Technical and health governance aspects of the External Quality Assessment Scheme for the SARS-CoV-2 molecular tests: institutional experience performed in all clinical laboratories of a Regional Health Service

Clin Chem Lab Med. 2022 Sep 19;61(1):173-179. doi: 10.1515/cclm-2022-0780. Print 2023 Jan 27.

Abstract

Objectives: Since December 2019, the worldwide public health has been threatened by a severe acute respiratory syndrome caused by Coronavirus-2. From the beginning, a turning point has been the identification of new cases of infection, in order to minimize the virus spreading among the population. For this reason, it was necessary introducing a panel of tests able to identify positive cases, which became crucial for all countries.

Methods: As a Regional Reference Centre, the CRQ Laboratory (Regional Laboratory for the Quality Control) developed and conducted an External Quality Assessment (EQA) panel of assay, so as to evaluate the quality of real-time reverse transcription polymerase chain reaction (PCR), which were used by 62 Sicilian laboratories, previously authorized to issue certificates for the COVID-19 diagnosis, on behalf of the Public Health Service.

Results: The qualitative performance test was based on pooled samples with different viral loads of SARS-CoV-2 or human Coronavirus OC43. 75% of the participating laboratories tested all core samples correctly, while the remaining 25% interpreted incorrectly the EQA exercise samples matching negatively the standards required.

Conclusions: Subsequent inspection visits confirmed the issue of incorrect positive and negative certifications for COVID-19 by private and public laboratories, despite the possession of the authorization requirements currently provided for by current regulations, with a significant impact on the SSR.

Keywords: COVID-19; Covid437; External Quality Assessment; ISO 15189; ISO/IEC 17025; ISO/IEC 17043; SARS-CoV-2; regional laboratories quality control; test performance evaluation.

MeSH terms

  • COVID-19 Testing
  • COVID-19* / diagnosis
  • Clinical Laboratory Services*
  • Humans
  • Laboratories
  • Laboratories, Clinical
  • SARS-CoV-2