Ordering Recommendations

For inpatients use the inpatient COVID order panel. For outpatients order “COVID-19 (SARS-CoV-2) RT-PCR” with the appropriate ordering indication.

Patient Preparation

None

Collect

Preferred specimen type:
A nasopharyngeal (NP) swab in a single collection tube containing viral transport medium (or equivalent medium).

Also acceptable specimens:
A nasopharyngeal swab in a single collection tube containing viral transport medium (or equivalent medium).

A nasal swab (anterior nares or NS) specimen in a single collection tube containing viral transport medium (or equivalent medium). A single swab should be used to sample both nares.

Broncohavelolar lavage (BAL), tracheal aspirates, and nasal aspirates collected in a sterile container are accepted and sendout testing is available. Contact the laboratory to coordinate sendout testing.

Sample collection with a flocked swab is preferred. Collection should be conducted with a sterile swab. Use only synthetic fiber (polyester or nylon) swabs with plastic or aluminum shafts.

Preferred media:
Viral transport media (VTM)
Universal transport media (UTM)
0.9% saline (sterile)

Alternative media that will be accepted but may be signed out with a disclaimer:
M4, M4RT, M5, M6, 1xPBS (sterile)

Pediatric Collection

Nasal swab (anterior nares or NS) specimens and nasal aspirate specimens collected from pediatric patients can be run in HUP Molecular Pathology or HUP Microbiology Labs. Please send to CR&P with comment that testing is for a pediatric patient.


 

Specimen Preparation

Ensure specimens are properly sealed to prevent leakage.
If sending sample in alternative media, be sure media type is clearly indicated on collection tube.
Do not spin or separate the specimen.
Place barcoded sticker on sample and send to Central Receiving or Rittenhouse Laboratory. 
 

Storage/Transport Temperature

Transport - Room temperature or refrigerated (4°C)
 

Stability (from collection to initiation)

VTM/UTM
Room temperature for approximately 8 hours.
Refrigerated for approximately 2 to 3 days.
Frozen for approximately 12 months (VTM/UTM) or 6 months (Saline).
 

Unacceptable Conditions

Inappropriate swab types: Do NOT use calcium alginate swabs or swabs with wooden shafts, as they may contain substances that inactivate some viruses and inhibit PCR testing. Inappropriate collection medium: Any medium not listed above as an acceptable alternative to VTM including gel and charcoal based mediums.

Inappropriate sample types: blood, stool, or CSF.

Lack of transport media: Swab must be sent in appropriate transport medium.
Do not send dry swabs.
Mislabeled, broken or leaking samples

Notes

NP swab: Insert the mini-swab into nostril parallel to the palate. Swab should reach depth equal to distance from nostrils to outer opening of the ear. Leave swab in place for several seconds to absorb secretions. Slowly remove swab while rotating it. Place the swab immediately into sterile tubes containing viral transport media.

NP/OP swab: For the NP sample, insert the mini-swab into nostril parallel to the palate. Swab should reach depth equal to distance from nostrils to outer opening of the ear. Leave swab in place for several seconds to absorb secretions. For the OP sample, swab the posterior pharynx, avoiding the tongue. Place both swabs immediately into sterile tubes containing viral transport media.

Nasal swab (anterior nares): A single swab should be used to sample both nares. Insert the swab into the nostril and then rotate in a circular motion at least 2 times. Leave the swab in place for several seconds to absorb secretions. Repeat the process for the other nostril using the same swab. Place the swab immediately into sterile tubes containing viral transport media.

Nasal aspirate: Collect 2-3 mL of aspirate into a sterile, leak-proof, screw-cap collection cup or sterile dry container.

Processing - HUP

Order the test (if necessary), place a barcoded sticker on the tube. Accession and place specimen and requisition in the Molecular RVP rack.

Processing - PAH

Send the approved requistion and sample to HUP Central Receiving.  The test will be ordered there. If the sample is already at HUP, fax the approved requisitions to CR&P at 215-349-8294.

