Key result
Multiplex flu testing yields ~95% negative predictive value for COVID-19 when detecting other viruses.
Why the study?
Syndromic multiplex panels offer rapid turnaround and accurate results for flu-like syndromes, prompting examination of their use and implications during the early COVID-19 pandemic.
Observational (n=2,145)
Viral syndromic panels can identify non-COVID pathogens with a high negative predictive value for COVID-19, aiding in diagnostic and treatment strategies during the pandemic.
May aid ruling out COVID-19 when other respiratory viruses detected; leaves open prospective validation before routine use.
Background: The diagnosis of viral causes for flu-like syndromes have positively been impacted by the availability of molecular assays. In recent years, syndromic multiplex panels have been able to give rapid turn-around-times and highly accurate results. We examine the use of this test during the first four months of 2020 during the COVID-19 pandemic. Methods: A retrospective review of 2145 patient results from a multiplex syndromic flu panel using Biofire RP2 was performed. Cases in which parallel testing for COVID-19 by real-time polymerase chain reaction (RT-PCR) was compared. Results: 53% of the patients tested identified as a viral agent. 13% of the positive cases were coinfection with more than a single virus. The most frequently detected virus(es) were rhinovirus/enterovirus, followed by coronaviruses (non-MERS, non-COVID-19). One hundred patients had simultaneous testing for COVID-19. Seventeen (17%) had positive COVID-19 by RT-PCR. Three of these patients had coinfection with rhinovirus/enterovirus and COVID-19. The negative predictive value for COVID-19 based on a positive non-COVID agent was 95% in our sample. Conclusions: Viral syndromic panels are useful for the rapid detection and appropriate treatment of patients. Our results suggest coinfection is infrequent, and we discuss the impact of COVID-19 on patient testing strategy. The use of multiplex panels is useful to provide accurate diagnosis and rule out important pathogens that have different treatment approaches.
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Han et al. (2020) conducted an observational in Flu-like syndromes (n=2,145). Multiplex syndromic flu panel (Biofire RP2) was evaluated on Detection of viral agents and negative predictive value for COVID-19. Multiplex syndromic flu testing identified a viral agent in 53% of patients and demonstrated a 95% negative predictive value for COVID-19 when a non-COVID viral agent was detected.
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