This makes it more have a problem. you have AAT deficiency, you have two damaged copies of this gene. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The only way to find out whether you have this genetic disorder is to get tested. the chance of a false abnormal result. Distinct early IgA profile may determine severity of COVID-19 symptoms: an immunological case series. PDF COVID-19 Quick Clinical Guide - Stanford Medicine Get the most important science stories of the day, free in your inbox. Indeed, a systematic review by Struyf et al.10 found that combinations of symptoms were not assessed in a single study. J. Infect Dis. Laboratory findings of COVID-19: a systematic review and meta - PubMed 2020;323:123942. Persistent symptoms and lab abnormalities in patients who recovered from COVID-19, https://doi.org/10.1038/s41598-021-91270-8. J. Hematol. The remaining 99 cases with normal Lymphocyte count had 19 patients (19%) with persistent symptoms and 80 patients without. The patient has since been discharged and is recovering at home. COVID-19 antibody test: MedlinePlus Medical Encyclopedia Complete blood count alterations in COVID-19 patients: A - PubMed J. Infect. 2023 Feb 18;13(2):355. doi: 10.3390/brainsci13020355. SSRN 21, 3566166 (2020). Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Terpos, E. et al. A novel coronavirus from patients with pneumonia in China, 2019. The COVID-19 virus test is not used to test your immunity to COVID-19. bruising, and feeling lightheaded. iGraph package. The COVID-19 antibody test is not used to diagnose a current infection with COVID-19. They resemble immature red blood cells (RBCs) and bone marrow cells (myeloid cells) circulating in the blood. 92(6), 577583 (2020). It also showed neutrophilia, highlighting the bodys rush to produce WBCs to fight the infection. The disorder can cause liver All authors significantly contributed to the manuscript and approved for publication. Google Scholar. 2021. JAMA 323(13), 12391242 (2020). 50(5), 436439 (2020). HHS Vulnerability Disclosure, Help & Kucia, M. SARS-CoV-2 infection and overactivation of Nlrp3 inflammasome as a trigger of cytokine storm and risk factor for damage of hematopoietic stem cells. Symptoms being highly similar were summarized to one medical concept. Bangalore, S; Sharma, A; Slotwiner, A et al. Post-Acute and Long-Term Covid-19 Complications and Manifestations. Google Scholar. official website and that any information you provide is encrypted To test if you have antibodies against the SARS-CoV-2 virus, you need a COVID-19 antibody test taken from a blood sample. All included patients provided informed consent for scientific analyses. Moreover, the majority of the population in Calvao-Schneider et al. advise talking with a genetic counselor before getting a medical test that will stay A procedure that involves taking a tiny sample of your liver to look This is related to the Test Result Value element and is closely linked to . A web-based platform was established to upload anonymous symptoms data to generate and reproduce network analysis based on own or other cohorts17. The three most. Covid-19 PCR and Antibody Testing. . What the blood tests of a COVID-19 patient can tell us - news Results: Elevated neutrophil-to-LYM ratio (NLR), D-dimer (D-D), interleukin (IL)-6, IL-10, IL-2, interferon-Y, and age were significantly associated with the severity of illness. Renegar, K. B. Negative when something isn't present. Standardized symptom characterization report forms and all free-text elements of discharge letters were added for analyses. 4 0 obj BMJ. COVID-19 (SARS-CoV-2) IgG Antibody Positive Test Result If your antibody test result was positive, this means that the test shows that you have COVID-19 antibodies in your blood. Laboratory-based changes in biomarkers can be more reliable indicators of response to . Moreover, details on persistent symptoms and duration to symptom-free phase could be sufficiently extracted in almost all of the cases. J Infect 81(6). Table 1 summarizes further cohort details. Our board certified pathologists provide testing services to clinics, hospitals, and other reference laboratories in Southern California. There are two main types of viral tests: nucleic acid amplification tests (NAATs) and antigen tests. Blood sampling enabled comprehensive lab-data including whole blood analysis, serum chemistry and immunoglobulins. Front Immunol. Severe covid-19 pneumonia: pathogenesis and clinical management. