When Should A Patient With Mild Cold-Like Symptoms Consider Taking An RT-PCR Test For COVID 19?

If symptoms begin very early, scheduling the test for around day 3–5 of symptom onset is often optimal; if still negative in the presence of high clinical suspicion, repeat testing should be considered.

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When evaluating a patient with mild cold like symptoms under current circumstances, several clinical factors and contextual considerations can help determine when an RT PCR test is indicated. 

Dr Deepesh G Aggarwal, Consultant Physician & HoD- Dept of Critical Care Medicine, Saifee Hospital, Mumbai shares why patient should take an RT-PCR test for COVID 19.  

1. Symptom Profile and Specificity

o Typical COVID 19 Clues mentioned above.
o Non specific Cold Symptoms: If the symptoms consist solely of nasal congestion or a mild cough typical of non COVID respiratory viruses, and there’s no known exposure or additional COVID specific signs, testing may be deferred for a short period while continuing to monitor symptom progression.

2. Exposure History and Local Epidemiology

o If there is recent contact with a confirmed COVID 19 case or resides in/ visited an area with high community transmission, testing may be done.
o patients with very mild, non specific symptoms might be managed conservatively at first, with advice to test if symptoms persist or worsen.

3. Timing and Viral Load Considerations

o Optimal Timing for Testing: Viral loads in COVID 19 generally peak around 3–5 days after symptom onset. Testing too early (on day 1 or 2) might yield a false negative result. Therefore, an RT PCR test should ideally be done around day 3–5 of symptom onset.
o Repeat Testing: In cases with high clinical suspicion, but the initial test is negative, a repeat RT PCR after 48–72 hours is advisable.

4. Risk Profile and Potential for Disease Progression

o At Risk Populations: In patients who are elderly or have significant co morbidities, even mild symptoms warrant testing because early detection can lead to more vigilant monitoring and timely intervention should the disease progress.
o General Public Health Considerations: Beyond individual risk, testing in patients with mild symptoms in settings with high transmission plays a key role in curbing community spread, especially when definitive isolation and contact tracing can follow a positive result.

In summary, a patient with mild, cold-like symptoms should consider taking an RT PCR test if they exhibit any typical COVID specific signs and symptoms, have a recent history of significant exposure, are in a high transmission environment, or belong to a high risk group.