This winter, West Michigan influenza infections peaked in December 2022 and significantly declined throughout February and March 2023. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
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Pediatrics
Chemistry, General Information, Test Spotlight
Microalbumin/Creatinine, Random Urine Result Comment Update
Effective January 4, 2023, the process for reporting the Microalbumin/Creatinine ratio was changed for situations where one of the results, microalbumin and/or creatinine, is below or above the assay’s analytical measuring range (AMR).
Effective February 28th, 2023, Vitamin D 25-Hydroxy Level (25-OH Vitamin D) [LAB535] will be replaced by 25-Hydroxyvitamin Level D2 and D3 [LAB1230925]. Send out testing for 25-Hydroxyvitamin D2 and D3, Serum [LAB1230428] to Mayo will be discontinued. The testing methodology will change from an immunoassay to liquid chromatography-mass spectrometry.
The new test will include concentrations for
- 25-hydroxyvitamin D2
- 25-hydroxyvitamin D3
- 25-hydroxyvitamin D Total
Corewell Health Laboratory (Grand Rapids) Coagulation laboratory is pleased to announce a change to our von Willebrand factor (VWF) activity test. The historical test von Willebrand ristocetin cofactor (LAB335) will be retired and replaced by von Willebrand factor activity (VWF activity, LAB1230904) on January 17, 2023.
Compliance & Safety, Education & Training, General Information, Main lab, Test Utilization
Inform: RSV Testing – Age Restrictions
Respiratory syncytial virus (RSV) primarily infects pediatric patients, but occasionally infects adults and may be of particular concern for the elderly and immunocompromised. Corewell Health Laboratories offers two tests for RSV. A rapid antigen test may be used to confirm RSV diagnosis in pediatric patients. This test is not approved by the FDA for testing adult patients, so tests will be cancelled if ordered on an off-label age group. There are no age restrictions for RSV testing by way of a molecular panel that also includes COVID and influenza as viruses with overlapping symptoms.
| Test name | Epic Test ID | Methodology | Specimen | Age restriction |
| RSV Rapid | LAB495 | Antigen | Nasopharyngeal (NP) swab | Approved for patients 0 – 18 years of age |
| COVID, Influenza, RSV PCR | LAB1230746 | Molecular/PCR | Nasopharyngeal (NP) swab | No age restriction |
Influenza cases numbers are currently increasing throughout West Michigan. Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen testing (e.g. Sofia instrument) to have improved performance. The use of rapid antigen testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Rapid antigen tests generally have high analytical specificity, but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative antigen result if influenza is still suspected and if the result will impact clinical decision making.
Starting November 29th, 2022, Corewell Health West, Hematology Laboratories will begin reporting absolute counts for white blood cell (WBC) manual differentials, in addition to relative (percentage) counts. The WBC differential count determines the number of each type of white blood cell present in the blood. It can be expressed as a percentage or as an absolute value. Of these, the absolute value is much more important than the relative value, given that clinically relevant WBC elevations and declines are defined by their absolute numbers, not by their relative proportions, and there is potential for error if this conversion is performed outside the laboratory.
Effective November 21, 2022, the following changes will be made to Meconium Drug Testing (LAB479).
- The cutoff for positivity for the opiate drug class (codeine, morphine, hydrocodone, hydromorphone, oxycodone, and oxymorphone) will increase to 20 ng/g from 10 ng/g.
- The format of reporting will be updated to include discrete reporting fields for all tested analytes. Positive results will no longer be denoted via comments.
Effective immediately, the following Regional Hospital Laboratories have the 4-Plex (COVID-19, Influenza A, Influenza B, RSV) test available for ordering and testing:
- Big Rapids Hospital Laboratory
- Blodgett Hospital Laboratory
- Gerber Hospital Laboratory
- Ludington Hospital Laboratory
- Pennock Hospital Laboratory
- Reed City Hospital Laboratory
- United/Greenville Hospital Laboratory
- Zeeland Hospital Laboratory
At the beginning of the COVID-19 pandemic Spectrum Health Laboratory implemented a protocol to call providers and patients to notify of positive COVID-19 PCR testing. The pandemic has shifted to an endemic phase and a positive COVID-19 test is no longer considered a critical value. Effective Friday, August 26, 2022, Spectrum Health Laboratory will no longer call positive COVID-19 PCR testing, for inpatient or outpatient specimens.
Results for COVID-19 PCR will still file to the patient’s chart in Epic and reported to the ordering provider through usual means of receiving results (fax or electronic) and to the Michigan Department of Health and Human Services (MDHHS). Patient’s will still be notified via their MyChart as well.
If you have any questions or concerns, please use the “contact us” link above.