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. SARS-CoV-2 is the name of the virus that causes coronavirus disease 2019 (COVID-19). These tests include: Serum AAT concentrations. However, hypoxia and systemic inflammation secondary to COVID-19 may lead to high levels of inflammatory cytokines16 and activation of the coagulation pathway. Moreover, the different follow-up times also lead to different time distances between last day of symptoms and the actual lab-assessment. The principal limitation of this study is the retrospective single-center design with symptom assessment not being objective and being prone to recall bias. American Venous Forum. There are several reports of hospitalized patients with thrombotic complications, most frequently deep venous thrombosis and pulmonary embolism.9-11 Other reported manifestations include: The pathogenesis for COVID-19-associated hypercoagulability remains unknown. The .gov means its official. and JavaScript. Chin Med J (Engl). Call for Appointment. These are also listed as long-term symptoms by the National Institute Health and Care Excellence18 and CDC as information for health care providers19. |. Comparing the two patient cohorts with (n=92) vs without persistent symptoms (n=24), no significant difference can be observed regarding age (t-test, p=0.2497) and gender (Fishers exact test, p=0.3415).Follow-up ranged from 22 to 102days. PMC Use appropriate personal protective equipment when collecting and handling specimens from individuals suspected of having COVID-19 as outlined in the CDC . Alpha Clinical Laboratory, INC Li, L. et al. Cochrane Database Syst. 2020 Dec 11;20(1):952. doi: 10.1186/s12879-020-05678-0. 202022 reported that 66% of patients experienced symptoms at day 6022. This is a single center retrospective study in the University Hospital of Mnster in Germany. All methods were performed in accordance with the Declaration of Helsinki and with the relevant guidelines and regulations. Calculations were conducted in R, version 4.03. In certain circumstances, one test type may be recommended over the other. Infection with SARS-CoV-2 causes abnormal laboratory results of Tests on a blood sample to look for the AAT protein. Med. %PDF-1.3 Afterward, the site may be sore. Our subgroup analyses showed that patients with lymphopenia experienced more frequently persistent symptoms. Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected by Pulmonary CT Angiography, Large-Vessel Stroke as a Presenting Feature of Covid-19 in theYoung. Shop All Tests. Our study adds some novelty about the identification of effective biomarkers of progressive disease, and might be helpful for diagnosis, prevention of complications, and effective therapy. Post COVID Blood. This is related to the Test Result Value element and is closely linked to provide interpretation by a laboratorian about the result value in relation to the reference ranges for the particular patient. 8600 Rockville Pike [cited 2020 Sep 15];n/a(n/a). You are using a browser version with limited support for CSS. 9(6), 323330 (2005). Sci Rep 11, 12775 (2021). a history of the above conditions. An association of persistent lymphopenia with increased rates of infections due to a relevant immunosuppressive status is hypothetic and needs further research. To the best of our knowledge, this is the first COVID-19-related study on the duration of lymphopenia along with other routine lab values going beyond 30days. A study of 193 symptomatic and 110 asymptomatic patients with SARS-CoV-2 infection found that viral RNA detection lasted a median of 17 to 19 days. All insurances accepted. A. Surez-Cuenca, Paul W. Blair, Joost Brandsma, the EPICC COVID-19 Cohort Study Group, Scientific Reports Persistent symptoms and lab abnormalities in patients who recovered from COVID-19. These cases had results below the lab-specific reference range of 1.263.35109/L (follow-up range: 45-102d, median: 70d). eCollection 2023 Feb. Udzik J, Kowalczyk A, Waszczyk A, Nowaczyk Z, Barczyszyn A, Dziaa K, Mularczyk M, Niekrasz M. Brain Sci. In 13% of the cases they persisted for 60days and longer. Yadav R, Yadav V, Pokhriyal S, Zahid U, Gandhi A. Cureus. Impact Of Severity Of Covid-19 On Haematological Parameters In Patients Reporting To Saidu Group Of Teaching Hospitals, Swat. Some lab tests are used to help diagnose, screen, or monitor a specific disease or condition. One of the main unmet needs for coronavirus disease 2019 is its unpredictable clinical course, which can rapidly change in an irreversible outcome. In patients with severe illness, the following tests should be ordered: The most common laboratory abnormalities in patients hospitalized with pneumonia include leukopenia, lymphopenia, leukocytosis, elevated liver transaminases, elevated lactate dehydrogenase, and elevated C-reactive protein (Table 7.1). The difference should be explained by our comorbidity-free and relatively young population (median age: 41 ys). Because laboratories already communicate test result interpretations along with reference ranges to the Centers for Medicare & Medicaid Services (CMS), this data element is already in wide usage and should be classified Level 2 at a minimum. 