COVID diagnostics at home

Shortly after the COVID-19 outbreak, following consultations with general practitioners, we set up a mobile point-of-care testing (POCT) service in the municipality of Breda, in which lab technicians visit patients at home to take blood samples. This service supports the general practitioner in differentiating severely ill from less severely ill patients more quickly and adequately during the COVID-19 pandemic. Moreover, swabs for COVID-19 diagnosis (PCR) are also taken when indicated.

Following a telephone request, a lab technician visits the patient at home to test one or more of the following parameters on request: oxygen saturation, pulse rate, body temperature and a C-reactive protein (CRP) POC test. According to the numerous studies on COVID-19 conducted over the past year, these parameters are of proven importance for the diagnosis and estimation of the severity and prognosis of the infection. But none of the tests is specific enough to correctly diagnose COVID-19. They do, however, offer guidance for the right treatment and on whether (emergency) referral is necessary. The NHG Guideline Acute cough will also continue to prevail in COVID-19.

The visiting service has been very well received and has recently been expanded to include the possibility of taking a nasopharyngeal swab for a COVID-19 PCR test in the central lab.

Currently, two brands of CRP devices dominate the market. Each is used in about 50% of Dutch GP practices. Star-shl now uses both systems, with Afinion (from Abbott) being used at one of 400 fixed locations (GP practices) and Quikread go easy CRP (from Aidian) as a mobile system. The test result is known within 3-4 minutes. Both devices have been extensively validated and have proven their added value in medical-scientific studies.