Eligibility criteria for COVID-19 and Influenza Testing for Patients at Risk of Severe Illness

Conformément au Règl. de l’Ont. 671/92 pris en application de la Loi sur les services en français, l’information sur la commande de tests et les instructions connexes fournies sur la présente page sont disponibles en anglais seulement parce qu’elles sont de nature scientifique ou technique et qu’elles sont destinées à l’usage exclusif des fournisseurs de soins de santé qualifiés et non des membres du public.

This page provides expanded criteria for testing eligibility in patients at higher risk of severe illness or outcomes from Influenza and COVID-19. This information supports decisions on testing for the following populations:

People 18 years of age and older with risk factors for severe illness from COVID-19
People 18 years of age and older seen in emergency departments, at risk of severe illness or outcomes from influenza and for whom treatment decisions may be impacted by test results

For a complete list of COVID-19 testing eligbility, please refer to the Ministry of Health’s guidance document.

For information on ordering tests from Public Health Ontario (PHO), refer to:

Respiratory virus testing (including influenza): Respiratory Virus Test Information Sheet.
COVID-19 PCR testing: COVID-19 PCR Test Information Sheet.

Conditions that increase risk of severe illness or outcomes in patients 18 years of age and older:

Covid-19^1,2	Influenza³
cancer cerebrovascular disease chronic kidney disease chronic liver diseases (limited to: cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease, and autoimmune hepatitis) chronic lung diseases (limited to: bronchiectasis, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary hypertension, pulmonary embolism) cystic fibrosis diabetes mellitus, type 1 and type 2 disabilities (e.g. Down syndrome, learning, intellectual, or developmental disabilities; ADHD; cerebral palsy; congenital disabilities; spinal cord injuries) heart conditions (e.g., cardiomyopathies, coronary artery disease, heart failure, etc.) HIV infection mental health disorders (limited to: mood disorders, including depression; schizophrenia spectrum disorders) obesity pregnancy and recent pregnancy primary immunodeficiency diseases smoking, current or former Solid organ or blood stem cell transplant tuberculosis use of corticosteroids or other immunosuppressive medication	asthma and other chronic pulmonary disease, including asthma, bronchopulmonary dysplasia, cystic fibrosis, chronic bronchitis, and emphysema cardiovascular disease (excluding isolated hypertension; including congenital and acquired heart disease, such as congestive heart failure and symptomatic coronary artery disease) renal disease chronic liver disease diabetes mellitus and other metabolic diseases anemia and hemoglobinopathies, such as sickle cell disease cancer, immunosuppression, or immunodeficiency due to disease (e.g., HIV infection, especially if CD4 is <200 × 106/L) or management of underlying condition (solid organ transplant or hematopoietic stem cell transplant recipients) neurological disease and neurodevelopmental disorders that compromise handling of respiratory secretions (cognitive dysfunction; spinal cord injury; neuromuscular, neurovascular, neurodegenerative, and seizure disorders; cerebral palsy; metabolic disorders) children aged younger than 5 years (note: the risk of hospitalization is further increased among those aged younger than 2 years individuals aged 65 years or older people of any age who are residents of nursing homes or other chronic care facilities pregnancy and up to 4 weeks postpartum regardless of how the pregnancy ended (Note: the risk of influenza-related hospitalization increases with length of gestation (i.e., it is higher in the third trimester than in the second) obesity with a BMI ≥40 or a BMI >3 z-scores above the mean for age and gender children and adolescents aged younger than 18 years undergoing treatment for long periods with acetylsalicylic acid because of the potential increase in Reye’s syndrome associated with influenza Indigenous/First Nations Peoples

Covid-19^1,2

Influenza³

cancer
cerebrovascular disease
chronic kidney disease
chronic liver diseases (limited to: cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease, and autoimmune hepatitis)
chronic lung diseases (limited to: bronchiectasis, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary hypertension, pulmonary embolism)
cystic fibrosis
diabetes mellitus, type 1 and type 2
disabilities (e.g. Down syndrome, learning, intellectual, or developmental disabilities; ADHD; cerebral palsy; congenital disabilities; spinal cord injuries)
heart conditions (e.g., cardiomyopathies, coronary artery disease, heart failure, etc.)
HIV infection
mental health disorders (limited to: mood disorders, including depression; schizophrenia spectrum disorders)
obesity
pregnancy and recent pregnancy
primary immunodeficiency diseases
smoking, current or former
Solid organ or blood stem cell transplant
tuberculosis
use of corticosteroids or other immunosuppressive medication

asthma and other chronic pulmonary disease, including asthma, bronchopulmonary dysplasia, cystic fibrosis, chronic bronchitis, and emphysema
cardiovascular disease (excluding isolated hypertension; including congenital and acquired heart disease, such as congestive heart failure and symptomatic coronary artery disease)
renal disease
chronic liver disease
diabetes mellitus and other metabolic diseases
anemia and hemoglobinopathies, such as sickle cell disease
cancer, immunosuppression, or immunodeficiency due to disease (e.g., HIV infection, especially if CD4 is <200 × 106/L) or management of underlying condition (solid organ transplant or hematopoietic stem cell transplant recipients)
neurological disease and neurodevelopmental disorders that compromise handling of respiratory secretions (cognitive dysfunction; spinal cord injury; neuromuscular, neurovascular, neurodegenerative, and seizure disorders; cerebral palsy; metabolic disorders)
children aged younger than 5 years (note: the risk of hospitalization is further increased among those aged younger than 2 years
individuals aged 65 years or older
people of any age who are residents of nursing homes or other chronic care facilities
pregnancy and up to 4 weeks postpartum regardless of how the pregnancy ended (Note: the risk of influenza-related hospitalization increases with length of gestation (i.e., it is higher in the third trimester than in the second)
obesity with a BMI ≥40 or a BMI >3 z-scores above the mean for age and gender
children and adolescents aged younger than 18 years undergoing treatment for long periods with acetylsalicylic acid because of the potential increase in Reye’s syndrome associated with influenza
Indigenous/First Nations Peoples

References

Ontario Ministry of Health. Bulletin 230906 — update: COVID‑19 antiviral treatments and testing [Internet]. Toronto, ON: King’s Printer for Ontario; 2023 [cited 2024 Jan 9]. Antiviral treatments for COVID-19. Available from: Antiviral treatments for COVID-19
Public Health Agency of Canada. People who are at risk of more severe disease or outcomes from COVID-19 [Internet]. Ottawa, ON: Government of Canada; 2022 [cited 2023 Jan 9]. Available from: People who are at risk of more severe disease or outcomes from COVID-19
Aoki FY, Allen UD, Mubareka S, Papenburg J, Stiver HG, Evans GA. Use of antiviral drugs for seasonal influenza: Foundation document for practitioners—update 2019. J Assoc Med Microbiol Infect Dis Canada. 2019;4(2):60-82. Available from: Use of antiviral drugs for seasonal influenza: Foundation document for practitioners—Update 2019

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Mis à jour le 20 déc. 2024

Eligibility criteria for COVID-19 and Influenza Testing for Patients at Risk of Severe Illness

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