146(6), 19721978 (1991). Coronavirus (COVID-19): Latest Updates | Visitation PoliciesVisitation PoliciesVisitation PoliciesVisitation PoliciesVisitation Policies | COVID-19 Testing | Vaccine InformationVaccine InformationVaccine Information, Alpha-1-antiprotease deficiency, alpha-1-antiproteinase inhibitor deficiency, AAT MeSH These include bleeding, infection, The CAP supports this data element to align with CLIAs test result interpretation reporting requirement. 2023 American College of Emergency Physicians. Article: Mitra et al. A cohort study was conducted on hospitalized COVID-19 pneumonia patients in Granada (Spain) during the first . addition to the code system must be done through HL7 terminology processes, Improving patient experience of care (quality and/or satisfaction), Corresponding CLIA Reporting Requirement: Test result interpretation. Comparing to a study by Garrigues et al.23 with a mean of 110.9days, Fatigue and Dyspnea were the most common, followed by Loss of Memory. Dis. Coronavirus disease 2019 (COVID-19) pandemic represents a scientific and social crisis. The Croatian Society of Medical Biochemistry and Laboratory Medicine. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit. Leukoerythroblastic reactions in blood usually indicate a significant deviation to the bodys normal immune response. COVID-19 associated coagulopathy and thromboembolic disease: Commentary on an interim expert guidance. . [cited 2020 Nov 18]. negative or not detected test result means that the virus that causes COVID-19 was not found in your sample. to look for the amount of AAT protein you have. This site needs JavaScript to work properly. Test results may vary depending on your age, gender, health history, and other things. . Genetic test. The road to commercialization for health care and life science technologies is long. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease. Patients with persistent symptoms had significantly lower serum IgA levels. would. 3 The placenta, which acts as an infectious barrier to the fetus, may be uniquely impacted in pregnancies complicated . Abnormal Screening Results Causes of Abnormal Screening Results Prolonged Protime Profile (117866) Prolonged Activated Partial Thromboplastin Time (aPTT) (117796) In many cases, a clinician must deal with an extended PT or aPTT in a patient who is not receiving anticoagulant therapy. 7(7), CD013665 (2020). [cited 2020 Oct 22]; Available from: https://academic.oup.com/cid/advance-article/doi/https://doi.org/10.1093/cid/ciaa1496/5913451. In 13% of the cases they persisted for 60 days and longer. For COVID-19, a negative or not detected test result for a sample collected while a person has symptoms usually means that COVID-19 did not cause your recent illness. We hope to avoid unnecessary blood work-up and diagnostic testing in patients with COVID-19, Graff said. Persistent symptoms and lab abnormalities in patients who - Nature Five of 35 cases (14%) had Lymphopenia in the later follow-up range of 80102days. Correspondence to Descriptive statistics were calculated for patient cohort characteristics. Klopfenstein, T. et al. Three days later, the patient had an increased level of WBCs (leukocytosis) and above normal levels of immature neutrophil cells. The three most frequent ones were Fatigue, Anosmia and Dyspnea. 2023;37:101188. doi: 10.1016/j.imu.2023.101188. for disease. A laboratory test result, has several components: The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Serum protein electrophoresis with thin-layer isoelectric focusing. Laboratory abnormalities in severe disease are further described in Table 7.2. 2023 University of Rochester Medical CenterRochester, NY, Clinical and Translational Sciences Institute, Monroe County Community Health Improvement Plan. By doing this, the study evaluated lab abnormalities including but not limited to general infection parameters, in particular lymphopenia, being discussed as a hot-topic and prognostic factor in disease onset12,13,14. Zhao, Q. et al. Internet Explorer). Macpherson, A. J., McCoy, K. D., Johansen, F.