Blood gas analysis can play an important role in the management of severe COVID-19 cases, but improper implementation can lead to inaccurate results and expose health workers to biosafety risks.

This is the key message from a recent video interview with Prof Xuefeng Wang, Director of the Laboratory Department of Shanghai Jiao Tong University School of Medicine in Shanghai, China. The video included frontline insights about how to manage blood gas testing from the core lab and at the point of care (POC). It also included tips for how to prevent infection transmission during the testing process.

One benefit of POC testing for blood gas is that it can provide rapid results. Yet Prof Wang cautioned that such testing should not be exclusively managed by clinical departments, as clinicians may not be familiar with quality control procedures and end up with results that are not reliable. He also argued that hospitals should make efforts to integrate their POC equipment with broader lab information systems, as this enables real-time cross-checking and storage of results data.

Prof Wang noted that anyone dealing directly with COVID-19 patients, including clinicians or nurses running POC tests, must adhere to strict biosafety protocols. Those working in the central lab may be less exposed, but biosafety level 3 (BSL-3) protective measures, including special protective clothing and disinfection protocols, may still be necessary, particularly in the case of high-risk specimens.

Part of the concern is that some procedures in the core lab, such as centrifugation and decapitation, could create risks of aerosol transmission of COVID-19. Moreover, the risk of aerosol transmission may be greater in a closed laboratory environment than it is in an open-air testing facility.

Prof Wang also urged lab professionals to pay close attention to quality control in pre-analytical processes, including needle handling and sample storage procedures. He also warned that post-analytical processes, such as issuing of paper reports from the lab that are then physically handed over to health workers in other departments, can also present transmission risks. Lab professionals are uniquely suited to assess and manage these risks.

His full interview (in Chinese with English subtitles) can be seen below.