The Need for Efficiency in SARS-CoV-2 Antibody Testing

Backlogs at private laboratories have ballooned, making it difficult to treat patients and contain the COVID-19 pandemic.¹ To assist in bringing the coronavirus pandemic under control, widespread testing is required to detect current and past infections. Testing can help guide treatment and quarantine decisions as well as offer data to understand the extent of the COVID-19 outbreak.

However, more testing means more pressure on laboratories, specifically with regard to labor and test turnaround time (TAT). Most of the current COVID-19-related lab tests take about a day to return results; some point-of-care tests are faster but need to be run one at a time, which is inefficient. And regardless of the test, there is a need for people to log the test, run the test, ensure quality controls are in place and report results. Right now, there is a shortage of skilled labor to support the influx of demand.²

Lab turnaround time is also vitally important. Time-to-negative results for a mildly ill patient can create a bottleneck and prevent physicians from focusing on patients who are infected. Patients who are intubated and sick cannot be given experimental drugs until they receive a positive PCR test result. According to Geoff Baird, acting laboratory-medicine chair at the University of Washington, “[TAT of] more than a day is a tragedy. Three to five is okay for outpatients if they can sit at home, but it doesn’t address the problem in a hospital.”³

Improving Lab Efficiency Supports Patient Care

Efficiency has always been an important focus area for laboratories and may be even more important during the current pandemic where the pressure on the laboratory is unprecedented.

To drive efficiency in COVID-19-related testing, laboratories need an assay that can seamlessly integrate into their routine workflow without batching and extra maintenance.

Here are some capabilities to look for when considering a COVID-19-related assay.

Single sample random access

As labs evaluate serology testing, it is important to understand if it can integrate into routine workflow or if there are special requirements. Single sample random access offers workflow flexibility to the laboratory as well as potential benefits from automation. In contrast, batch processing of antibody testing for SARS-CoV-2 is inefficient as it requires laboratories to wait until they have enough tests to satisfy their batch size before they can run the tests. In addition, when a laboratory runs the antibody test, they have to stop all other immunoassay testing, slowing down TAT for all assays. Batching can sometimes turn a 30-minute test TAT into a much longer TAT, depending on how long the laboratory is left to collect samples before running the test.

The goal of Beckman Coulter’s Access SARS-CoV-2 IgG assay was to seamlessly integrate into routine laboratory workflow without the need for batching or special maintenance, offering industry-leading uptime. The test can be run on DxI 800 immunoassay analyzers with industry-leading throughput of 200 tests/hour—which means a laboratory with one DxI 800 analyzer can run up to 4,800 tests per day. The Access SARS-CoV-2 assay is also designed for use on DxI 600 immunoassay analyzers (100 tests/hour) and DxCi and Access 2 immunoassay analyzer platforms (50 tests/hour).

In addition, QC procedures for this assay need only be conducted once every 24 hours (or as required by individual laboratory procedures). Combined with its 200 tests/kit capacity, laboratories can be more efficient without running extra QC or other processes involved with changing test kits.

Clinical Informatics to Improve Reporting

With laboratories running an unprecedented amount of SARS-CoV-2 related tests—both diagnostic and serological—there is an even higher need for these test results to be collated and delivered to health organizations so they can get a clearer Access-SARS-CoV-2-IgG antibody test picture of disease prevalence. 

One of the unique benefits of a Beckman Coulter solution is REMISOL Advance, a middleware system that integrates with third-party systems that run diagnostic tests, such as Cepheid’s GeneXpert® Systems that are running Xpert® Xpress SARS-CoV-2 test.

Laboratories are required to report any positive SARS-CoV-2-related test results to public health authorities in a timely fashion. Utilizing robust reporting capabilities in REMISOL Advance, the lab can create a custom list of relevant tests and associated positive results for extract from the system, thereby allowing for simple and seamless reporting to federal agencies without cumbersome manual tracking or queries of Laboratory Information Systems.

Learn more about the Access SARS-CoV-2 IgG assay.