All persons under investigation require testing for SARS-CoV-2 by means of reverse transcriptase PCR (RT-PCR).

Rapid point-of-care antibody tests are NOT currently approved for testing.

Samples to be sent are: 

  • Upper respiratory tract samples – nasophargyngeal and/or oropharyngeal swabs (combined in the same universal transport medium tube) in outpatients.

  • Lower respiratory tract samples – Sputum (if produced – do NOT induce) and/or tracheal aspirate or bronchoalveolar lavage in severe cases

Respiratory viruses are best isolated from material that contains infected cells and secretions. Therefore, swabs should aim to brush cells and secretions off the mucous membranes of the upper respiratory tract. Good specimen quality (i.e. containing sufficient cells and secretions) and appropriate packaging and transport (i.e. to keep virus viable/detectable) are essential. Ensure that samples (placed in a cooler box with ice packs) are kept between 2-8°C until they are processed.

Obtaining samples for SARS-CoV-2 testing

Healthcare workers obtaining respiratory samples require appropriate personal protective equipment, including those for contact, droplet and aerosol precautions (see Infection, prevention and control).

Step-by-step instructions for specimen collection and transport can be found here:

A single negative test result, especially if from upper respiratory tract specimen, does not exclude infection. Repeat sampling and testing of lower respiratory tract samples is recommended for case with severe disease or in whom COVID-19 is strongly suspected.

Transport of specimens
Ensure that samples (in the cooler box with ice packs) are kept between 2-8°C until they are processed.
Transport to NHLS or private laboratory on the day of specimen collection
NHLS laboratories use usual overnight regional courier service; private labs will ship via existing systems
If shipping to NICD (for reference testing only), mark: “Suspected COVID-19, NHLS/NICD, Centre for Respiratory Diseases and Meningitis (CRDM), Lower North Wing, SAVP building, 1 Modderfontein Rd, Sandringham, Johannesburg, 2131”.

Answers extracted from: NICD Coronavirus disease 2019 (COVID-19) Quick Reference for Health Workers 09 April 2020 

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