The rise in preanalytical errors during COVID-19 pandemic

Area of Science:

• Clinical laboratory science
• Medical diagnostics
• Public health

Background:

• The COVID-19 pandemic presented significant operational challenges for global clinical laboratories.
• Preanalytical errors in sample collection, transport, and processing can lead to adverse clinical outcomes.

Purpose of the Study:

• To determine and compare blood specimen rejection rates in a clinical laboratory.
• To characterize and compare preanalytical error types between pre-pandemic and pandemic periods.

Main Methods:

• A retrospective study was conducted in a hospital converted to a COVID-19 care center.
• Data from pre-pandemic (Oct 2019–Mar 2020) and pandemic (Mar–Oct 2020) phases were analyzed.
• Blood specimen rejection rate was calculated as the percentage of tubes with preanalytical errors.

Main Results:

• A total of 107,716 blood specimens were analyzed; 40.3% were from the pandemic phase.
• The blood specimen rejection rate was significantly higher during the pandemic (3.0%) compared to the pre-pandemic phase (1.1%).
• Clotted samples were the most common error; improperly labeled samples and insufficient volume increased, while inadequate sample-anticoagulant ratio and hemolysis decreased.

Conclusions:

• Preanalytical errors and blood specimen rejection rates have significantly increased during the COVID-19 pandemic.
• Changes in logistics during the pandemic contributed to the rise in errors.
• Corrective measures are needed to reduce preanalytical errors, optimize patient care, and improve resource utilization.