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“The most common laboratory tests for COVID-19 patients constitute C-reactive protein, D-dimer, CBC, CMP, magnesium, and creatine kinase,” said Radke. “Admission labs are more diverse and include BNP, Procalcitonin, Urine Legionella Antigen, LDH, Vitamin D, and more. With COVID trending towards becom- ing more of an endemic and less lethal virus, I see our health system reducing some of the daily and admission labs. We are in discussions to reduce D-dimer, CBC w/ differential, BNP, and a few other assays to an as needed basis.” For COVID-19 specifically, Radke says testing methodology has changed with the availability of supplies. For most of the pandemic, his lab was running the 7500 Fast Dx instrument for high-volume PCR testing because they could obtain the required supplies and had the technical staff to perform it. They complimented this testing with faster PCR methods from Cepheid and BioFire for cases requir- ing rapid/urgent results.
“With the Omicron surge, we split testing between the 7500 Fast Dx and the Hologic Panther TMA assay as supply became more available,” Radke explained. “This allowed for expansion of our testing person- nel to provide timely molecular results, balanced workloads, and decreased supply constraints.”
“As we have been dealing with bouts of Stealth Omicron infections, most routine testing is occurring on the Hologic Panther instrument as the platform is more conducive to runs below 100 samples,” he added. “I’d like to believe we will not be changing methodology for COVID testing this year, but supply constraints may drive that consideration.”
More use of multiplex
Among lab professionals surveyed, 69% said they are using syndromic testing (multiplex) to detect SARS-CoV-2 and other infectious diseases, such as Flu A & B, RSV (up from 55% in 2021), and a further 2% said they plan to begin this type of testing in the future (down from 9% in 2021). “Adapting to the various variants and the episodic surges prompted us to update our testing method- ologies for COVID,” said Fontanilla. “We have the ID NOW and the Cepheid for our in-house needs, and we sent our pre-ops to a reference lab. However, when we were not able to obtain kits due to supplies being back ordered, we had to limit in-house testing for urgent COVID tests and send the majority to the reference lab. We also had to switch from the single Cepheid reagent to the four-plex cartridge.” When asked if reimbursement for PCR tests to
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