-E. & Brandtzaeg, P. The immune geography of IgA induction and function. As leaders in medical diagnostic testing, we use the latest technology and innovation to ensure quick and accurate results. Passive transfer of local immunity to influenza virus infection by IgA antibody. PDF CHARTING REFERENCE INTERVALS AND FLAGGING ABNORMAL RESULTS - ARUP Lab Google Scholar. A summary of the results is provided in Table 1. Accessed April 2020. You may have been infected with another virus from the same family of viruses (coronavirus). Careers. The acute phase of COVID-19 infection is defined by the symptoms occurring the first 4 weeks after initial symptom onset [8, 9].While evidence about stages beyond the acute phase is still evolving, some suggest the presence of symptoms beyond 12 weeks from onset of illness comprises post-acute COVID-19 syndrome as one group . To test if you are currently infected, you will need a SARS-CoV-2 (or COVID-19 . 2020;133:108795. Description: The College of American Pathologists (CAP) supports this data element as written and urges that it be brought up to Level 2 and ideally included in USCDI v4. PRT and RV have jointly supervised the work and contributed equally as co-senior authors. When the needle pricks your arm or hand, you may ACS Chem Neurosci. Her blood test also showed a mild increase in the number of monocytes (immune cells) and a reduced level of lymphocytes. Further follow-up studies should assess lymphopenia with additional lab analysis to understand the pathogenetic details of lymphocyte-virus interaction. Clipboard, Search History, and several other advanced features are temporarily unavailable. This is a CLIA requirement: 493.1291(c)(6): The test result and, if applicable, the units of measurement or interpretation, or both.. 1499. ST-Segment Elevation in Patients with COVID-19-A Case Series, Impact on Research, Education, Licensure, and Credentialing. 95(7), 834847 (2020). The findings were published March 25 in the American Journal . Ratajczak, M. Z. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI, - Must be represented by a vocabulary standard or an element of a published technical specification, - Used in limited production environments, 1 or 2 different systems, - Demonstrates exchange between 2 or 3 organizations with different EHR/HIT systems, - Used by many, but not most, patients, providers or events requiring its use, Interoperability Standards Advisory (ISA), Sources of Security Standards and Security Patterns, State and Local Public Health Readiness for Interoperability, Unique Device Identifier(s) for a Patients Implantable Device(s), Administrative Transaction Acknowledgements, Enrollment and Disenrollment in a Health Plan, Health Care Eligibility Benefit Inquiry and Response, Health Care Eligibility Benefit Inquiry and Response for Retail Pharmacy Coverage, Administrative Transactions to Financial Exchanges, Electronic Funds Transfer for Payments to Health Care Providers, Health Care Payment and Remittance Advice, Health Plan Premium Payments for Covered Members, Administrative Transactions to Support Clinical Care, Health Care Attachments to Support Claims, Referrals and Authorizations, Referral Certification and Authorization for Pharmacy Transactions, Referral Certification and Authorization Request and Response for Dental, Professional and Institutional Services, Health Care Claims and Coordination of Benefits, Health Care Claim Status Request and Response, Health Care Claims or Equivalent Encounter Information for Dental Claims, Health Care Claims or Equivalent Encounter Information for Institutional Claims, Health Care Claims or Equivalent Encounter Information for Professional Claims, Health Care Claims or Equivalent Encounter Information for Retail Pharmacy Claims, Health Care Claims or Equivalent Encounter Information for Retail Pharmacy Supplies and Professional Services, Operating Rules to Support Administrative Transactions, Operating Rules for Enrollment and Disenrollment, Operating Rules for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA), Operating Rules for Prior Authorization and Referrals, Operating Rules to Support Claim Status Transactions, Operating Rules to Support Electronic Prescribing Transactions, Operating Rules to Support Eligibility Transactions, Appendix I Sources of Security Standards and Security Patterns, Appendix III - Educational and Informational Resources, Understanding Emerging API-Based Standards, Understanding Observations and Observation Values, Appendix IV - State and Local Public Health Readiness for Interoperability, Sending a Notification of a Long-Term Care Patients Admission, Discharge and/or Transfer Status to the Servicing Pharmacy, Sending a Notification of a Patients Admission, Discharge and/or Transfer Status to Other Providers, Sending a Notification of a Patients Encounter to a Record Locator Service, Referral from Acute Care to a Skilled Nursing Facility, Referral to a Specialist - Request, Status Updates, Outcome, Referral to Extra-Clinical Services - Request, Updates, Outcome, Documenting and Sharing Care Plans for a Single Clinical Context, Documenting and Sharing Medication-Related Care Plans by Pharmacists, Documenting Care Plans for Person Centered Services, Domain or Disease-Specific Care Plan Standards, Sharing Patient Care Plans for Multiple Clinical Contexts, Communicate Appropriate Use Criteria with the Order and Charge to the Filling Provider and Billing System for Inclusion on Claims, Provide Access to Appropriate Use Criteria, Clinical Quality Measurement and Reporting, Reporting Aggregate Quality Data for Quality Reporting Initiatives, Reporting Patient-level Quality Data for Quality Reporting Initiatives, Sharing Quality Measure Artifacts for Quality Reporting Initiatives, Establishing the Authenticity, Reliability, and Trustworthiness of Content Between Trading Partners, Exchanging Diet and Nutrition Orders Across the Continuum of Care, Family Health History (Clinical Genomics), Representing Family Health History for Clinical Genomics, Format for Sharing Social Care Services Information, Format for Structuring and Sharing Social Care Directory Information, Format of Medical Imaging Reports for Exchange and Distribution, Format of Radiation Exposure Dose Reports for Exchange and Distribution, Format of Radiology Reports for Exchange and Distribution, Medical Image Formats for Data Exchange and Distribution, Exchange InVitro Diagnostics (IVD) Orders and Results, Transmit Laboratory Directory of Services to Provider System, Medical Device Communication to Other Information Systems/Technologies, Transmitting Patient Vital Signs from Medical Devices to Other Information Systems/Technologies, Clinical Information Systems to Request Context-Specific Clinical Knowledge From Online Resources, Patient Identity/Identification Management, Recording Patient Preferences for Electronic Consent to Access and/or Share their Health Information with Other Care Providers, Allows Pharmacy Benefit Payers to Communicate Formulary and Benefit Information to Prescriber Systems, Allows a Long Term or Post-Acute Care to Request to Send an Additional Supply of Medication, Allows a Pharmacy to Notify a Prescriber of Prescription Fill Status, Allows a Pharmacy to Request Additional Refills, Allows a Pharmacy to Request a Change to a Prescription, Allows a Pharmacy to Request a New Prescription For a New Course of Therapy or to Continue Therapy, Allows a Pharmacy to Request, Respond to or Confirm a Prescription Transfer, Allows a Prescriber or a Pharmacy to Request a Patients Medication History, Allows a Prescriber to Cancel a Prescription, Allows a Prescriber to Communicate Drug Administration Events, Allows a Prescriber to Communicate with a REMS Administrator, Allows a Prescriber to Prescribe Medication Using Weight-Based Dosing, Allows a Prescriber to Recertify the Continued Administration of a Medication Order, Allows a Prescriber to Request a Patients Medication History from a State Prescription Drug Monitoring Program (PDMP), Allows a Prescriber to Request, Cancel or Appeal Prior Authorization for Medications, Allows a Prescriber to Send a New Prescription to a Pharmacy, Allows a Prescriber to Send a Prescription to a Pharmacy for a Controlled Substance, Allows for Communication of Prescription Information Between Prescribers and Dispensers, Allows for the Exchange of State Prescription Drug Monitoring Program (PDMP) Data, Data Submission for Title X Family Planning Annual Reporting, Electronic Transmission of Reportable Laboratory Results to Public Health Agencies, Exchanging Immunization Data with Immunization Registries, Newborn Screening Results and Birth Defect Reporting to Public Health Agencies, Reporting Antimicrobial Use and Resistance Information to Public Health Agencies, Reporting Birth and Fetal Death to Public Health Agencies, Reporting Cancer Cases to Public Health Agencies, Reporting Death Records to Public Health Agencies, Reporting Syndromic Surveillance to Public Health (Emergency Department, Inpatient, and Urgent Care Settings), Sending Health Care Survey Information to Public Health Agencies, Data Collection for Submission to Registries and Reporting Authorities, Prepopulation of Research Forms from Electronic Health Records, Submission of Clinical Research Data Contained in EHRs and Other Health IT Systems for General Purpose or Preserving Specific FDA Requirements, Submission of Clinical Research Data to FDA to Support Product Marketing Applications, Submit Adverse Event Report from an Electronic Health Record to Drug Safety Regulators, Support a Transition of Care or Referral to