Mobile COVID-19 diagnostics service

The mobile point-of-care testing (POCT) service in the Breda region supports general practitioners in quick and appropriate triage, identifying seriously ill and less seriously ill patients during the COVID-19 pandemic.

C-reactive protein (CRP) is often moderately elevated in COVID-19 infections, with outliers reaching >100 mg/l. It has prognostic relevance for serious illness and death due to COVID-19. In our mobile service, 58% of the last 200 patients examined were found to have a mild infection (CRP <20 mg/l). In 33% CRP was moderately elevated (20-99 mg/l) and 9% showed signs of a severe infection (CRP >100 mg/l). At most, this distribution is a slight shift towards higher CRP test results compared to the regular CRP POCT service in general practices. Other results:

  1. On the PCR test, 29% of patients tested positive for COVID-19;
  2. CRP was nearly twice as high in patients with a positive PCR test result, averaging 51 mg/l compared to 27mg/l in patients with a negative PCR test result;
  3. Low oxygen saturations (<93%) have prognostic relevance in COVID-19 but were often (in 65% of the patients visited) also present in patients who did not appear to have COVID-19 (negative PCR)
  4. No patients with high CRP test results (>100 mg/l) and normal oxygen saturation levels tested positive for COVID-19 on a PCR test.

The GPs requested the mobile service several times a day and indicated that they were very satisfied. Rapid feedback was specifically mentioned. One suggested expansion that the GPs mentioned: providing other acute blood tests (blood count, d-dimer, BNP and troponin) through the mobile service.

The Star-shl employees who organise and execute the service are also very satisfied with this innovative service, giving it marks between 8 and 10 out of 10. Employees indicate that they have been able to gain sufficient experience to conclude that this service improves care for these patients, who are often ill. They are eager to continue the service and would also recommend it to other care organisations. The mobile CRP test (QuikRead go) felt user-friendly to the employees. At the request of the GPs, the service has since been expanded to include a second mobile team.