Journal: Wires Mechanisms of Disease

Article Title: Caring for COVID‐19 patients through a pandemic in the intensive care setting: A narrative review

doi: 10.1002/wsbm.1577

Figure Lengend Snippet: Summary of diagnostics for COVID patients admitted to The General Intensive Care Unit, at University Hospital Southampton, United Kingdom

Article Snippet: In‐laboratory COVID‐19 diagnosis , Patients were tested for SARS‐CoV‐2 RNA at our Specialist Virology Centre. Using combined mid‐turbinate and throat swabs were placed in to VIROCULT virus transport medium (Sigma). Swabs were extracted using MicrosensDx RapiPREP nucleic acid extraction reagents and purified using magnetic particle extraction on the Thermo Scientific KingFisher Flex using the current standard operational procedures. All lower respiratory tract samples were extracted using the QIAsymphony SP and the QIAsymphony DSP Virus/Pathogen Mini Kit (both from Qiagen, Germantown, MD) according to the manufacturer's recommendations. Amplification took place on Applied Biosystems (ABI) 7500s using the Viasure NCO2 SAR‐CoV‐2 RT‐PCR kit (Prolabs, ORF1ab, and N genes). Additionally, each sample was tested using an in‐house World Health Organization E sarbecco gene assay (including an internal amplification control from extraction), to enhance sensitivity and prevent false negative results from being reported. The difference in method reflects the move from QIAsymphony to Kingfisher for respiratory swabs; however, saliva and lower respiratory samples were still processed using the QiaSymphonySP. PCR was performed using the ABI 7500 no matter which extraction technology was used. Patients provided an upper respiratory tract (combined mid‐turbinate and throat) swab prior to GICU admission in ICU most of these samples being endotracheal aspirates, sputum specimens and BALs. Average turnaround time was around 8 h for in lab PCR and at the time ~2500–3000 test per day during the peak period from both waves..

Techniques: Purification, Amplification, Gene Assay, Infection, AST Assay, Coagulation, D-dimer Assay, Microscopy, Polymerase Chain Reaction