Another Health Care Provider, Defining a Globally Unique Device Identifier, Representing Unique Implantable Device Identifiers, An Unsolicited "Push" of Clinical Health Information to a Known Destination and Information System User, An Unsolicited Push of Clinical Health Information to a Known Destination Between Systems, Push Communication of Vital Signs from Medical Devices, Remote Patient Monitoring to Support Chronic Condition Management, Patient Education and Patient Engagement, Providing Patient-Specific Assessments and Recommendations Based on Patient Data for Clinical Decision Support, Retrieval of Contextually Relevant, Patient-Specific Knowledge Resources from Within Clinical Information Systems to Answer Clinical Questions Raised by Patients in the Course of Care, Consumer Access/Exchange of Health Information, Collection and Exchange of Patient-Reported Outcomes, Patient Exchanging Secure Messages with Care Providers, Push Patient-Generated Health Data into Integrated EHR, Remote Patient Authorization and Submission of EHR Data for Research, View, Download and Transmit Data from EHR, Listing of Providers for Access by Potential Exchange Partners, Exchanging Images Outside a Specific Health Information Exchange Domain, Exchanging Images Within a Specific Health Information Exchange Domain, Exchanging Patient Identification Within and Between Communities, Transport for Immunization Submission and Query/Response, Data Element Based Query for Clinical Health Information, Query for Documents Outside a Specific Health Information Exchange Domain, Query for Documents Within a Specific Health Information Exchange Domain, Finding and Retrieving Human Services Information, Representing Patient Allergies and Intolerances; Environmental Substances, Representing Patient Allergies and Intolerances; Food Substances, Representing Patient Allergies and Intolerances; Medications, Representing Non-Imaging and Non-Laboratory Clinical Tests, Representing Patient Contact Information for Telecommunications, Representing Nutrition Assessment, Diagnosis, Interventions and Monitoring/Evaluation, Representing Health Care Data for Emergency Medical Services, Representing Assessment and Plan of Treatment, Representing Patient Dental Encounter Diagnosis, Representing Patient Medical Encounter Diagnosis, Representing Patient Family Health History, Representing Patient Functional Status and/or Disability, Health Care Providers, Family Members and Other Caregivers, Representing Provider Role in Team Care Settings, Representing Relationship Between Patient and Another Person, Imaging (Diagnostics, Interventions and Procedures), Representing Imaging Diagnostics, Interventions and Procedures, Representing Clinical/Nursing Assessments, Representing Patient Problems for Nursing, Patient Clinical Problem List (i.e., "Conditions"), Representing Patient Clinical Problems (i.e., Conditions), Representing Patient Preferred Language (Presently), Representing Medical Procedures Performed, Public Health Emergency Preparedness and Response, Representing Hospital/Facility Beds Utilization, Representing Laboratory Operations (Population Laboratory Surveillance), Representing Population-Level Morbidity and Mortality, Representing Data for Biomedical and Health Services Research Purposes, Sex at Birth, Sexual Orientation and Gender Identity, Representing Patient-Identified Sexual Orientation, Social, Psychological and Behavioral Data, Representing Exposure to Violence (Intimate Partner Violence), Representing Social Connection and Isolation, Representing Patient Electronic Cigarette Use (Vaping), Representing Patient Secondhand Tobacco Smoke Exposure, Representing Patient Tobacco Use (Smoking Status), Representing Units of Measure (For Use with Numerical References and Values), Representing Job, Usual Work, and Other Work Information, http://www.hl7.org/implement/standards/product_brief.cfm?product_id=98 LRI: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=279 FHIR observation in US Core lab observation profile: https://build.fhir.org/ig/HL7/US-Core/Struct, http://www.hl7.org/implement/standards/product_brief.cfm?product_id=279, https://build.fhir.org/ig/HL7/US-Core/StructureDefinition-us-core-observation-lab.html, https://art-decor.ihe-europe.net/art-decor/decor-templates--XDLAB-?section=templates&id=1.3.6.1.4.1.19376.1.3.1.6&effectiveDate=2008-08-08T00:00:00&language=en-US, https://terminology.hl7.org/CodeSystem-v3-ObservationInterpretation.html, THIA Comment on Laboratory: Result Interpretation, CAP Comment on Test Interpretation (Abnormal Flag) Data Element, U.S. Department of Health and Human Services.

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