Practical laboratory considerations amidst the COVID-19 outbreak: early experience from Singapore

Tan, Shaun; Yan, Benedict; Saw, Sharon; Lee, Chun Kiat; Chong, Ai Teng; Jureen, Roland; Sethi, Sunil

doi:10.1136/jclinpath-2020-206563

Cited by 47 publications

(54 citation statements)

References 10 publications

(9 reference statements)

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“…Samples were collected in serum separator tubes (Beckton Dickinson, USA), centrifuged at 3000 rpm for 8 min and after clinical testing, residual sera were collected in accordance with previously described laboratory protocols for COVID-19 sample handling. 6 Days of symptoms were recorded based on first day of onset of COVID-19 symptoms, as documented by managing clinicians. Patients who were asymptomatic at the time of PCR testing were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Archived serum samples taken from patients prior to December 2019 representing COVID-19 naivety were used as negative controls. These included healthy blood donors as well as patients with and without other positive serological tests: anti-extractable nuclear antigen antibodies (9); anti-glomerular basement membrane antibodies (4); antismooth muscle antibody (3); hepatitis A IgM (3); Epstein -Barr virus IgM (3); anti-intrinsic factor IgG (5); cytomegalovirus IgM (4); cytomegalovirus IgG (3); syphillis treponemal antibody (5); Epstein -Barr virus IgA (7); Leptospira IgM (3); hepatitis C antibody (9); hepatitis B surface antigen (7); hepatitis B e antigen (2); anti-double stranded DNA IgG (3); rubella IgM (4); antinuclear antibodies (3); hepatitis A IgG (3); dengue virus IgG (1); varicella zoster IgM (1); human immunodeficiency virus (8); and varicella zoster virus IgG (6). Prior to testing patients' sera, calibration was performed and quality controls were passed as per manufacturers' instructions.…”

Section: Methodsmentioning

confidence: 99%

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Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

et al. 2020

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In this study, we evaluated and compared six SARS-CoV-2 serology kits including the Abbott SARS-CoV-2 IgG assay, Beckman Access SARS-CoV-2 IgG assay, OCD Vitros OCD Anti-SARS-CoV-2 Total antibody assay, Roche Elecsys Anti SARS-CoV-2 assay, Siemens SARS-CoV-2 Total assay, and cPass surrogate viral neutralising antibody assay. A total of 336 non-duplicated residual serum samples that were obtained from COVID-19 confirmed patients (n=173) on PCR and negative controls (n=163) obtained pre-December 2019 before the COVID-19 pandemic were used for the study. These were concurrently analysed on the different immunoassay platforms and correlated with clinical characteristics. Our results showed all assays had specificity ranging from 99.3% to 100.0%. Overall sensitivity across all days of symptoms, in descending order were OCD (49.1%, 95% CI 41.8-56.5%), cPass (44.8%, 95% CI 37.5-52.3%), Roche (41.6%, 95% CI 34.5-49.0%), Siemens (39.9%, 95% CI 32.9-47.3%), Abbott (39.8%, 95% CI 32.9-47.3%) and Beckman (39.6%, 95% CI 32.5-47.3%). Testing after at least 14 days from symptom onset is required to achieve AUCs greater than 0.80. OCD and cPass performed the best in terms of sensitivity for >21 days symptoms with 93.3% (95% CI, 73.5-99.2%) and 96.7% (95% CI, 82.8-99.9%), respectively. Both also shared the greatest concordance, kappa 0.963 (95% CI 0.885-1.0), p<0.001, and had the lowest false negative rates. Serology results should be interpreted with caution in certain cases. False negatives were observed in a small number of individuals with COVID-19 on immunosuppressive therapy, paucisymptomatic or who received antiretroviral therapy. In conclusion, all assays exhibited excellent specificity and total antibody assays with spike protein configurations generally outperformed nucleocapsid configurations and IgG assays in terms of diagnostic sensitivity.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

et al. 2020

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“…All HCP should be checked twice a day for ARIS symptoms, and body temperature to increase the chances of early diagnosis. If a member of the team is infected with COVID-19, all close contacts should take quarantine measures [9].…”

Section: Measures To Reduce Exposure Riskmentioning

confidence: 99%

Protective measures for COVID-19 for healthcare providers and laboratory personnel

2020

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In the COVID-19 pandemic, which affects the whole world, healthcare professionals (HCP) are at high risk of transmission due to their direct contact with patients with COVID-19. Therefore, how to ensure the triage of the patient with acute respiratory symptoms should be determined in advance, the contact distance should be arranged to be at least 2 m, COVID-19 suspect or diagnosed patient should be instructed to wear a surgical mask. During the care of these patients, HCP should wear their personal protective equipment (PPE) in accordance with the procedure and should not neglect hand hygiene. The samples of the patient with known or suspected COVID-19, patient should also be known to be risky in terms of contamination, and a risk assessment should be performed for the procedures to be performed in laboratories. The PPE should be used in accordance with the procedure to be performed. The protection of the HCP, who sacrifice at the risk of life, is possible only by complying with infection control and precautions.

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“…To ensure infection control during a COVID-19 outbreak, a strict sample transportation protocol should be implemented. All specimens must be considered to be potentially infectious, and appropriate personal protective equipment must be used during specimen collection [6]. The molecular diagnosis of COVID-19 typically begins with the collection of a nasopharyngeal or an oropharyngeal swab and its transport to a laboratory in a universal/viral transport medium.…”

Section: Concerns Regarding Rt-pcr Testingmentioning

confidence: 99%

Current laboratory diagnosis of coronavirus disease 2019

Lim

Lee

2020

Korean J Intern Med

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Coronavirus disease 2019 (COVID-19) emerged in December 2019 in Wuhan, China; it has since caused a pandemic, with more than 10,000 confirmed cases (> 800,000 tests) in Korea as of May 2020. Real-time reverse transcription polymerase chain reaction (RT-PCR) is currently the most commonly used method for the diagnosis of COVID-19 worldwide. The Korean Society for Laboratory Medicine and Korea Centers for Dis ease Prevention and Control regularly update the guidelines for COVID-19 diagnosis. Emergency use authorization for some laboratory diagnostic kits has been granted, enabling the timely diagnosis and treatment of COVID-19, and the isolation of infected patients. Due to the collective efforts of the government, medical professionals, local authorities, and the public, Korea's response to the COVID-19 outbreak has been accepted widely as a model. Here, we summarize the currently available laboratory tests for COVID-19 diagnosis. Although RT-PCR tests are used widely to confirm COVID-19, antibody tests could provide information about immune responses to the virus.

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Practical laboratory considerations amidst the COVID-19 outbreak: early experience from Singapore

Cited by 47 publications

References 10 publications

Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

Protective measures for COVID-19 for healthcare providers and laboratory personnel

Current laboratory diagnosis of coronavirus disease 2019

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