MDCalc

ACEP ED COVID-19 Management Tool

Emergency department classification and management tool for adult patients (greater than 18 years old) with suspected or confirmed SARS-CoV-2 (v3.0, updated Fall 2023).

Launched during COVID-19 crisis. This tool is an expert consensus flowsheet based on evidence based studies, but has not been validated as an evidence based tool itself.

This ACEP ED COVID-19 Management Tool was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number 1 NU50CK000570). The CDC is an agency within the Department of Health and Human Services (HHS). The contents of this ACEP tool do not necessarily represent the policy of CDC or HHS and should not be considered an endorsement by the Federal Government.

  • This is intended for patients 18 years and older.

  • Evidence on this topic is evolving quickly and may change.

Severity classification

Select the patient's severity of disease based on NIH criteria above

Result:

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Advice

Patients presenting with symptoms conditions that may be manifestations of severe or critical COVID-19 may also be manifestations of other diseases (e.g. MI, PE, stroke), requiring additional specific diagnostic and therapeutic interventions.

Management
  • Refer to step 5 of the ACEP ED COVID-19 Management Tool for pharmacologic treatment recommendations.

  • Imaging, lab tests, treatment and disposition should be considered based on severity and risk for disease progression. 

  • ACEP maintains information on laboratoratory findings at hospital admission, laboratory abnormalities in severe disease, and hypercoaguability in the ACEP COVID-19 Field Guide section on laboratory abnormalities.

  • The CDC has more information on how race, ethnicity, and access to health care resources may affect outcomes. 

  • AJOG has published a guideline to assist with risk stratification of pregnant patients. 

  • NIH guidance for COVID-19 is no longer available as of August 2024. An archive version of the guidance can be found here.

  • Clinical recommendations are still maintained by some medical societies such as the IDSA and ACEP.
Critical Actions

  • There is no need to apply this tool to patients who are not being evaluated for COVID-19.

  • If the patient is considered mild disease, this tool may help avoid further testing.

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