2020/08/01/ 2020;81(2):266-275. doi:https://doi.org/10.1016/j.jinf.2020.05.046, Gerver SM, Guy R, Wilson K, et al. Isolation relates to behavior after a confirmed infection. Clin Infect Dis. Application of these precautions depends on the nature of the healthcare worker-patient interaction and the anticipated exposure to a known infectious agent. Secondary Attack Rate, Transmission and Incubation Periods, and Serial Coronavirus (2019-nCoV) This Fact Sheet informs you of the significant known and potential risks and benefits of the emergency use of the Centers for Disease Control and Prevention (CDC) 2019-nCoV Real-Time RT-PCR Diagnostic Panel. "Lets say somebody is diagnosed with COVID and they are in a setting during a time that they might be infectious, we know that with COVID, for the first five days you need to be isolated because you can definitely be spreading COVID at that point," Chicago Department of Public Health Commissioner Dr. Allison Arwady said during a previous Facebook live. MMWR Morb Mortal Wkly Rep. Nov 6 2020;69(44):1641-1647. doi:10.15585/mmwr.mm6944e3, Jamieson DJ, Rasmussen SA. If you test positive, followisolationrecommendations. Clin Infect Dis. More severe cases may shed more virus for longer periods of time. Genomic evidence for reinfection with SARS-CoV-2: a case study. If you continue to have fever or your other symptoms have not improved after 5 days of isolation, you should wait to end your isolation until you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved. Cookies used to make website functionality more relevant to you. cough. Journal of Infection. Ending Isolation and Precautions for People with COVID-19: Interim Guidance, Centers for Disease Control and Prevention. If equipment needs to be shared among patients, it should be cleaned and disinfected between use for each patient using products containing ethyl alcohol of at least 70%. Clinical Microbiology and Infection. Pediatrics. Apr 19 2021;193(16):E540-e548. If you dont get tested, delay travel until 10 days after your last close contact with a person with COVID-19. Added new recommendations for duration of isolation for people with COVID-19 who are moderately or severely immunocompromised. People who have asymptomatic or symptomatic infections can transmit SARS-CoV-2, with varying rates and timelines for transmission. The role of antiviral treatment in the COVID-19 pandemic. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Under the CDC guidance, those in isolation should: While testing out of isolation is not required, the CDC says those who choose to should use an antigen test and not a PCR test. Use of At-Home COVID-19 Tests United States, August 23, 2021March 12, 2022. 2020:1-7. doi:10.1080/14767058.2020.1793320, Grechukhina O, Greenberg V, Lundsberg LS, et al. 2021:n385. COVID-19 vaccination decreases the risk of severe disease, hospitalization, and death from COVID-19. You cannot tell the difference between these illnesses by symptoms alone. COVID-19 in Immunocompromised Hosts: What We Know So Far. These cookies may also be used for advertising purposes by these third parties. The information in this document draws from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidance documents and Infection Prevention and Control (IPC) priorities for the response to COVID-19 in healthcare settings and includes information that can be used in non-U.S. contexts. 2021;73(10):1882-1886. doi:10.1093/cid/ciab234, Kronbichler A, Kresse D, Yoon S, Lee KH, Effenberger M, Shin JI. J Ophthalmic Vis Res. Dermatology. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. SARS-CoV-2 Incubation Period during the Omicron BA.5-Dominant Period in MMWR Morb Mortal Wkly Rep. Apr 30 2021;70(17):644-650. doi:10.15585/mmwr.mm7017e3, Chevinsky JR, Tao G, Lavery AM, et al. So how do you calculate your isolation period? Quarantine refers to the time following exposure to the virus or close contact with someone known to have COVID-19. Among potential transmission pairs, we identified pairs with clear infector-infectee relationships where onset dates for both were available. COVID-19 isolation rooms or wards should have dedicated bathrooms, which should be cleaned and disinfected at least twice daily. MMWR Morb Mortal Wkly Rep. Feb 4 2022;71(5):177-181. doi:10.15585/mmwr.mm7105e1, Olson SM, Newhams MM, Halasa NB, et al. You will be subject to the destination website's privacy policy when you follow the link. Racial and Ethnic Disparities in Receipt of Medications for Treatment of COVID-19 - United States, March 2020-August 2021. Characteristics and Disease Severity of US Children and Adolescents Diagnosed With COVID-19. If You Test Positive for COVID-19 (Isolate), If You Were Exposed to Someone with COVID-19 (Quarantine), Centers for Disease Control and Prevention. If you develop symptoms get a test and stay