Coronavirus in Poland. What is its diagnosis? [WE EXPLAIN]

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Coronavirus is not easy to spot. It happens that the tests give false-positive results and have to be repeated. Laboratory diagnosticians working in 11 centers scattered all over the country ensure that they are delivered as soon as possible.

1. In order to detect the coronavirus, a multi-stage molecular test must be carried out on a sample, most often a nasopharyngeal swab. The laboratory diagnostician must first evaluate the value of the collected material
2. Two types of laboratories are involved in the study of the new coronavirus strain: the third and the second degree of airtightness
3. – We currently do not have any reliable high-speed «strip» tests for the presence of the SARS-CoV-2 virus. But we are still working on improving the tests and we will probably see the next generations soon – says laboratory diagnostics, Dr. Karolina Bukowska-Strakova

Coronavirus Test. Step by step

Performing a laboratory test for the presence of coronavirus is a complicated and multi-step procedure. You have to carry out molecular test, i.e. nucleic acid analysis. It is performed not only to identify pathogens, but also, inter alia, in the diagnosis of genetic diseases and the study of the basis of neoplastic diseases. The sensitivity of molecular tests is over 99%. What is the study conducted with the help of such tests? This is explained in an interview with Medonet by the laboratory diagnostician:

– This is a test that requires professional knowledge, entirely carried out in a medical laboratory by highly qualified personnel, i.e. by laboratory diagnosticians. The question of research into a new pathogen is complicated. At this stage where we are now, diagnostic tests confirm the presence of the virus using tests recommended by WHO and the European Center for Disease Prevention and Control. The tests used are fully reliable and validated – says Dr. Karolina Bukowska-Strakova.

Samples from patients who have been indicated by sanitary inspectors are tested for coronavirus. It is the poviat sanitary and epidemiological station that should be the first contact in the event of suspected infection with this virus. Sanepid conducts an initial interview with the patient and refers him to the appropriate hospital, and then has supervision over him.

SARS-CoV-2 is detected by analysis nasopharyngeal swabs, blood or stool samples (it is droplet transmission, but also oral-fecal transmission cannot be ruled out).

A sample taken from the patient from the infectious diseases ward is transported to the laboratory by medical transport in a tightly closed, multi-layer package. Goes to third degree hermetic laboratory (BSL-3). The third level is recommended for work with a live virus that requires inactivation by adding special reagents. After inactivation, the nucleic acid (in this case RNA) is isolated – then the virus ceases to have infectious potential. Determinations of inactivated material can already be carried out in the laboratory of stage 2 (BSL-2), where the isolated RNA is transported. That’s when molecular research begins.

– We are using two different methods at the moment. The first is PCR reaction using reverse transcriptase, the second method is the same, but uses thermocyclers to read the result in real time, the so-called real-time PCR using a special DNA probe. Each of these methods has its own advantages and targets different parts of the viral genome. The real-time method gives the result quickly and is very sensitive, i.e. we can detect a small amount of the virus, but also there is a risk of false positives – precisely because of such a high sensitivity – explained in an interview with PAP Prof. Rafał Gierczyński, deputy director for epidemiological and environmental safety at NIZP-PZH.

It all depends on diagnosticians

The personnel performing the examination must comply with the standards of increased personal protection. He wears protective clothing that covers his mouth, eyes and hands: a mask, gloves, long-sleeved coveralls, which are disposed of or sanitized at the end of the work, as are test tubes and other waste. The working conditions are very difficult due to negative pressure maintained in the laboratory. Dry air, constantly changed and cleaned with HEPA filters, prevents the diagnostician from spending more than 3-4 hours in the laboratory.

– For the assessment of the diagnostic value of the result, the appropriate competences and experience of the diagnostician are particularly important, as it is the diagnostician who determines whether the obtained result has a diagnostic value and whether it can be passed on to the doctor. Thus it is the diagnostician who de facto decides whether it is possible to announce that we already have a coronavirus in Poland – emphasizes Dr. Bukowska-Strakova.

While everything is now in the hands of specialists quietly doing their work in laboratories, their key role in the entire process is often overlooked:

– When talking about medical consultations, investigators are rarely invited to consultation teams. Even now we hear: “we are ready, the laboratories are ready, the doctors are ready”, as if diagnostics did not exist. In fact, laboratory tests, such as coronavirus tests – the waiting time for the result, whether the test is reliable, etc. – should be asked by diagnosticians, as they are the most competent in this field – emphasizes our interlocutor.

Also read: Now our safety is in their hands. Interview with Alina Niewiadomska, president of the National Council of Laboratory Diagnosticians

How long does it take to be tested for coronavirus?

The duration of the diagnostic process itself is from a few to even 18 hours. In case of any doubts, another attempt is made.

– Different methods and laboratory procedures have different durations, hence the fact that some tests results are waiting a week, while others are available on the spot. The waiting time for the result consists not only of the test execution procedure itself. The diagnostician must also assess the diagnostic value of the delivered material (whether it has been properly downloaded / delivered), and then, after performing the test itself, evaluate its diagnostic value. At present, we do not have any reliable high-speed «strip» tests for SARS-CoV-2. But we are still working on improving the tests and we will probably see the next generations soon – explains Dr. Bukowska-Strakova.

Coronavirus research laboratories in Poland

At the moment, it functions in Poland 11 centers that are prepared to perform tests for the SARS-CoV-2 coronavirus. The Minister of Health announces that their list will gradually expand.

Laboratories in:

1. National Institute of Public Health – National Institute of Hygiene (NIZP – PZH), 
2. The Infectious Hospital in Warsaw 

and in nine voivodeship sanitary and epidemiological stations (Olsztyn, Wrocław, Łódź, Katowice, Kielce, Rzeszów, Gorzów Wielkopolski, Poznań, Gdańsk).

Within XNUMX hours, Polish laboratories can analyze as much as possible 2000 samples.

The editorial board recommends:

1. What we don’t know about the SARS-CoV-2 coronavirus? There are still many questions
2. What are the disinfectants and personal protection stocks in hospitals like? We check
3. Coronavirus. Why does it kill some and run like a cold for others?

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