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Giuseppe Agosta

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Supplemento Speciale - Pandemia da SARS-CoV-2 (COVID-19)

Diagnosi del diabete gestazionale durante l’emergenza COVID-19: semplificazione del protocollo
TAG: SARS-CoV-2   COVID-19   diabete gestazionale  
Biochimica Clinica
DOI: 10.19186/BC_2020.055
Pubblicato online il: 25.05.2020
COVID-19 - COVID-19
 
Valutazione di IgG e IgM anti-SARS-CoV-2 su Maglumi 800 (Snibe)
Evaluation of Anti-SARS-CoV-2 immunoglobulin G and M on Snibe Maglumi 800

Introduction: the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a due to new beta-coronavirus causing the pandemic called Coronavirus disease 2019 (COVID-19). The evaluation of the presence of immunoglobulin G and M anti-SARS-CoV-2 (IgG and IgM) is important to understand the epidemiology of the disease and to confirm the presence of the disease when clinical signs are present, but RNA is not detected.
Methods: leftover serum samples from different types of patients were used: sera from biobank collected in 2018 as negative controls; patients recovering from the disease as positive controls; patients presenting at the Emergency Room with a positive rhino-pharyngeal swab; patients in Intensive Care Units. Anti-SARS-CoV-2 IgG and IgM were measured with MAGLUMI 2019-nCoV IgM/IgG Kits on Maglumi 800.
Results: one out of 61 expected negative resulted positive, and 2 were borderline for IgG (95% specificity, 95%CI 89.6-100), 1 positive for IgM (98.4% specificity, 95%CI 95.2-100); one out of 41 expected IgG positive resulted negative (97.6% sensitivity, 95%CI 92.8-100). All the 13 Intensive Care patients were positive for IgG, 11 for IgM. IgG were negative in 50.9% of the 55 swab positive from Emergency Room patients, while IgM were negative in 87.3%.
Discussion: sensitivity and specificity of the test appear good for IgG, some false positive is expected and low antibody titles in subjects with no disease story should be rechecked with an alternative method. IgM show a good specificity, but the unexpected low percentage of positivity in Emergency Room patients compared to IgG, pose some relevant doubts on the sensitivity of the test.

TAG: SARS-CoV-2   COVID-19   indagini epidemiologiche  
Biochimica Clinica
DOI: 10.19186/BC_2020.054
Pubblicato online il: 25.05.2020
COVID-19 - COVID-19
 
IL VALORE DELLA MEDICINA DI LABORATORIO NELLA PANDEMIA DA SARS-CoV-2
The value of laboratory medicine in SARS-CoV-2 outbreak
M. Plebani  | 

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a challenge to all heathcare systems. It represents, however, a formidabile opportunity to highlight the value of laboratory medicine. Laboratory tests, in fact, play a key role in allowing the etiological diagnosis thanks to the reverse transcription-plymerase chain reaction (rRT-PCR) to detect the virus in nasopharingeal specimes as well as in other samples collected by using a flocked swab. The second essential contribution that laboratory tests are providing encompasses staging, prognostication and therapeutic monitoring of COVID-19. Finally, serological tests play a central role for surveillance purposes, for using plasma containing antibodies from recovered patients as experimental treatment and for better understanding the immune response to SARS-CoV-2 to eventually address vaccine developments.

TAG: SARS-CoV-2   COVID-19   medicina di laboratorio  
Biochimica Clinica
DOI: 10.19186/BC_2020.053
Pubblicato online il: 18.05.2020
COVID-19 - COVID-19
 
Guida sintetica alla diagnostica della malattia da coronavirus 2019 (COVID-19)
Concise guide to coronavirus disease 2019 (COVID-19) diagnostics

Several months after its emergence, the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still prepotently disrupting health, societies and economies worldwide. The current approach for diagnosing SARS-CoV-2 remains based on identification of viral RNA by means of molecular biology techniques in upper or lower respiratory tracts specimens. Nevertheless, the development of immune response against the virus may also provide valuable diagnostic information. The paradigmatic kinetics of anti-SARS-CoV-2 antibodies in patients with COVID-19 would allow to conclude that serological testing shall not replace viral RNA detection in diagnosing acute SARS-CoV-2 infection, but may instead remain an essential tool for identifying patients who have been infected and have developed an immune response, as well as for monitoring the progress of herd immunity. For this purpose, the choice of the antigens used for constructing the immunoassays appears critical, as these shall use epitopes towards which neutralizing antibodies could be generated. Other important aspects in serological testing encompass the absence of cross-reactivity with other coronaviruses, the ability to distinguish the antibody class (i.e. IgG, IgA and/or IgM), quantitative assessment, wide range of linearity and low imprecision at diagnostic thresholds. A finalaspect, almost essential for both clinical and public health purposes, is the evidence of analytical and clinical validation before each method enters clinical practice.

TAG: SARS-CoV-2   COVID-19   diagnostica di laboratorio  
Biochimica Clinica
DOI: 10.19186/BC_2020.052
Pubblicato online il: 18.05.2020
COVID-19 - COVID-19