home. If you come into close contact with someone with COVID-19, you should quarantine if you are notup-to-dateon COVID-19 vaccines or are unvaccinated. Thank you for taking the time to confirm your preferences. Co-infections in people with COVID-19: a systematic review and meta-analysis. COVID Incubation Periods Have Fallen Over Time If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19. BNT162b2 mRNA Vaccination Against COVID-19 is Associated with Decreased Likelihood of Multisystem Inflammatory Syndrome in U.S. Children Ages 5-18 Years. Aug 2021;69(6):1253-1255. doi:10.1136/jim-2021-001853, Roskosky M, Borah BF, DeJonge PM, et al. You can review and change the way we collect information below. Data from South Africa and the United Kingdom demonstrate that vaccine effectiveness against infection for two doses of an mRNA vaccine is approximately 35%. Mar 2 2022;376:e068632. Extended use and re-use of certain PPE items such as masks and gowns can be considered when there are supply shortages. Clinical Infectious Diseases. headache. For more details, including details on certain non-healthcare settings, please review Setting-Specific Guidance. Even with the introduction of vaccinations as a tool for prevention against COVID-19 and the proper use of masks, CDC recommends the following key COVID-19 preventative activities: 7 avoiding crowded spaces or spaces that have poor ventilation or wear a mask in these spaces; performing proper hand hygiene; keeping high touch surfaces clean; monitoring symptoms; and getting tested if ill. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Pulmonary Aspects of COVID-19. Standard precautions include: Transmission-based precautions are a set of practices specific for patients with known or suspected infectious agents that require additional control measures to prevent transmission. Aug 24 2022;75(1):e741-e748. MMWR Morb Mortal Wkly Rep. Jan 28 2022;71(4):118-124. doi:10.15585/mmwr.mm7104a2, Kwon JH, Tenforde MW, Gaglani M, et al. Jenna James, who has long covid and other chronic conditions, feels . Thank you for taking the time to confirm your preferences. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. CDC's COVID Data Tracker publishes estimates of how common variants are at national and regional levels. Clin Infect Dis. In a typical infectious disease, the incubation period signifies the period taken by the multiplying organism to reach a threshold necessary to produce symptoms in the host. Coronavirus disease 2019 pregnancy outcomes in a racially and ethnically diverse population. How COVID-19 Spreads Getting Sick Again (Reinfection) Variants of the Virus Map of Variant Proportions in the US How to Protect Yourself Protect Yourself Wear a Mask If You Are Sick When to wear a mask Wear a mask with the best fit, protection, and comfort for you. "If your test result is positive, you should continue to isolate until day 10. Clin Infect Dis. The criteria for serial testing to end isolation are: Results are negative from at least two consecutive respiratory specimens collected 24 hours apart (total of two negative specimens) tested using an antigen test or nucleic acid amplification test. Older adults may present with different symptoms than children and younger adults. MMWR Morb Mortal Wkly Rep. Aug 13 2021;70(32):1081-1083. doi:10.15585/mmwr.mm7032e1, National Center for Immunization and Respiratory Diseases (NCIRD), Post-COVID Conditions: Healthcare Providers, Decontamination & Reuse of N95 Respirators, Purchasing N95 Respirators from Another Country, Powered Air Purifying Respirators (PAPRs), U.S. Department of Health & Human Services. This data can change over time as more information is available. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services. Stay home for 5 days. Consider consultation with infection control experts. The CDC is. CDCs updated recommendations for isolation and quarantine balance what we know about the spread of the virus and the protection provided by vaccination and booster doses. Additionally, healthcare facilities can also consider designating healthcare workers to care for patients with COVID-19 and restricting the number of visitors allowed in the facility. Updated guidance reflects new recommendations for isolation and precautions for people with COVID-19. MMWR Morb Mortal Wkly Rep. Aug 5 2022;71(31):993-999. doi:10.15585/mmwr.mm7131a3, Zavala M, Ireland G, Amin-Chowdhury Z, Ramsay ME, Ladhani SN. 2021/12/01/ 2021;80:229-238. doi:https://doi.org/10.1016/j.clinimag.2021.06.039, Kanne JP, Bai H, Bernheim A, et al. May 19 2021;373:n1098. N Engl J Med. Multisystem Inflammatory Syndrome in Children-United States, February 2020-July 2021. Hospitalization of Infants and Children Aged 0-4 Years with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 2020-February 2022. Are unvaccinated, If you develop