The use of whole blood capillary samples to measure 15 analytes for a home-collect biochemistry service during the SARS-CoV-2 pandemic: A proposed model from North West London Pathology.
Author(s): Ansari S, Abdel-Malek M, Kenkre J, Choudhury SM, Barnes S, Misra S, Tan T, Cegla J
Publication: Ann Clin Biochem, 2021, Vol. , Page 45632211004995
PubMed ID: 33715443 PubMed Review Paper? No
Purpose of Paper
This paper compared levels of 15 biochemistry analytes in matched self-collected capillary blood specimens centrifuged after 3 days and venous blood processed within 4 h.
Conclusion of Paper
Levels of calcium, creatinine, and albumin were all higher in capillary specimens stored for 3 days than in the venous specimen stored for 4 h. Importantly, the differences exceeded the maximal permitted difference and were judged by the panel of experts to be clinically significant. Levels of total cholesterol, triglyceride, high-density lipoproteins (HDL)-cholesterol, low-density lipoproteins (LDL)-cholesterol, HbA1c, bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), urea, and magnesium were found to be comparable between venous blood processed within 4 h and capillary specimens analyzed after 3 days.
Studies
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Study Purpose
This study compared levels of 15 biochemistry analytes in matched self-collected capillary blood specimens centrifuged after 3 days and venous blood processed within 4 h. Venous blood was collected from 27 healthy patients and one patient with type II diabetes into EDTA and lithium heparin plasma separator tubes (PSTs) that were inverted five times and then stored at room temperature (20-22°C) protected from light for up to 4h. Each patient also self-collected capillary blood specimens in EDTA and PST Microtainer Microtubes that were inverted five times and then stored in the biochemistry laboratory at room temperature (20-22°C) protected from light for 72 h. Plasma was obtained from all specimens by centrifugation at 3000 x g for 10 min. Levels of 15 biochemistry analytes were analyzed by clinical chemistry autoanalyzer. Specimens were excluded if the analyzer reported icterus or lipemia. Clinical acceptability was judged independently by a panel of five experts and a consensus-based decision was made on if the change would be clinically significant for the intended use. The maximum acceptable bias for each analyte was based on the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) biological variation database.
Summary of Findings:
Levels of calcium, creatinine, and albumin were all higher in capillary specimens stored for 3 days than in the venous specimen stored for 4 h. Importantly, the differences exceeded the maximal permitted difference and were judged by the panel of experts to be clinically significant. Levels of total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, HbA1c, bilirubin, ALT, AST, GGT, ALP, urea, and magnesium were found to be comparable between venous blood processed within 4 h and capillary specimens analyzed after 3 days.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Small molecule Clinical chemistry/auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Lipid Clinical chemistry/auto analyzer Steroid Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Biospecimen location Vein
Capillary
Storage Storage duration 4 h
3 days
Biospecimen Aliquots and Components Centrifugation Centrifugation delays investigated