Over the past two months we’ve ramped up our testing efforts and now have a second SARS-CoV-2 testing option (SARS-CoV-2 is the virus that causes the COVID-19 infection). The test most familiar is the PCR nasal swab test, which should be the first-line test for active signs and symptoms of COVID-19. The new test identifies SARS-CoV-2 antibodies in individuals who have had a previous infection of the virus. Our testing capacity is very limited, so we will be prioritizing these tests as follows:
First Priority Category:
Hospitalized patients with signs and symptoms of COVID-19 for at least 7 days AND a negative SARS-CoV-2 PCR test. The viral load in the upper respiratory tract in patients with COVID-19 begins to fall early in the disease course. If a patient has signs and symptoms of COVID-19 and their PCR test is negative, an antibody test may be helpful in diagnosing the acute infection, but the test should be sent at least 7 days after symptom onset. If the initial serology test is negative, repeat the test after the patient has had symptoms for at least 14 days if clinical suspicion remains high.
Second Priority Category:
Patients or healthcare workers who had a respiratory tract infection consistent with COVID-19 after December 1, 2019 that was previously undiagnosed. Individuals must have resolution of respiratory tract symptoms for at least 14 days prior to serology testing.
Asymptomatic patients and healthcare workers with high-risk, unprotected exposures to known COVID-19 patients. The testing should be greater than seven days from the exposure (preferably 14 days) to ensure sensitivity of the test. A household contact of a COVID-19-infected patient is an example of an asymptomatic, high-risk exposure patient. Intermountain caregivers with a high-risk, unprotected COVID-19 exposure may contact ASK HR to access Employee Health directly for testing.
CAUTION
- Please keep in mind that the role and interpretation of antibody tests in the diagnosis of acute or previous SARS-CoV-2 infection is unclear and is subject to change given the rapidly evolving science of SARS-CoV-2 infection.
- Results of antibody testing should not be used as the sole basis to diagnose acute infection. Results should also not be used to make recommendations on limiting social or environmental exposures or changes to work-related policies, particularly PPE, masking, and face-covering guidelines.
- A positive test should not provide assurance that a patient is immune to SARS-CoV-2. At this time, we do not know if a positive antibody test provides any protective immunity against repeat SARS-CoV-2 infection.
If you are ordering the SARS-CoV-2 serology test, please do not send symptomatic patients to laboratories or blood collection sites.
Ordering providers may use the PowerForm instructions here to follow the iCentra algorithms.
More information on supporting and providing antibody testing access to asymptomatic patients who are not hospitalized will be provided shortly.