Updated on November 8, 2020.
Respiratory Virus Testing
Cleveland Clinic Laboratories offers several respiratory testing services to healthcare organizations & providers.
At this time, COVID-19 testing is offered only to healthcare providers & organizations within the state of Ohio.
The SARS-CoV-2 assay is available for the qualitative detection of the COVID-19 virus in respiratory specimens from individuals with the appropriate signs, symptoms, and epidemiologic exposure.
Our physicians and leaders collaborate closely with public health officials on a local, state, and national level.
As a healthcare provider, Cleveland Clinic continues to focus on caring for our patients, caregivers, and organization as part of the greater healthcare community. We will continue monitoring the situation and update our client resources accordingly.
Testing will be performed at Cleveland Clinic as possible based on operational capacity. Samples may be referred to another laboratory without prior notice if onsite capacity is exceeded. Capacity restrictions and/or external referrals may impact turnaround time (see below for details).
Interested in COVID-19 Testing?
Ohio Healthcare Providers
1. Contact Client Services at 1.800.628.6816.
2. Provide your name, organization, and phone number.
If you are a current or previous client, please also provide your Client ID code.
3. A CCL Account Manager will respond to your inquiry within 24 hours.
Please determine your organization’s anticipated daily specimen volumes before the representative calls.
If your organization is currently sending testing and expects an increase in COVID-19 specimen volumes, please contact your CCL Account Representative immediately.
COVID-19 Test Overview
Test Name
Coronavirus 2019 (COVID)
Turnaround Time
24 hours from the time of receipt by the laboratory*
Testing is performed 24 hours a day, 7 days a week
Testing will be performed at Cleveland Clinic as possible based on operational capacity. Samples may be referred to another laboratory without prior notice if onsite capacity is exceeded. Capacity restrictions and/or external referrals may impact turnaround time.
Specimen Requirements
Type:
(1) Nasopharyngeal (NP) Swab – preferred
Volume:
3 mL
Specimen Container:
Universal Transport Media (UTM)
Transport Temperature:
Refrigerated; transport to the laboratories on cold packs or wet ice.
Alternative
Type:
(1) Nasopharyngeal (NP) swab, or
(1) Nasal (anterior nares) swab
Volume:
3 mL
Specimen Container:
Saline transport medium
Transport Temperature:
Refrigerated; transport to the laboratories on cold packs or wet ice.
Alternative
Type:
(1) Oropharyngeal (OP) Swab
Volume:
3 mL
Specimen Container:
Regular Tip Flocked Swab in Universal Transport Media (UTM)
Transport Temperature:
Refrigerated; transport to the laboratories on cold packs or wet ice.
Alternative
NP/OP swabs (shown above) are the preferred specimen type.
Type:
Lower respiratory specimens: sputum or bronchoalveolar lavage (BAL)
Volume:
3 mL
Specimen Container:
Sterile specimen container
Transport Temperature:
Refrigerated; transport to the laboratories on cold packs or wet ice.
Stability
Ambient:
Unacceptable
Refrigerated (2-8ºC):
72 hours
Frozen:
Up to 30 days
Rejection Criteria
Swabs used for Group A Strep testing are not acceptable.
Unacceptable:
COVID-19, Influenza, & Respiratory Syncytial Virus (RSV) Testing Overview
In accordance with CDC recommendations, Cleveland Clinic Laboratories recommends multiplex testing for the detection of influenza, respiratory syncytial virus, & COVID-19.
All influenza tests interrogate the specimen for both influenza A & influenza B, and types are reported individually.
For the most up-to-date information on influenza prevalence, please refer to resources provided by the Centers for Disease Control and Prevention (CDC) and the Ohio Department of Health (ODH).
For Symptomatic Adults:
Recommendation:
Routine COVID with Flu (COVFLU)
For Symptomatic Pediatric Patients:
Recommendation:
Coronavirus 2019 (COVID) + Routine Flu & RSV Testing (RTFRSV)
For clients who have already performed COVID testing, Routine Flu & RSV Testing (RTFRSV) is available as a stand-alone order.
Test Name
Routine COVID with Flu A+B (COVFLU)
Routine Flu & RSV Testing (RTFRSV)
Turnaround Time
24 hours from the time of receipt by the laboratory
Specimen Type
Type:
(1) Nasopharyngeal (NP) Swab – preferred, or
(1) Anterior nasal swab, or
(1) Midturbinate swab
Transport Media
Universal Transport Media
(UTM), 3 mL
Viral Transport Media
(VTM), 3 mL
Saline Transport Media,
3 mL
eSwab Liquid Amies Transport
Media, 3 mL
Stability
Ambient:
Unacceptable
Refrigerated (2-8ºC):
72 hours
Frozen:
Up to 30 days
Transport Temperature
Refrigerated. Transport to the laboratories on cold packs or wet ice.
Patient Demographics & Reporting
Due to mandatory reporting for COVID-19 testing, additional patient demographic information is needed to complete a test order.
Failure to provide the required information will result in delayed testing.
Cleveland Clinic will report positive test results to the Ohio Department of Health (ODH).