Processing - Presbyterian

Send the approved requistion and sample to HUP Central Receiving.  The test will be ordered there. If the sample is already at HUP, fax the approved requisitions to CR&P at 215-349-8294.

Reference Interval

Not Detected

Interpretive Data and Information

Refer to the report for full interpretative details.
SARS-CoV-2 testing is based on more than one method. The methodology is specified in each report. A fact sheet for each method is provided below.

GenMark Fact Sheet for HealthCare Providers

Cobas 6800/8800 SARS-CoV-2 & Influenza A/B V2 Fact Sheet for HealthCare Providers

Clinical Significance

This assay was developed in response to the SARS-CoV-2 public health emergency using readily available information and resources. This test is intended for individuals suspected to have COVID-19 by their health care provider. The assay detects nucleic acid from SARS-CoV-2 (see method). It does not detect other common respiratory pathogens, including the common human coronavirus strains (229E, HKU1, NL63, OC43). SARS-CoV-2 is generally detectable in respiratory specimens during infection, but may be affected by sample collection methods, patient factors (e.g., presence of symptoms), and/or stage of infection. While a nasopharyngeal specimen is the preferred choice for swab-based testing, other upper respiratory specimen types are considered acceptable alternatives for SARS-CoV-2 testing based on guidance from the CDC and FDA. However, the performance characteristics of mid-turbinate and nasal swab specimens have not been fully established for all methods, so their performance may differ from nasopharyngeal samples. A "Positive" result suggests an active infection with SARS-CoV-2 but does not rule out bacterial infection or co-infection with other viruses.  A "Not Detected" result does not preclude SARS-CoV-2 infection and should not be used as the sole basis for treatment or other patient management decisions.

News and Updates

04/07/2020 - COVID 19 Critical Value Discontinuation
 
 

CPT Codes

U0003

LOINC

  • 94533-7
Collection & Processing

Ordering Recommendations

For inpatients use the inpatient COVID order panel. For outpatients order “COVID-19 (SARS-CoV-2) RT-PCR” with the appropriate ordering indication.

Patient Preparation

None

Collect

Preferred specimen type:
A nasopharyngeal (NP) swab in a single collection tube containing viral transport medium (or equivalent medium).

Also acceptable specimens:
A nasopharyngeal swab in a single collection tube containing viral transport medium (or equivalent medium).

A nasal swab (anterior nares or NS) specimen in a single collection tube containing viral transport medium (or equivalent medium). A single swab should be used to sample both nares.

Broncohavelolar lavage (BAL), tracheal aspirates, and nasal aspirates collected in a sterile container are accepted and sendout testing is available. Contact the laboratory to coordinate sendout testing.

Sample collection with a flocked swab is preferred. Collection should be conducted with a sterile swab. Use only synthetic fiber (polyester or nylon) swabs with plastic or aluminum shafts.

Preferred media:
Viral transport media (VTM)
Universal transport media (UTM)
0.9% saline (sterile)

Alternative media that will be accepted but may be signed out with a disclaimer:
M4, M4RT, M5, M6, 1xPBS (sterile)

Pediatric Collection

Nasal swab (anterior nares or NS) specimens and nasal aspirate specimens collected from pediatric patients can be run in HUP Molecular Pathology or HUP Microbiology Labs. Please send to CR&P with comment that testing is for a pediatric patient.


 

Specimen Preparation

Ensure specimens are properly sealed to prevent leakage.
If sending sample in alternative media, be sure media type is clearly indicated on collection tube.
Do not spin or separate the specimen.
Place barcoded sticker on sample and send to Central Receiving or Rittenhouse Laboratory. 
 

Storage/Transport Temperature

Transport - Room temperature or refrigerated (4°C)
 

Stability (from collection to initiation)

VTM/UTM
Room temperature for approximately 8 hours.
Refrigerated for approximately 2 to 3 days.
Frozen for approximately 12 months (VTM/UTM) or 6 months (Saline).
 

Unacceptable Conditions

Inappropriate swab types: Do NOT use calcium alginate swabs or swabs with wooden shafts, as they may contain substances that inactivate some viruses and inhibit PCR testing. Inappropriate collection medium: Any medium not listed above as an acceptable alternative to VTM including gel and charcoal based mediums.

