COVID-19 Pandemic: Total Testing Cost Impact on Neisseria Gonorrhoeae and Chlamydia Trachomatis Testing and Positivity Rate in the Veteran Population

Abstract

Abstract Introduction/Objective The College of American Pathologists (CAP) checklist includes the quality assurance (QA) monitoring of the rate of diagnosis of Neisseria Gonorrhoeae (NG) and/or Chlamydia trachomatis (CT) by the molecular laboratory. Recently, the societal impacts of the economic lockdowns of the COVID-19 pandemic had a significant effect on the number of tests. However, the impact on the total testing costs as well as the positivity rate has not been well studied in the Veteran population. Methods/Case Report Quarterly quality assurance data from October 1st, 2018, to December 31st, 2022, was reviewed to obtain both the test volume for CT/NG and the number of positive test results at a Veterans Affairs Medical Center (VAMC). In addition, the cost to perform each test in reagents and consumables was also noted. Quarter 1 at the VAMC begins in October of the prior calendar year. The quarters in the period of April 1st, 2020, to December 31st, 2020 (corresponding to Quarter 3 2020 to Quarter 1 2021), was analyzed and compared to both the quarterly data prior to and after this period to note the impact of the COVID-19 pandemic on the quality assurance data. Testing had been performed using the Abbott m2000 RealTime System (Abbott Park, Illinois). Results (if a Case Study enter NA) A total of 18,904 tests for CT/NG had been performed on the Veteran population during the study period. Of these 18,904 tests, 385 were positive for NG and 515 were positive for CT. Quarterly percentage rates on a quarterly basis ranged from 1.58% to 4.53% (CT) and 1.16% to 4.53% (NG) with average rates of 2.78% and 2.13%, for Chlamydia and Gonorrhea respectively. The total reagent and consumable cost for each test was $28.84 per test. The period of Quarter 3 2020 to Quarter 1 2021 was marked by a decrease in total tests (331, 713 and 781 tests respectively compared with 1,049 tests in the quarter just before this period) with a corresponding decreased total test cost expenditure ($9,546.04, $20,592,92, and $22,524.04 respectively compared with $30,253.16 in the quarter just before this period) for performed tests. There was also an increase in the positivity rate (the highest positivity rate for both CT and NG of 4.53% was noted in quarter 3 2020) in this period of Quarter 3 2020 to Quarter 1 2021. Conclusion The initial period of the COVID-19 pandemic was marred by widespread economic lockdowns that impacted the total number of CT and NG tests performed, total test expenditures for tests performed, as well as the positivity rate.