The following details are required for COVID-19 testing:
Patient Details
- First & last name
- Guardian’s name (for patients 16 years old and under only)
- Date of birth
- Sex
- Race/ethnicity
- Current address (street, city, county, state, zip code)
- Primary telephone number (please include area code)
- Insurance details
Specimen Details
- Collection date
- Collection time
- First & last name of the collector
- Specimen type (e.g., NP swab, sputum)
Healthcare Provider Details
- First & last name
- Address (street, city, county, state, zip code)
- Phone number
For Mandatory US Department of Health & Human Services Reporting:
1. Is the patient being tested for COVID-19 for the first time?
2. Are they employed in health care?
3. Is the patient symptomatic as defined by CDC? (If yes, please indicate Date of Symptom onset)
4. Are they currently hospitalized?
5. Are they currently admitted to an ICU?
6. Is the patient a resident in a congregate care setting (e.g., nursing home, residential care for people with intellectual and developmental disabilities, psychiatric treatment facility, group home, board & care home, homeless shelter, foster care, or other setting)?
7. Is the patient pregnant?
Specimen Collection Instructions
You will need:
• Personal protective equipment (PPE)
• (1) tube of transport medium
– Universal Transport Media (UTM)
– Viral Transport Media (VTM)*
– Saline solution
• (1) swab
• Patient identification labels
Before you begin:
• Confirm the patient’s name and date of birth.
• Wash your hands, then put on personal protective equipment, including gloves.
If you are having difficulties obtaining appropriate COVID-19 specimen collection and transport supplies, please contact your CCL Account Manager.
Nasopharyngeal (NP)/Oropharyngeal (OP) Swabs
Step 1:
Carefully remove the swab from the packaging without touching the tip.
Step 2a – for nasopharyngeal (NP) swabs:
– Gently insert the NP swab along the nasal septum just above the floor of the passage to the nasopharynx until resistance is met.
– Rotate the swab gently against the nasopharyngeal mucosa for 10 – 15 seconds, then remove.
Step 2b – for oropharyngeal (OP) swabs:
– Insert the OP swab into the back of the patient’s throat and gently swab the tonsillar pillars and posterior oropharynx.
Avoid touching the patient’s teeth, gums, and tongue.
Step 3:
Remove the cap from the tube, then insert the swab all the way to the bottom of the vial.
Step 4:
While holding the tube away from your face, bend the swab in the vial at a 180-degree angle to break at the marked breakpoint.
Step 5:
Close the tube tightly. If possible, wrap the cap with Parafilm.
Any leaking specimens will be rejected.
Step 6:
Label specimen with the printed label or write the patient’s first & last name, date of birth, and the date, time, and site of collection (e.g., NP or OP) on the tube.
Step 7:
Double-bag the specimen, place on wet ice, then refrigerate.
Step 8:
Complete a Coronavirus 2019 (COVID) Test Requisition.
Please ensure to provide the required Patient Demographics.
Step 9:
Place the completed requisition in the pocket of the specimen bag.
Do not place any paperwork in the part of the bag containing the specimen.
Step 10:
For the fastest turnaround time, deliver the specimen directly to the Main Campus LL Building Specimen Receiving Area:
Cleveland Clinic Laboratories
10300 Carnegie Avenue
Cleveland, OH 44106
Need a COVID-19 Test Requisition?
Contact your CCL Account Manager or Client Services.
Nasal (Anterior Nares) Swabs
Specimen Collection:
Step 1:Carefully remove the swab from the packaging without touching the tip.
Step 2:
Position the patient’s head slightly back, then insert the swab into their LEFT nostril (less than one inch) and gently push until a slight resistance is met.
Step 3:
Rotate the swab against the inside of the patient’s nostril four times for 10-15 seconds.
Step 4:
Remove the swab, then repeat Steps 2 & 3 in the RIGHT nostril with the same swab.
Remove the swab from the patient’s nose when finished.
Preparing for Transport:
Step 5:
While holding the swab, open the tube and set the cap down with the threads facing up.
Insert the swab into the tube until the breakpoint is level with the tube opening.
Step 6:
While holding the tube away from your face, bend the swab until it snaps at the break point.
You may need to gently rotate the swab shaft to complete the breakage.
Step 7:
After discarding the remaining swab shaft into an approved disposal container, screw the cap back onto the tube.
Apply the test label or write the patient’s information onto the tube.
Step 8:
Place the specimen into a biohazard bag, then insert any lab paperwork into the outside pouch.
Refrigerate the specimen during storage and transport to the lab.
Unacceptable Specimen Types
If you are unsure if a specific viral transport media (VTM) is accepted for testing, please contact Client Services for assistance.
Refer to the FDA’s Letter to Healthcare Providers regarding Transport Media Safety Risk for additional guidance.
BD CultureSwabs with Stuart’s or Amies Transport Medium
Beaver Biomedical Viral Transport Media (VTM)
NEST Solution for swab sample collection, transportation and storage
Due to incompatibilities with COVID-19 testing laboratory equipment, specimens in Beaver Biomedical VTM or NEST Solution for Sample Collection, Transport, and Storage are not acceptable for COVID-19 testing performed by CCL.
If you have any questions, please contact your CCL Account Manager or Client Services for assistance.