Information For Laboratories

We understand that due to various issues many hospitals are reducing or stopping calprotectin testing in laboratories whilst the COVID-19 pandemic is ongoing.

However, the laboratories listed below are still offering a testing service and may be able to assist. Please contact them directly for volume, turnaround time and pricing information.

Location: Sandwell and West Birmingham NHS Trust
Contact name: Rajvinder Garcha
Email: rajvindergarcha@nhs.net
Telephone: 01215075348
Assay: BÜHLMANN fCAL ELISA

Location: Affinity Biomarkers
Contact name: Tracy Neal
Email: tracy@affinitybiomarkerlabs.com
Telephone: 02080901307
Assay: BÜHLMANN fCAL turbo or BÜHLMANN fCAL ELISA

Location: Spire Healthcare Manchester
Contact name: Kaleem Fayyaz
Email: Kaleem.fayyaz@spirehealthcare.com
Assay: BÜHLMANN fCAL ELISA

If any other hospital is able to offer a testing service then please let our Senior Product Manager, Amanda Appleton know via email: aappleton@alphalabs.co.uk

Keep in Touch!

Let us know the situation with testing in your hospital now, when things are slowing and when things start moving again to ensure the correct level of stock is available for you when you need it most.

Tell us what’s happening at your hospital

Risk Assessment

At the bottom of this page are additional documents which may be of use for laboratory health and safety risk assessment for calprotectin measurement, as recommended by the RCPath and Professional Bodies (IBMS, ACP and ACB) in their recent publication (Prioritisation/deferral of Pathology Laboratory Work (in light of SARSCoV-2 (COVID19) epidemic).

Faecal Calprotectin Indicates Intestinal Inflammation in COVID-19

This pilot study explores a relation between GI symptoms, intestinal inflammation (determined by FC) and faecal SARS-CoV-2-RNA in hospitalised patients with COVID-19.

Click Here to Find Out More

Neutrophil Calprotectin Identifies Severe Pulmonary Disease in COVID-19

Serum calprotectin levels track closely with current and future COVID-19 severity, strongly implicating neutrophils as active perpetuators of inflammation and respiratory compromise in COVID-19.

Click Here to Find Out More

Alternative Testing Solutions for Your Laboratory

BÜHLMANN Quantum Blue® – Rapid, Individual Calprotectin Testing

As BSG guidelines are showing that colonoscopies are being heavily restricted, calprotectin testing will become more important to get an indication of the gut health.

BÜHLMANN calprotectin assays offer a range of testing options, including Quantum Blue® individual lateral flow tests for those urgent requests.

Quantum Blue® can give you quantitative faecal calprotectin results in just 4 easy steps and can also easily be linked directly to your computer for quick data input, making it an ideal choice in an emergency situation.

There are three assay ranges available:

LF-CAL25 30 – 300µg/g
LF-CHR25 100 – 1800µg/g
LF-CALE25 30 – 1000µg/g

Each pack contains 25 individually sealed tests – therefore if you only want one test, then you only have to use one.

Quantum Blue® has a well documented correlation to clinical outcome:

“This rapid bedside test can facilitate clinical decisions on hospital admission, such as deciding whether the IBD treatment should be intensified. Similarly, in the ambulatory setting, it is crucial when determining whether a patient should undergo endoscopy or not.”

Moniuszko et al. Polish Archives of Internal Medicine 2017. Rapid fecal calprotectin test for prediction of mucosal inflammation in ulcerative colitis and Crohn’s disease: A prospective cohort study.

“Quantum Blue® provides high diagnostic accuracy and was less time consuming in clinical routine than quantification of faecal calprotectin by ELISA. This makes the test an excellent candidate for the use in clinical routine.”

Schulz et al. Clinical Laboratory 2016. Validation of Two Calprotectin Rapid Tests in Daily Routine

Click Here to Visit the Quantum Blue® Page to Find Out More

IBDoc® – Remote Management for IBD Patients

Using smartphone technology the IBDoc enables UC and CD patients to test their own calprotectin levels in the comfort and safety of their own homes freeing up valuable resource at this challenging time.

The IBDoc generates a quantitative result between 30 – 1000µg/g which is quickly and securely transmitted to the clinic for immediate access by the clinical teams enabling them to continue to monitor their patients giving a good indication on the health of the gut.

Click Here to Visit the IBDoc® Page to Find Out More

Information Required for Risk Assessment

Extraction Buffer Biocide Statement from BÜHLMANN – NEW UPDATE

DS2 aerosol statement from DYNEX Technologies.

Risk of COVID-19 Infection from Faecal Samples

It has been well documented that Coronavirus is shed in stool samples with many publications documenting that viral RNA can be detected in both symptomatic and non-symptomatic individuals. However, due to the speed of the coronavirus pandemic, extensive evaluation has not been carried out and most of these publications have not been peer reviewed. What is unclear, is if the viral RNA that has been detected poses an infection risk, or what viral load is required to cause transmission.

We have summarised some of the publications that are available that you may wish to study when reviewing the risk assessment for handling samples within your laboratory:

Prof. Dr. med. C. Drosten et al. March 2020, demonstrated that they were unable to isolate viable virus from faecal samples positive for viral RNA.  However, this data was very limited and not peer reviewed, so it has yet to be validated. There were only 13 serial samples tested (between days 6-12) on 4 patients so very limited. In addition, at the time of publication of the German pandemic, the severity of affected patients has been lower than other countries.

Most of the peer reviewed data are from the early experiences in China.  Characteristics of paediatric SARS-CoV-2 infection and potential evidence for persistent faecal viral shedding, Yi Xu et al, Nature Medicine, April 2020 stated that RNA remained positive in faecal samples even after nasopharyngeal samples were negative and thus postulated that a potential faecal oral route of transmission was feasible, as was the case with SARS and MERS.  However, they did not evaluate the viability of virus in these faecal samples.  Similarly, there are more publications which look at the detection of Viral RNA, but do not test for intact/viable virus.

Correspondence in the Lancet by Yongjian Wu et al, prolonged presence of SARS-CoV-2 viral RNA in faecal samples provided further evidence of viral RNA in faecal samples and that viral shedding could occur for up to 5 weeks after a patient’s respiratory sample tested negative.  Again, this did not look at the viability of the viral RNA but likened the infectivity potential to that of SARS and MERS.  Replies to the correspondence stated that detection of Viral RNA did not indicate the presence of viable viral particles, nor the degree of infectivity the samples represented.  However, the authors argued that although viral culture is an important method to evaluate viral infectivity and activity, it is unavailable in clinical practice because of its low sensitivity and long turn-around time for virus detection.  Furthermore, two negative SARS-CoV-2 RNA PCR tests, at least 24 h apart, was recommended by WHO as one of several criteria for discharge.

In summary there is much conflicting evidence in press regarding the infective potential of faecal samples to provide a conclusive opinion.  Whilst it is acknowledged that faecal samples may contain viral RNA, this does not necessarily mean that these are infectious.