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COVID-19 Insights & Analytics Issue 9
Impact on Microbiology Specimens Tested

Mar 3, 2021

Overview

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The COVID-19 Insights & Analytics newsletter is designed to provide you with a summary to quantify national trends that may help in COVID-19 response planning. The included data, analytics and dashboards are generated utilizing BD HealthSight™ Infection Advisor Analytics and are derived from electronic patient data from 338 participating U.S. hospitals initiated on March 1, 2020 through January 26, 2021 unless otherwise indicated.

Introduction

The availability of PCR testing for COVID-19 heralded a clinical need to differentiate between COVID and other types of infections resulting in a surge of testing specimen volumes for Microbiology & Molecular labs. This issue looks at the total impact on specimen volumes in hospital and related outpatient labs.

Executive Summary

  • Since the start of the pandemic, overall microbiology testing has increased +40% from June 2020 through January 2021 correlating with increasing access and availability to COVID-19 PCR diagnostics.
  • This widescale increase in COVID-19 testing is offset by reductions in non-COVID-19 microbiology testing (down 20% compared to the prior pre-pandemic year) explained by reduced non-COVID-19 related inpatient admission and outpatient appointments.
  • Epidemics and pandemics can greatly affect microbiology lab volume and throughput. Signals of largescale infection surges in the community could be used to gauge microbiology lab resource needs. What will be the impact on your microbiology lab going forward with the roll out of COVID-19 vaccination and the reductions in daily COVID-19 positives & COVID-19 hospitalizations?

Figure 1: % Change is weekly Microbiology specimens tested

Figure 1 Commentary

  • During the beginning of the first wave of the pandemic, where restrictions on elective surgeries and stay at home orders presumably kept patients out of the emergency room and formal outpatient appointments, there was a -20% reduction in specimens tested.
  • Microbiology specimen volumes in the outpatient setting normalized by late May 2020, assumedly due to a combination of increased COVID-19 cases and the re-establishment of elective procedures and outpatient visits.
  • The availability of EUA COVID-19 (SARSCoV-2) PCR tests (starting April 21, 2020) correlates with significant increase in microbiologic diagnostic demand in both inpatient and outpatient areas. This demand has remained consistent through the first month of 2021.
  • Overall specimens have grown +40% since June 2020. (Note green line in Figure 1 & 2 graphics) Inpatient specimens have been up a consistent +30% through the period, with outpatient specimens outpacing it with consistent +50% growth compared to a year ago.

Figure 2: % Change is weekly Microbiology specimens tested (Excluding specimens tested for COVID-19)

Figure 3: % Change in weekly inpatient admissions

Figure 2 examines weekly % change vs year ago for Inpatient Admissions

Figure 2 & 3 Commentary

  • Since June 2020, non-COVID-19 microbiology tests have been down from -10 to -20%. With a downward trend from June through January.
  • Inpatient specimens have been down -5 to -10%, from June through December with a slight dip down to -15% in January
  • Inpatient Admission were down -10% from June through November, and down -15 to -20% in November to January, which roughly correlates with the % decrease in non-COVID-19 microbiology testing.
  • The presence of COVID-19+ inpatients likely drove other non-COVID-19 microbiology testing and is a credible reason why inpatient specimens were down less than inpatient admissions. Patients with COVID-19 are tested up to 98% of the time with a microbiology diagnostic other than SARS-CoV-2 testing1
  • Outpatient specimens tested has been down -20% June through November, then dipped to -25 to -30% in December and January. Likely indicating a reduction in outpatient appointments during the height of the 3rd wave of the pandemic.
  • The recent decline (November 2020 through February 2021) in inpatient admissions and outpatient appointments are likely driven by an unusually mild influenza season2.

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