SARS-CoV-2 detecting the virus and immunity
At the beginning of March it was clear that the corona pandemic was not going to skip the Netherlands. Medical Microbiology (MMB) was in for a busy period. MMB staff were rapidly being prepared to make the diagnosis of this infection, and microbiology experts were involved in the coordination, organization and implementation of all kinds of matters relating to the SARS-CoV-2, both at the UMC Utrecht and at the national level.
The number of patients was growing and the UMC Utrecht was preparing for the pandemic. The SARS-CoV-2 PCR was implemented at the molecular virology laboratory. Soon the diagnostic capacity was scaled up because of the large number of samples that came in. The drive-through at P-South was also set up. Its design and coordination is in the hands of P&O, MMB and the Facilities Department. Staffing is arranged from our division.
7,000 throat/nose swabs
In addition to a few employees and AIOS of the MMB (research), staff from other laboratories and students are involved in taking the throat/nose swabs. Some institutions in the vicinity also use the drive-through, such as the Hoogstraat, the Princess Máxima Center and the RAVU. Shortly after the opening in March, the number of applications for a test for the SARS-CoV-2 virus increased in a few weeks to a maximum of 600 applications on one day. Currently the number is stable at around 30-50 per day. The test result is usually known within one day. In total, nearly 7,000 throat and nose swabs have now been taken at P-South. In addition to samples from our own test facility and clinical samples, samples from the SALTRO diagnostic general practitioners' laboratory and the GGD municipal public health service also arrive at the MMB laboratory. Several hundred samples are tested daily for the SARS-COV-2 virus and capacity can be increased if the number of samples increases.
New antibody test
Since Tuesday, June 2, a new, sensitive test for detecting SARS-CoV-2 IgG antibodies has been available at MMB. It is used to check whether patients who have had, currently or recently, mild to severe COVID-19-like symptoms for at least 14 days have been infected with the coronavirus. Having mild or severe COVID-19-like symptoms for at least 14 days is an important limit. With fewer number of days, the body may not have produced sufficient antibodies to be able to detect an infection with certainty. As a matter of fact, the presence of antibodies does not mean you are protected against the coronavirus – and even if you are, the question is for how long the immunity will last.
The MMB department developed the antibody test in collaboration with the Virology department of the Faculty of Veterinary Medicine (Utrecht University). By developing the test in-house, we are less dependent on the availability of commercial tests. The antigen that MMB uses to develop the test is the one that the Serology Task Force, which is part of the National Coordination Structure for Testing Capacity (LCT), has identified as the best for SARS CoV-2 IgG antibody testing.
PCR rapid diagnosis
In addition to the regular PCR for the detection of the coronavirus for the screening of staff and patients, MMB has now also implemented a rapid test for the detection of SARS-CoV-2 infection. There are specific indications for which it is important that these diagnoses are established more quickly. From the beginning of June it will be possible to use PCR diagnoses of SARS-CoV-2 cito for these strict indications by means of rapid molecular diagnostic testing. Unlike the regular PCR, this rapid diagnosis is only possible on a combined throat/nasopharynx swab and can only take place in consultation with the virologist on duty. One of the indications is, for example, testing the donor/recipient of a transplant.
In addition to MMB's participation in the coordination and diagnostics at the UMC Utrecht, MMB staff members are also part of national organizations such as the Molecular Diagnostics Task Force, the LDCK, and the Diagnostics Expertise Team of the Federation of Medical Specialists. The diagnostic tests carried out by MMB for the SARS-CoV-2 virus can be found on the UMC Utrecht website at Medical Microbiology.
Complaints? Get tested!
For staff the advice remains: Do you have any complaints? Get tested! This helps detect infections among staff in good time and hence prevent them from spreading within our hospital. In order to guarantee the safety of staff, patients and students, it is important that everyone who has complaints is (quickly) tested for the presence of SARS-CoV-2 via P&O Health. You can sign up for a test via Connect.