Research

The impact of a mobile COVID-19 polymerase chain reaction laboratory at a large tertiary hospital during the first wave of the pandemic: A retrospective analysis

S Omar, J M Brown, R L Mathivha, I Bahemia, F Nabeemeeah, N Martinson

Abstract


Background. The onset of the COVID-19 pandemic in South Africa (SA) created numerous supply challenges. Demand for diagnostic testing overwhelmed the capacity to deliver. We describe the utility and outcomes of a mobile laboratory staffed by non-laboratory healthcare workers and established to perform polymerase chain reaction (PCR) testing for the rapid diagnosis of COVID-19 at a large hospital in SA.

Objectives. To describe the performance of the mobile PCR COVID-19 laboratory. The secondary objective was to determine the prevalence of COVID-19 infections in the non-COVID intensive care unit (ICU).

Methods. This was a retrospective descriptive study of data from the newly established mobile COVID-19 PCR laboratory database and the non-COVID ICU database during the first peak of the COVID-19 pandemic (20 May - 8 August 2020) at a tertiary hospital in SA.

Results. The mobile laboratory received 1 113 emergency COVID-19 PCR test requests for patients with non-COVID clinical presentations. The median (interquartile range) turnaround time was 152 (123 - 184) minutes (n=36). Primary outcome (20 May - 19 June, n=315): The sensitivity and specificity were 95% and 97%, respectively, and the positive and negative predictive values 82.4% and 99.2%, respectively. Secondary outcomes (9 June - 8 August): The prevalence of COVID-19 infections among patients admitted to the multidisciplinary adult and paediatric non-COVID ICU was 2.4% (n=4/168). The mean (standard deviation) COVID-19 positive rate for the mobile laboratory during this period was 18.1% (6%). The prevalence of COVID-19 infections among medical staff in the non-COVID ICU was 3.1% (n=1/32).

Conclusions. The establishment of a mobile PCR laboratory staffed by non-laboratory healthcare workers during the COVID-19 pandemic provided a rapid, accurate and clinically effective solution for emergency hospital admissions with non-COVID-19 presentations.


Authors' affiliations

S Omar, Intensive Care Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

J M Brown, Intensive Care Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

R L Mathivha, Intensive Care Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

I Bahemia, Intensive Care Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

F Nabeemeeah, Intensive Care Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

N Martinson, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

COVID-19; Mobile laboratory; Intensive care unit; Emergency admissions; Polymerase chain reaction; PCR

Cite this article

South African Medical Journal 2021;111(10):957-960. DOI:10.7196/SAMJ.2021.v111i10.15690

Article History

Date submitted: 2021-10-05
Date published: 2021-10-05

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