What advice should I give a patient who has tested positive for COVID‑19?

Patient Information for Positive COVID-19 Test Result

If you have tested positive for COVID-19, you should immediately begin self-isolation, monitor your symptoms closely, and contact your healthcare provider if you develop worsening symptoms—particularly shortness of breath, persistent chest pain, confusion, or inability to stay awake. 1

Immediate Actions After Positive Test

Isolation Requirements

• Begin isolation immediately upon receiving your positive test result, regardless of whether you have symptoms 1, 2
• Isolate for at least 5 days from symptom onset (or from test date if asymptomatic) 1
• You may end isolation after 5 days if you are fever-free for 24 hours without fever-reducing medications and your symptoms are improving 1
• Continue wearing a high-quality mask around others through day 10 1

Household Precautions

• Stay in a separate room from other household members when possible 1
• Use a separate bathroom if available 1
• Avoid sharing personal household items (cups, towels, utensils) 1
• Household members should be considered exposed and should follow current quarantine guidance 1

Symptom Monitoring

Common Symptoms to Expect

The most common symptoms associated with COVID-19 infection include 3:

• Fatigue and malaise (general feeling of being unwell)
• Headache
• Cough
• Fever
• Loss of taste (dysgeusia)
• Loss of smell (hyposmia)

Warning Signs Requiring Immediate Medical Attention

Contact emergency services (call 911) immediately if you experience 1, 2:

• Difficulty breathing or shortness of breath
• Persistent chest pain or pressure
• New confusion or inability to stay awake
• Bluish lips or face
• Severe, persistent dizziness

When to Contact Your Healthcare Provider

Call your doctor if 1, 2:

• Your symptoms worsen after initial improvement
• You develop high fever (>103°F/39.4°C) that doesn't respond to fever reducers
• You cannot keep down fluids
• Your symptoms do not improve after 7 days

Treatment Considerations

Antiviral Medications

• If you are at high risk for severe COVID-19 (age ≥65, obesity, diabetes, heart disease, lung disease, immunocompromised), contact your healthcare provider immediately about antiviral treatment 4
• Antiviral medications like Paxlovid (nirmatrelvir-ritonavir) must be started within 5 days of symptom onset to be effective 4
• Your doctor will review your current medications, as Paxlovid has significant drug interactions 4
• Do not delay contacting your provider—early treatment is critical for effectiveness 4

Home Management

• Get plenty of rest and stay well-hydrated 5, 6
• Use over-the-counter medications (acetaminophen or ibuprofen) to manage fever and body aches 5
• Monitor your oxygen levels if you have a pulse oximeter; contact your doctor if oxygen saturation falls below 94% 2
• Avoid non-steroidal anti-inflammatory drugs (NSAIDs) if you have inflammatory bowel disease or other specific conditions 1

Medication Management

Do NOT Stop Your Regular Medications

• Continue taking all your regular prescribed medications unless specifically instructed otherwise by your healthcare team 1
• This is particularly important for medications treating chronic conditions like inflammatory bowel disease, heart disease, or diabetes 1
• Stopping medications without guidance can lead to disease flares that may require hospitalization 1

Special Considerations

• If you are on immunosuppressive therapy for conditions like inflammatory bowel disease, contact your specialist for guidance 1
• Some medications may need temporary adjustment during active COVID-19 infection 1

Testing and Clearance

Duration of Positive Tests

• PCR tests can remain positive for extended periods (weeks to months) even after you are no longer infectious 7
• A positive PCR test does not necessarily mean you are still contagious after completing isolation 1, 7
• Rapid antigen tests are better indicators of current infectiousness than PCR tests 1

Retesting Guidance

• You do not need a negative test to end isolation if you meet the time and symptom criteria 1
• Retesting is generally not recommended for discontinuing isolation 1
• If you remain symptomatic beyond 10 days, consult your healthcare provider 1

Protection Against Reinfection

Natural Immunity

• Prior COVID-19 infection provides approximately 82-85% protection against reinfection for at least 90 days 8
• Protection against symptomatic reinfection is even higher at approximately 84.5% 8
• This protection appears to increase over time in the months following infection 8

Vaccination After Infection

• You should still receive COVID-19 vaccination after recovery, as vaccination provides additional protection 1
• Follow CDC or local health authority guidelines for timing of vaccination after infection 1
• Vaccination after natural infection provides the strongest protection against future infection 1

Work and Social Considerations

Return to Work

• Work from home if possible during your isolation period 1
• Do not return to work or school until you meet isolation criteria (minimum 5 days, fever-free for 24 hours, improving symptoms) 1
• Wear a high-quality mask when returning to work through day 10 1

Protecting Others

• Inform close contacts of your positive test so they can monitor for symptoms and follow quarantine guidance 1
• Avoid non-essential travel during your isolation period 1
• Practice good hand hygiene—wash hands frequently and avoid touching your face 1

Common Pitfalls to Avoid

• Do not assume you are no longer infectious just because you feel better—complete the full isolation period 1
• Do not stop prescribed medications without consulting your doctor, as this can lead to serious complications 1
• Do not delay seeking medical attention if you develop warning signs, even if you think your symptoms are mild 1, 2
• Do not rely on PCR testing to determine when you can end isolation, as these tests remain positive long after infectiousness has resolved 1, 7

Follow-Up Care

• Schedule a follow-up appointment with your healthcare provider 3 weeks after your positive test, even if you recovered without complications 1
• Report any persistent symptoms (fatigue, shortness of breath, brain fog) to your doctor, as some patients develop long COVID 5, 6
• Keep a record of your positive test date and symptoms for future medical reference 1