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February 23, 2020 Healthcare professionals must consider an unusual course, a sudden worsening, a poor response to therapies as a "suspected case" of coronavirus infection. This is foreseen by the new circular of the Ministry of Health sent to ministries and doctors, entitled "Covid-2019. New indications and clarifications", which updates the previous circulars of 22 and 27 January.

The document confirms that a suspect case must be considered "A person with acute respiratory infection (sudden onset of at least one of the following symptoms: fever, cough, dyspnoea) who required or not to be hospitalized and in the 14 days preceding the onset of symptomatology, has met at least one of the following conditions: travel history or residence in China; or close contact with a probable or confirmed case of SARS-CoV-2 infection; or has worked or attended a healthcare facility where patients were hospitalized with SARS-CoV-2 infection ".

But in addition to these characteristics, the prevention departments and health services are invited to evaluate "any direct and documented exposures in other countries with local transmission of SARS-CoV-2" and "people who experience an unusual or unexpected clinical course, especially a sudden deterioration despite adequate treatment, regardless of place of residence or travel history, although another etiology has been identified that fully explains the clinical situation. "