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l site at which temperatures are taken, and the instrument used to measure temperatures should each be described. In the absence of such information, what is meant by the term "fever" is uncertain.

Pneumatic tube transportation of samples is an effective way of reducing turn-around-time, but evidence of the effect of pneumatic tube transportation on urine samples is lacking. We thus wished to investigate the effect of pneumatic tube transportation on various components in urine, in order to determine if pneumatic tube transportation of these samples is feasible.

One-hundred fresh urine samples were collected in outpatient clinics and partitioned with one partition being carried by courier to the laboratory, while the other was sent by pneumatic tube system (Tempus600). Both partitions were then analysed for soluble components and particles, and the resulting mean difference and limits of agreement were calculated.

Albumin, urea nitrogen, creatinine, protein and squamous epithelial cells were unaffected by transportation in the Tempus600 system, while bacteria, renal tubular epithelial cells, white blood cells and red blood cells were affected and potassium and sodium may have been affected.

Though pneumatic tube transportation did affect some of the investigated components, in most cases the changes induced were clinically acceptable, and hence samples could be safely transported by the Tempus600 pneumatic tube system. For bacteria, white blood cells and red blood cells local quality demands will determine if pneumatic tube transportation is appropriate.

Though pneumatic tube transportation did affect some of the investigated components, in most cases the changes induced were clinically acceptable, and hence samples could be safely transported by the Tempus600 pneumatic tube system. For bacteria, white blood cells and red blood cells local quality demands will determine if pneumatic tube transportation is appropriate.The in vitro diagnostic medical devices regulation (IVDR) will take effect in May 2022. This regulation has a large impact on both the manufacturers of in vitro diagnostic medical devices (IVD) and clinical laboratories. For clinical laboratories, the IVDR poses restrictions on the use of laboratory developed tests (LDTs). To provide a uniform interpretation of the IVDR for colleagues in clinical practice, the IVDR Task Force was created by the scientific societies of laboratory specialties in the Netherlands. A guidance document with explanations and interpretations of relevant passages of the IVDR was drafted to help laboratories prepare for the impact of this new legislation. Feedback from interested parties and stakeholders was collected and used to further improve the document. Here we would like to present our approach to our European colleagues and inform them about the impact of the IVDR and, importantly we would like to present potentially useful approaches to fulfill the requirements of the IVDR for LDTs.

Accurate SARS-CoV-2 serological assays are urgently needed to help diagnose infection, determine past exposure of populations and assess the response to future vaccines. The study aims at assessing the performance of the multiplex D-tek COVIDOT 5 IgG assay for the detection of SARS-CoV-2 IgG antibodies (N, S1+S2, S1, S2 and RBD).

Sensitivity and dynamic trend to seropositivity were evaluated in 218 samples obtained from 46 rRT-PCR confirmed COVID-19 patients. Non-SARS-CoV-2 sera (n=118) collected before the COVID-19 pandemic with a potential cross-reaction to the SARS-CoV-2 immunoassay were included in the specificity analysis.

A gradual dynamic trend since symptom onset was observed for all IgG antibodies. Sensitivities before day 14 were suboptimal. At≥21days, sensitivities reached 100% (93.4-100%) for N, S1+S2, S2 and RBD-directed IgG and 96.3% (87.3-99.6%) for S1-directed IgG. In 42 out of 46 patients (91.3%), all five antibodies were detected at≥14days. Selleckchem Z-YVAD-FMK The four remaining patients had between 2 and 4 positive antibodies at their respective maximal follow-up period. The specificity was 100 % for S1+S2, S2 and RBD, 98.3% for N and 92.4% (86.0-96.5%) for S1-directed IgG. The combined use of antigens increases the early sensitivity whilst enforcing high specificity.

Sensitivities at≥21days and specificities were excellent, especially for N, S1+S2, S2 and RBD-directed IgG. Caution is however required when interpreting single S1-directed reactivities. Using a multiplex assay complies with the orthogonal testing algorithm of the CDC and allows a better and critical interpretation of the serological status of a patient.

Sensitivities at ≥21 days and specificities were excellent, especially for N, S1+S2, S2 and RBD-directed IgG. Caution is however required when interpreting single S1-directed reactivities. Using a multiplex assay complies with the orthogonal testing algorithm of the CDC and allows a better and critical interpretation of the serological status of a patient.

The pattern of global COVID-19 has caused many to propose a possible link between susceptibility, severity and vitamin-D levels. Vitamin-D has known immune modulatory effects and deficiency has been linked to increased severity of viral infections.

We evaluated patients admitted with confirmed SARS-COV-2 to our hospital between March-June 2020. Demographics and outcomes were assessed for those admitted to the intensive care unit (ICU) with normal (>50nmol/L) and low (<50nmol/L) vitamin-D.

There were 646 SARS-COV-2 PCR positive hospitalisations and 165 (25.5%) had plasma vitamin-D levels. Fifty patients were admitted to ICU. There was no difference in vitamin-D levels of those hospitalised (34, IQR 18.5-66nmol/L) and those admitted to the ICU (31.5, IQR 21-42nmol/L). Higher proportion of vitamin-D deficiency (<50nmol/L) noted in the ICU group (82.0 vs. 65.2%). Among the ICU patients, low vitamin D level (<50nmol/L) was associated with younger age (57 vs. 67 years, p=0.04) and lower cycle threshold (CT) real time polymerase chain reaction values (RT-PCR) (26.96 vs. 33.6, p=0.02) analogous to higher viral loads. However, there were no significant differences in ICU clinical outcomes (invasive and non-invasive mechanical ventilation, acute kidney injury and mechanical ventilation and hospital days) between patients with low and normal vitamin-D levels.

Despite the association of low vitamin-D levels with low CT values, there is no difference in clinical outcomes in this small cohort of critically ill COVID-19 patients. The complex relationship between vitamin-D levels and COVID-19 infection needs further exploration with large scale randomized controlled trials.

Despite the association of low vitamin-D levels with low CT values, there is no difference in clinical outcomes in this small cohort of critically ill COVID-19 patients. The complex relationship between vitamin-D levels and COVID-19 infection needs further exploration with large scale randomized controlled trials.

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