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Discharge criteria for confirmed COVID-19 cases – When is it safe to discharge COVID-19 patients from the hospital or end home isolation?

Below is a review of existing guidance documents and protocols from national and international organisations from the ECDC

Table: Comparison of current guidelines on de-isolation of COVID-19 cases

Symptomatic Cases, Hospitalised
Italy: Ministero della Salute, Consiglio Superiore di SanitàA COVID-19 patient can be considered cured after the resolution of symptoms and 2 negative tests for SARS-CoV-2 at 24-hour intervals

For patients who clinically recover earlier than 7 days after onset, an interval of 7 days between the first and the final test is advised

Note: Virus clearance is defined as viral RNA disappearance from bodily fluids of symptomatic and asymptomatic persons, accompanied by appearance of specific IgG
China: CDC
Diagnosis and treatment
protocol for COVID-19 patients
(trial version 7, revised)
Patients meeting the following criteria can be discharged if:
Afebrile for >3 days
Improved respiratory symptoms
Pulmonary imaging shows obvious absorption of inflammation, and
Nucleic acid tests negative for respiratory tract pathogen twice consecutively (sampling interval
≥ 24 hours)

After discharge, patients are recommended to continue 14 days of isolation management and health monitoring, wear a mask, live in a single room with good ventilation, reduce close contact with family members, eat separately, keep hands clean and avoid outdoor activities

It is recommended that discharged patients should have follow-up visits after 2 and 4 weeks
Singapore: National Centre for Infectious Diseases (NCID)
De-isolation of COVID-19 suspect cases: link
Discharge patient with advisory and clinic follow-up if indicated and with daily wellness calls until day 14 after last possible exposure, under the following conditions:
Afebrile ≥ 24 hours
2 respiratory samples tested negative for SARSCoV-2 by PCR in ≥ 24 hours
Day of illness from onset ≥ 6 days
Alternative aetiology found (e.g. influenza,
Not a close contact of a COVID-19 case
Does not require in-patient care for other reasons
Interim guidance for discontinuation of transmission based precautions and disposition of hospitalised patients with COVID-19: link
Negative rRT-PCR results from at least 2 consecutive sets of nasopharyngeal and throat swabs collected ≥ 24 hours apart from a patient with COVID-19 (a total of four negative specimens)

AND resolution of fever, without use of antipyretic medication, improvement in signs and symptoms of illness

Note: Decision to be taken on a case-by-case basis in consultation with clinicians and public health officials


When deciding on criteria for hospital discharge of COVID-19 patients, health authorities should take into account several factors such as the existing capacity of the healthcare system, laboratory diagnostic resources, and the current epidemiological situation.

Sources & links

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