Inappropriate sample types: blood, stool, or CSF.

Lack of transport media: Swab must be sent in appropriate transport medium.
Do not send dry swabs.
Mislabeled, broken or leaking samples

Notes

NP swab: Insert the mini-swab into nostril parallel to the palate. Swab should reach depth equal to distance from nostrils to outer opening of the ear. Leave swab in place for several seconds to absorb secretions. Slowly remove swab while rotating it. Place the swab immediately into sterile tubes containing viral transport media.

NP/OP swab: For the NP sample, insert the mini-swab into nostril parallel to the palate. Swab should reach depth equal to distance from nostrils to outer opening of the ear. Leave swab in place for several seconds to absorb secretions. For the OP sample, swab the posterior pharynx, avoiding the tongue. Place both swabs immediately into sterile tubes containing viral transport media.

Nasal swab (anterior nares): A single swab should be used to sample both nares. Insert the swab into the nostril and then rotate in a circular motion at least 2 times. Leave the swab in place for several seconds to absorb secretions. Repeat the process for the other nostril using the same swab. Place the swab immediately into sterile tubes containing viral transport media.

Nasal aspirate: Collect 2-3 mL of aspirate into a sterile, leak-proof, screw-cap collection cup or sterile dry container.

CR&P Information

Processing - HUP

Order the test (if necessary), place a barcoded sticker on the tube. Accession and place specimen and requisition in the Molecular RVP rack.

Processing - PAH

Send the approved requistion and sample to HUP Central Receiving.  The test will be ordered there. If the sample is already at HUP, fax the approved requisitions to CR&P at 215-349-8294.

Processing - Presbyterian

Send the approved requistion and sample to HUP Central Receiving.  The test will be ordered there. If the sample is already at HUP, fax the approved requisitions to CR&P at 215-349-8294.
Result Interpretation

Reference Interval

Not Detected

Interpretive Data and Information

Refer to the report for full interpretative details.
SARS-CoV-2 testing is based on more than one method. The methodology is specified in each report. A fact sheet for each method is provided below.

GenMark Fact Sheet for HealthCare Providers

Cobas 6800/8800 SARS-CoV-2 & Influenza A/B V2 Fact Sheet for HealthCare Providers

Clinical Significance

This assay was developed in response to the SARS-CoV-2 public health emergency using readily available information and resources. This test is intended for individuals suspected to have COVID-19 by their health care provider. The assay detects nucleic acid from SARS-CoV-2 (see method). It does not detect other common respiratory pathogens, including the common human coronavirus strains (229E, HKU1, NL63, OC43). SARS-CoV-2 is generally detectable in respiratory specimens during infection, but may be affected by sample collection methods, patient factors (e.g., presence of symptoms), and/or stage of infection. While a nasopharyngeal specimen is the preferred choice for swab-based testing, other upper respiratory specimen types are considered acceptable alternatives for SARS-CoV-2 testing based on guidance from the CDC and FDA. However, the performance characteristics of mid-turbinate and nasal swab specimens have not been fully established for all methods, so their performance may differ from nasopharyngeal samples. A "Positive" result suggests an active infection with SARS-CoV-2 but does not rule out bacterial infection or co-infection with other viruses.  A "Not Detected" result does not preclude SARS-CoV-2 infection and should not be used as the sole basis for treatment or other patient management decisions.
Testing Updates

News and Updates

04/07/2020 - COVID 19 Critical Value Discontinuation
 
 
Billing Codes

CPT Codes

U0003

LOINC

  • 94533-7

Ordering Information

Cerner Orderable
 Case – COVID-19; COVID19
Penn Chart Orderable
COVID-19 (SARS-CoV-2) RT-PCR
Performing Lab
Rittenhouse Molecular Testing Lab;  HUP Clinical Microbiology
Performed
Sunday - Saturday
Reported
Daily
Methodology
RT-PCR
Synonyms
  • Wuhan
  • 2019-nCoV
  • SARS Coronavirus

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