App makes it easier to identify patients at risk for COVID-19 in A&E Labmate Online

Beckman Coulter’s MDW-SARS CoV-2 diagnostic test has been granted CE Mark for its MDW application as an aid in identifying adult patients at risk of SARS-CoV-2 viral infection when they are present to the emergency department (A&E) .

MDW (Monocyte Distribution Width) is a measure of the increased morphological variability of monocytes in response to bacterial, viral or fungal infections. MDW is an in vitro diagnostic parameter automatically reported as part of complete blood count (CBC) with differential, and is routinely requested in A&E. MDW is the only proprietary, regulatory-cleared hematology biomarker exclusive to Beckman Coulter analyzers that helps identify the risk of serious infection and sepsis in adult A&E patients.

Several influential European studies have reported elevated MDW in patients diagnosed with COVID-19. These studies found that MDW is significantly higher in patients with COVID-19 than in those without, suggesting that the initial measurement of MDW while awaiting molecular results of SARS-CoV-2 could allow rapid differential diagnoses in emergency situations. The observations are consistent with the current understanding of COVID-19 as a multi-organ disease resulting from an increased circulating pro-inflammatory cytokine response through the activity of morphologically differentiated monocytes.

Tommaso Trenti, director of the department of laboratory medicine at the local health unit in Modena, Italy, and researcher in the study published in Nature explained: “The morphology of monocytes changes when the activation of the immune system triggers a stimulus, as in the case of bacterial or viral infections. Thanks to the new DxH 900 hematology analyzer for CBC, we can measure the nature of these cellular alterations in the laboratory. I am very pleased that our center was able to help confirm the role of this new test, which now also has CE mark approval for IVD devices, meaning it can now be used on COVID-19 patients. 19.

The MDW-SARS CoV-2 is a very sensitive test (87%) with a high NPV (96%). It allows physicians to perform more accurate COVID-19 risk assessments for patients for whom RT-PCR data is unavailable or contradicts the clinical presentation, allowing better decisions to be made regarding patient disposition in A&E.

“A year ago, we already considered MDW results to be a useful parameter for patients with COVID-19, also because of its speed and the ease with which it could be obtained,” said Agostino Ognibene, MD, director of the laboratory and transfusion medicine department at San Donato Hospital in Arezzo, Italy, and principal investigator of the study published in Clinica Chimica Acta. “The monocyte population is the first element to be implicated in the immune response to COVID-19. This response underlies the morphological changes of monocytes that result in an alteration of the MDW parameter, which can be obtained with a simple CBC. The aggressiveness of the virus and the reactive status of the patient have been shown to be related to the MDW parameter, which can therefore be included in clinical assessments of patients. The validation of the test obtained by obtaining CE approval for IVD devices is a significant step forward, confirming the results of the study carried out in our medical center in Arezzo.

Testing and screening for the new hematology biomarker MDW is available on the Beckman Coulter DxH 900 and DxH 690T hematology analyzers as part of a CBC-DIFF.

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