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Practical Considerations for Implementation of SARS-CoV-2 Serological Testing in the Clinical Laboratory: Experience at an Academic Medical Center.
Humble, Robert M; Merrill, Anna E; Ford, Bradley A; Diekema, Daniel J; Krasowski, Matthew D.
  • Humble RM; Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Merrill AE; Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Ford BA; Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Diekema DJ; Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Krasowski MD; Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Acad Pathol ; 8: 23742895211002802, 2021.
Article in English | MEDLINE | ID: covidwho-1199890
ABSTRACT
Molecular techniques, especially reverse transcriptase polymerase chain reaction (RT-PCR), have been the gold standard for the diagnosis of acute severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Serological tests for SARS-CoV-2 have been widely used for serosurveys, epidemiology, and identification of potential convalescent plasma donors. However, the clinical role of serologic testing is still limited and evolving. In this report, we describe the experience of selecting, validating, and implementing SARS-CoV-2 serologic testing for clinical purposes at an academic medical center in a rural state. Successful implementation involved close collaboration between pathology, infectious diseases, and outpatient clinics. The most common clinician concerns were appropriateness/utility of testing, patient charges/insurance coverage, and assay specificity. In analyzing test utilization, serologic testing in the first month after go-live was almost entirely outpatient and appeared to be strongly driven by patient interest (including health care workers and others in high-risk occupations for exposure to SARS-CoV-2), with little evidence that the results impacted clinical decision-making. Test volumes for serology declined steadily through October 31, 2020, with inpatient ordering assuming a steadily higher percentage of the total. In a 5-month period, SARS-CoV-2 serology test volumes amounted to only 1.3% of that of reverse transcriptase polymerase chain reaction. Unlike reverse transcriptase polymerase chain reaction, supply chain challenges and reagent availability were not major issues for serology testing. We also discuss the most recent challenge of requirements for SARS-CoV-2 testing in international travel protocols. Overall, our experience at an academic medical center shows that SARS-CoV-2 serology testing assumed a limited clinical role.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Prognostic study Language: English Journal: Acad Pathol Year: 2021 Document Type: Article Affiliation country: 23742895211002802

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Prognostic study Language: English Journal: Acad Pathol Year: 2021 Document Type: Article Affiliation country: 23742895211002802