patients who present to the out‐patient clinics in China. We believe that our study makes a significant contribution to the literature because we have little reliable literature to refer to with regard to the COVID‐19 pandemic and this protocol has been admirably efficient in China. This article is protected by copyright. All rights reserved. epidemic, it is important to circumvent the risk that this pandemic indirectly increases mortality and morbidity of commonly treatable diseases. Patients with life-threating illness such as congestive heart failure, myocardial infarction, acute liver failure, and malignancy still require attention and care 2, 3 . To help countries navigate through these challenges, the WHO has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating the risk of system collapse on March 30, 2020 4 suggestion from China has been to build dedicated COVID-19 units and hospitals that allow other hospitals to function normally. Therefore, there is an urgent need for a reasonable patient screening and disposal process in outpatient clinics that provide essential health services. This process aims to detect asymptomatic patients and suspected patients of COVID-19, to minimize the incidence of nosocomial infections and to prevent hospitals from becoming epidemic foci in the long run. There are several key points in the screening process ( Figure 1) . First, suspected patients must be transferred to a designated "Fever clinic," launching an inter-departmental collaboration (early detection, early diagnosis, and early isolation). All close contacts must undergo a complete reverse transcriptase polymerase chain reaction (RT-PCR) check-up for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Second, all patients without symptoms or history of contact must undergo both, RT-PCR testing and SARS-CoV-2 antibody testing. SARS-CoV-2 Accepted Article antibody detection is an effective supplement to RNA testing to identify patients with COVID-19 6 . Third, it is suggested that patients with negative results of RT-PCR and antibody testing should undergo chest computed tomography. This would be regarded as the basic clinical data in case of hospital admission, and it would also help to identify asymptomatic patients with only radiological abnormalities. Inpatients must be accommodated in single rooms considering the possibility of false negative results on examination. Family members of the inpatients must not allowed to accompany them, and inpatients would have restricted mobility around the ward to avoid cross-infection. Our protocol is reviewed every two weeks by an internal board according to the latest insights on COVID-19. This process has been admirably efficient in the screening and management of patients presenting to the outpatient clinics in China and provides a guideline for other countries around the world to emulate in this fight against the COVID-19. Coronavirus disease (COVID-19) Situation Dashboard. World Health Organization website Coronavirus Disease 2019 and Transplantation: a view from the inside Lest we forget WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic. World Health Organization website The authors would like to acknowledge anonymous colleagues for helpful comments. The authors declare that there are no conflict of interests This article is protected by copyright. All rights reserved. ZD and FZG drafted the manuscript. TBW critically read and revised the manuscript, and gave final approval for publication.