Yaara Ben-Yosef, regulatory & clinical affairs manager at PixCell Medical, examines the innovations in point-of-care diagnostic solutions during the COVID-19 pandemic.
Throughout the COVID-19 pandemic there have been several tests, treatments, and methods claiming to manage the disease, many of which have proved to be ineffective.
One key source of information that has proven consistently valuable is the blood. Floating in our bloodstream, along with red blood cells, white blood cells, and platelets, is a treasure trove of information about our health. Gathering and interpreting this data is of great importance, allowing doctors and epidemiologists to fully understand the impact of the disease on the patient and the wider population.
The science – the Complete Blood Count
One of our most heavily relied upon haematological tools, both prior to and during the pandemic, is the Complete Blood Count (CBC) test, the most frequently ordered blood test in the US and globally. This test evaluates the cells that circulate in the blood, including red blood cells (RBCs), white blood cells (WBCs), and platelets (PLTs), providing critical information on a patient’s health status.
The CBC is used routinely in initial screenings upon admission of suspected COVID-19 patients to the hospital, as the RT-PCR test has a non-negligible false negative or false positive rate, and adjunctive tests assist in assigning degrees of urgency to patients. The CBC is used to monitor the progression of disease and host response and can provide a reliable indication of how severe the disease will become in each patient. A recent study that published a meta-analysis of 21 COVID patients concluded that for hospitalised patients with respiratory distress, it is strongly recommended that clinicians closely monitor WBC count, lymphocyte count, and platelet count as markers of disease progression. These counts are all included in the routine CBC test.
The CBC is an essential resource for efficiently assessing the urgency of each patient’s situation, allowing clinicians to prioritise the most severe cases, and manage the disease throughout its progression.
The technology – point-of-care testing
The current method of processing a blood test is familiar to most of us - the patient presents themselves at a clinic where blood is drawn by a technician, after which the sample is sent to a centralised laboratory while the patient awaits the results. This can take from hours up to days to receive.
As the need for rapid blood testing has grown, diagnostic instruments must become portable and easier to use. While results from clinical laboratories remain a crucial component of our healthcare system, they should be complemented by tests performed outside of the laboratory, at the point of care.
Decentralising the testing process for suspected or quarantined COVID-19 patients is necessary to properly evaluate, monitor and treat the disease. Decentralised diagnostic solutions must be readily deployable, easy-to-use, compact, and accurate so that they fit “pop-up” treatment centres, field hospitals, and isolation wards within hospitals. Without these features, clinicians struggle to create an efficient workflow in COVID-19 hospital units and risk contamination of hospital labs and staff.
A major concern throughout the pandemic is that hospitals will not be able to function due to shortages in resources and medical staff. Medical personnel have become infected by the virus at exceedingly high rates – according to the International Council of Nurses, as many nurses have died during this pandemic than in World War I and an estimated 10% of cases are among healthcare workers. It is therefore critical to introduce technologies that help minimise the risk of contamination, including diagnostic devices that can be operated within isolation wards rather than needing to carry samples through the hospital to the lab where staff and equipment have the potential to become contaminated.
In some cases, infectious patients can have their own point-of-care (POC) device in their hospital room and can perform the CBC testing on themselves by taking a simple finger prick of blood and using the automated, easy-to-use device to run the test. This conserves resources and greatly lightens the load on hospital staff, as patients are monitored daily – and can potentially perform these tests autonomously. These tests provide accurate and rapid information, allowing doctors to make timely clinical decisions and personalise treatment plans for each patient.
Point-of-care CBC testing can lead to more efficient, effective medical treatments and improved quality of medical care, allowing for more frequent and consistent testing cases of COVID-19. These tests can also help lower the risk of hospital personnel contamination, alleviate hospital overcrowding by reducing the time it takes to treat patients, and efficiently allocate resources to the most severe cases.
