Working behind the scenes: UAB pathologists play key role in fighting coronavirus pandemic

In a span of 30 days, UAB has completed 8,000 tests, including for patients, community and staff.

Pathology2Photography: Jeff MyersPathologists at the University of Alabama at Birmingham have been a crucial part of battling the COVID-19 pandemic in Alabama.

Testing has been a major cause for concern worldwide ever since the pandemic began, but clinicians and researchers with UAB’s Department of Pathology have been working around the clock to make testing available for as many people as possible, making sure accurate results are available in a timely manner.

“Our department faculty and staff have been both proactive and nimble in our response to the COVID-19 pandemic,” said Department of Pathology Chair George Netto, M.D. “Pathologists and laboratory medicine professionals, both here at UAB and nationally, have been at the forefront of fighting this pandemic. As always, we are used to working behind the scenes; however, this event has allowed our colleagues to step up and retool their labs and staff to pivot toward tackling COVID-19.”

Due to UAB’s efforts in molecular testing led by Assistant Professor Sixto Leal, M.D., UAB was among the first academic medical centers in the country to offer in-house testing by launching a laboratory-developed test in March. Leal and his team are currently testing between 300 and 500 samples daily with COVID-19 RNA testing, confirming the presence of the virus in patients, with a turnaround time of less than 24 hours. This includes all inpatient admissions and health care workers, as well as all patients undergoing surgical procedures at UAB Hospital, and labor and delivery patients. A second COVID-19 RNA testing platform with less than two hours’ turnaround time is now operational.

“Our ability to scale up to high-throughput testing platforms has allowed us to support rural and affiliate hospitals throughout our county and state,” Netto said. “We have faculty working full time in more than half a dozen smaller hospitals around the state, filling a crucial need in these areas.”

DeMoss says, in a span of 30 days, UAB has completed 8,000 tests, including for patients, community and staff.

As one of the top academic medical centers in the nation and a recognized leader in quality patient care, UAB Hospital has partnered with the Jefferson County Department of Health to help provide the first appointment-based community coronavirus testing site. Workers at the downtown Birmingham site have currently tested more than 4,000 people to date.

Jordan DeMoss, vice president for Clinical Operations at UAB Hospital, says safety, efficiency and access to the community for testing were the main objectives for this site.

“Our main goal with a drive-through testing site is really to limit the exposure of our staff as we try to figure out who is positive and who isn’t,” DeMoss said. “It’s so important for us to provide that access across our community, and this site allows us to do that in a safe and accessible way.”

Pathology4George Netto, M.D. Many experts across the country claim nationwide testing is needed to help determine the spread of the virus and to assist in our return to clinical and research operations, and Netto says that, in this unprecedented time, there have been quite a few challenges, but the work of the department speaks for itself.

“Our team has adapted to many challenges in the face of this pandemic, from initiating our own laboratory-developed tests to securing PPE and testing supplies, and ensuring all shifts are covered around the clock with personnel,” Netto said. “We have had to be nimble to respond to our residents’ and fellows’ continuing education needs, for example, and to work out ways for our research faculty to continue their lab work wherever possible. Our colleagues have organized blood drives and encouraged participation in them to the point that critically low blood supply levels in the area have leveled off.”

One example of the department’s staff’s adapting to serve unmet needs is reconfiguring the department’s Roche COBAS 6800 machine — usually used for hepatitis and STD testing — now running high-throughput COVID-19 tests. This effort, under the direction of Craig Mackinnon, M.D., Ph.D., division director for Genomic Diagnostics and Bioinformatics, has resulted in more highly automated testing that requires less personnel and tech time to complete, with results reporting directly to the electronic medical record.

“If there is a silver lining in this, it is the acquisition of new information systems we can use to develop a huge database of all patients tested in the labs to identify trends for patient outcomes and treatments,” Mackinnon said.

Netto says the next step, in addition to faster turnaround times on COVID tests, is serology testing — offering the ability to detect COVID-19 specific antibodies in serum to test for prior exposure.

"The serology test is coming online this week," Netto said. "Serology testing could also support convalescent serum therapy — using blood plasma from recovered COVID patients to treat critically ill COVID-19 patients."

Pathology3Photography: Jeff MyersThe work does not stop there, as more departmental faculty are submitting funding applications for more COVID-19 research. Leal was recently awarded a School of Medicine grant to optimize the current test assay and increase capacity fourfold, including the detection of other viruses such as influenza and RSV, “to speed the time to an accurate diagnosis for our patients and limit the need for unnecessary testing with expensive viral respiratory panels.”

Both Netto and DeMoss say they are grateful for how hard the teams at UAB are working.

“Our teams with the Department of Pathology and UAB Hospital Labs are extremely important during this pandemic,” DeMoss said. “They have moved mountains with our testing capabilities for patients, UAB faculty and staff, and we are getting more efficient with our testing with each passing day.”

At UAB, Netto holds the Robert and Ruth Anderson Endowed Chair.

For more information, visit uab.edu/coronavirus.