symptoms get a test and stay home, ### National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave. Feb 24 2022;386(8):713-723. doi:10.1056/NEJMoa2117995, Price AM, Olson SM, Newhams MM, et al. All information these cookies collect is aggregated and therefore anonymous. COVID-19 Testing: What You Need to Know | CDC These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Apr 20 2022;doi:10.1093/cid/ciac303, Hernandez-Romieu AC, Leung S, Mbanya A, et al. Centers for Disease Control and Prevention. COVID-19-Associated Hospitalizations Among Adults During SARS-CoV-2 Delta and Omicron Variant Predominance, by Race/Ethnicity and Vaccination Status - COVID-NET, 14 States, July 2021-January 2022. Jun 1 2021;4(6):e2111182. JAMA Pediatr. (8) Multiple publications have reported cases of people with abnormalities on chest imaging that are consistent with COVID-19 very early in the course of illness, even before the onset of symptoms or a positive COVID-19 test. Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients. Clinicians should also consider advising people who are infected with COVID-19 to follow CDC guidelinesfor isolation. 1 MMWR Morb Mortal Wkly Rep. Sep 10 2021;70(36):1255-1260. doi:10.15585/mmwr.mm7036e2, Siegel DA, Reses HE, Cool AJ, et al. Jul 2022;6(7):459-465. doi:10.1016/s2352-4642(22)00100-6, Belay ED, Godfred Cato S, Rao AK, et al. Detection of SARS-CoV-2 Among Residents and Staff Members of an Independent and Assisted Living Community for Older Adults - Seattle, Washington, 2020. COVID-19 can spread quickly and is more contagious than the flu. They help us to know which pages are the most and least popular and see how visitors move around the site. Jul 15 2021;73(Suppl 1):S5-S16. N Engl J Med. The risk of severe disease increases steadily as people age. While the symptoms may vary from person to person, typically those with walking pneumonia will have: Cold-like symptoms. International Journal of Infectious Diseases. Notes from the Field: SARS-CoV-2 Omicron Variant Infection in 10 Persons Within 90 Days of Previous SARS-CoV-2 Delta Variant Infection - Four States, October 2021-January 2022. Applying standard precautions during any vaccination activity, Performing additional IPC precautions like mask use in the context of the COVID-19 pandemic, Providing healthcare workers with specific training and providing the public with targeted information regarding IPC measures for safe vaccine delivery, Having a clean, hygienic, and well-ventilated environment with appropriate waste management, and adequate spaces that facilitate best IPC practices like physical distancing, Ensuring consultation and adherence to national guidance and protocols for IPC measures, including those related to COVID-19, Cleaning and disinfection of devices and environmental surfaces, Use a medical mask (at least a surgical/medical mask), Wear eye protection (goggles) or facial protection (face shield), Wear a clean, non-sterile, long-sleeve gown, Identification of Healthcare Workers and Inpatients with Suspected COVID-19. Jan 27 2022;73:81-93. doi:10.1146/annurev-med-042220-014817, Bhaskaran K, Bacon S, Evans SJ, et al. Preventing chronic disease. JAMA Network Open. (5) Some people with COVID-19 have gastrointestinal symptoms such as nausea, vomiting, or diarrhea, sometimes prior to having fever or lower respiratory tract signs and symptoms. Changed from improvement in respiratory symptoms to improvement in symptoms to address expanding list of symptoms associated with COVID-19. The incubation period from infection to symptoms or a first positive COVID-19 test has decreased as the coronavirus has evolved, dropping from 5 days to 3.5 days, according to a new study . These symptoms may include fatigue, brain fog, shortness of breath, chills, body ache, headache, joint pain, chest pain, cough, and lingering loss of taste or smell. The COVID-19 virus is passed on by coughing, or by contact with hands, surfaces or objects that are contaminated with the virus. More information is available, Travel requirements to enter the United States are changing, starting November 8, 2021. American Journal of Clinical Pathology. Pediatr Infect Dis J. Dec 1 2021;40(12):e482-e487. Nature medicine. MMWR Morb Mortal Wkly Rep. Mar 18 2022;71(11):429-436. doi:10.15585/mmwr.mm7111e2, Delahoy MJ, Ujamaa D, Whitaker M, et al. 2022:o110. Oct 1 2021;4(10):e2128568. Duration of Symptoms and Association With Positive Rapid Antigen Tests EClinicalMedicine. The following is attributable to CDC Director, Dr. RochelleWalensky: The Omicron variant is spreading quickly and has the potential to impact all facets of our society. Avoid contact with other members of the household and pets. Those who test positive, regardless of vaccination status, must isolate, according to the CDC. This may warrant extending the duration of isolation and precautions for up to 20 days after symptom onset (with day 0 being the day symptoms appeared). Thank you for taking the time to confirm your preferences. Attributes and predictors of long COVID. Close contact is defined by the CDC and the Illinois Department of Public Health as "someone who was less than 6 feet away from an infected person for a cumulative total of 15 minutes or more over a 24-hour period.". First, you'll need to know the difference between whether you must quarantine or isolate. Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged >/=65 Years - United States, January-March 2021. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. Radiology. If you are unable to wear a mask when around others, you should continue to quarantine for 10 days. According to the CDC, the Omicron variant spreads more easily than the original SARS-CoV-2 virus and the Delta variant. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Follow recommendations in theisolationsection below. Eur J Obstet Gynecol Reprod Biol. Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19. Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until a full 10 days after your first day of symptoms. How Long Are You Contagious With COVID? Here's What the CDC Says Trends in Geographic and Temporal Distribution of US Children With Multisystem Inflammatory Syndrome During the COVID-19 Pandemic. Clinical considerations for care of children and adults with confirmed COVID-19, Data suggest that incubation periods may differ by variant of the virus. COVID-19 can be prevented through pharmaceutical (i.e., vaccination) and non-pharmaceutical interventions (e.g., masking, physical distancing, hand hygiene). Sep 2021;8(9):ofab428. MMWR Morb Mortal Wkly Rep. Jan 21 2022;71(3):96-102. doi:10.15585/mmwr.mm7103e1, Murthy NC, Zell E, Fast HE, et al. The clinical presentation of COVID-19 ranges from asymptomatic to severe illness, and COVID-19 symptoms may change over the course of illness. Apr 2022;21(4):435-451. doi:10.1080/14760584.2022.2035222, Lee A, Wong SY, Chai LYA, et al. Alternatively, if a 5-day quarantine is not feasible, it is imperative that an exposed person wear a well-fitting mask at all times when around others for 10 days after exposure. We calculated the incubation period by using the calendar dates of contact and symptom onset, regardless of duration or number of contacts. MMWR Morb Mortal Wkly Rep. Mar 25 2022;71(12):466-473. doi:10.15585/mmwr.mm7112e2, Johnson AG, Amin AB, Ali AR, et al. The CDC urges those who have or may have COVID-19 to watch for emergency warning signs and seek medical care immediately if they experience symptoms including: "This list is not all possible symptoms," the CDC states. How Long Are You Contagious When You Have COVID? | HuffPost Life Clin Infect Dis. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 - Six Hospitals, United States, July-August 2021. Racial Bias in Pulse Oximetry Measurement. In adults, age is the strongest risk factor for severe COVID-19. You can review and change the way we collect information below. Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults: A Systematic Review. Other factors, such as end-stage renal disease, likely pose a lower degree of immunocompromise, and there might not be a need to follow the recommendations for those with moderate to severe immunocompromise. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. When you have COVID-19, isolation is counted in days, as follows: If you had no symptoms Day 0 is the day you were tested (not the day you received your positive test result) Day 1 is the first full day following the day you were tested MMWR Morb Mortal Wkly Rep. April 1, 2022;71(13):489494. COVID-19 Overview and Infection Prevention and Control Priorities in non-US Healthcare Settings [PPT 5 MB]. Ending Isolation and Precautions for People with COVID-19 - CDC Long-Term Symptoms Among Adults Tested for SARS-CoV-2 - United States, January 2020-April 2021. The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. Unvaccinated healthcare workers, patients, and visitors should be offered resources and counseled about the importance of vaccination. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. Omicron Incubation Period Is 3 DaysWhat That Means - Health The utility of iPhone oximetry apps: A comparison with standard pulse oximetry measurement in the emergency department. That means that Day 1 is the first full dayafteryour symptoms developed. Feb 2022;10(2):e18. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Dont share personal household items, like cups, towels, and utensils. While safe and effective vaccines are a great tool for prevention, it is important to continue other preventative actions such as wearing masks, performing hand hygiene, physically distancing from others, and avoiding crowded spaces and spaces with poor ventilation.7 There are several vaccine candidates, and many have been listed under WHOs emergency use. CDC twenty four seven. MMWR Morb Mortal Wkly Rep. Jun 19 2020;69(24):759-765. doi:10.15585/mmwr.mm6924e2, Roxby AC, Greninger AL, Hatfield KM, et al. (12), Several studies have reported ocular symptoms associated with COVID-19 infection, including redness, tearing, dry eye or foreign body sensation, discharge or increased secretions, and eye itching or pain.(13). Please see instructions for putting on and removing PPEfor guidance. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Feb 2022;226(2):177-186. doi:10.1016/j.ajog.2021.08.054, Barbero P, Mugerza L, Herraiz I, et al. Oct 3 2022;75(Supplement_2):S303-s307. When selecting a mask, there are many factors to consider.8 Masks should. A. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. doi:10.1001/jamanetworkopen.2021.11182, Feldstein LR, Tenforde MW, Friedman KG, et al. Incubation Period Data suggest that incubation periods may differ by variant of the virus. Am J Emerg Med. Saving Lives, Protecting People, Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the, The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. As safe and effective COVID-19 vaccines continue to be delivered, there are certain recommendations and principles that should be implemented and considered for vaccine administration. JAMA Intern Med. OR These coronaviruses range from the common cold to more severe diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19. Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0-17 Years - United States, August 2020-August 2021. Cmaj. Pediatr Infect Dis J. Mar 1 2022;41(3):e81-e86. To receive email updates about COVID-19, enter your email address: We take your privacy seriously. Annu Rev Med. Am J Obstet Gynecol. Coronavirus: How long is a person contagious? - Medical News Today 2022;386(8):744-756. doi:10.1056/NEJMoa2116597, Lansbury L, Lim B, Baskaran V, Lim WS. Effect of Covid-19 Vaccination on Transmission of Alpha and Delta Variants. doi:10.1016/j.cmi.2021.07.030, Abu-Raddad LJ, Chemaitelly H, Bertollini R, National Study Group for C-E. Severity of SARS-CoV-2 Reinfections as Compared with Primary Infections. Sep 18 2020;doi:10.1093/cid/ciaa1419, Wortham JM, Lee JT, Althomsons S, et al. Avoid people who haveweakened immune systemsorare more likely to get very sickfrom COVID-19, and nursing homes and other high-risk settings, until after at least 10 days. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. Someone with walking pneumonia can be contagious for a couple of weeks, even after starting treatment. May 1 2022;41(5):424-426. doi:10.1097/inf.0000000000003502, Pellegrino R, Chiappini E, Licari A, Galli L, Marseglia GL. Wear awell-fitting maskwhen around others at home, if possible. According to the CDC, if you have mild to moderate COVID-19, you may be contagious for 10 days from the first day you noticed symptoms. Contact and droplet precaution PPE are recommended for healthcare workers before entering the room of suspected or confirmed COVID-19 patients. doi:10.1097/inf.0000000000003328, Kompaniyets L, Bull-Otterson L, Boehmer TK, et al. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Thank you for taking the time to confirm your preferences. Multisystem inflammatory syndrome in adults (MIS-A): case finding through systematic review of electronic medical records. Feb 9 2021;doi:10.1093/cid/ciab100, Singanayagam A, Patel M, Charlett A, et al. Post-COVID-19 Symptoms and Conditions Among Children and Adolescents - United States, March 1, 2020-January 31, 2022. These cookies may also be used for advertising purposes by these third parties. If possible, stay away from people you live with, especially people who are at. BMC Pregnancy Childbirth. These precautions are used in addition to standard precautions. (6,7) However, it is unclear what percentage of people who have asymptomatic infection progress to clinical disease (presymptomatic presentation). CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. This overview was created for healthcare workers in non-U.S. healthcare settings and government officials at ministries of health working on the Coronavirus Disease 2019 (COVID-19) response. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. You can review and change the way we collect information below. If you must travel before the 10 days are completed, wear awell-fitting maskwhen you are around others for the entire duration of travel during the 10 days. doi:10.5888/pcd18.210123, Ko JY, Danielson ML, Town M, et al. Although there is a difference in determination on which procedures generate infectious aerosol, the current WHO list of Aerosol Generating Procedures includes:1. Jan 15 2021;doi:10.1001/jamainternmed.2020.9241, Matar R, Alrahmani L, Monzer N, et al.