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New Emirates Medical Journal

Editor-in-Chief

ISSN (Print): -
ISSN (Online): 0250-6882

Review Article

Flu Viral Multiplex Testing and its Implication for COVID-19 Testing

Author(s): Aaron Han* and Janet Hicban

Volume 2 , Issue 1 , 2021

Published on: 08 September, 2020

Page: [16 - 19] Pages: 4

DOI: 10.2174/0250688201999200908150437

open access plus

Abstract

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.

Conclusion: 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.

Keywords: PCR, Flu, Lab, Molecular, COVID-19, Virus.

[1]
Ruggiero P, McMillen T, Tang YW, Babady NE. Evaluation of the BioFire FilmArray respiratory panel and the GenMark eSensor respiratory viral panel on lower respiratory tract specimens. J Clin Microbiol 2014; 52(1): 288-90.
[http://dx.doi.org/10.1128/JCM.02787-13] [PMID: 24131685]
[2]
Popowitch EB, O’Neill SS, Miller MB. Comparison of the Biofire FilmArray RP, Genmark eSensor RVP, Luminex xTAG RVPv1, and Luminex xTAG RVP fast multiplex assays for detection of respiratory viruses. J Clin Microbiol 2013; 51(5): 1528-33.
[http://dx.doi.org/10.1128/JCM.03368-12] [PMID: 23486707]
[3]
Azadeh N, Sakata KK, Brighton AM, Vikram HR, Grys TE. FilmArray respiratory panel assay: Comparison of nasopharyngeal swabs and bronchoalveolar lavage samples. J Clin Microbiol 2015; 53(12): 3784-7.
[http://dx.doi.org/10.1128/JCM.01516-15] [PMID: 26378282]
[4]
Tan W, Zhao X, Ma X, et al. G GAO, G Wu. A novel coronavirus genome identified in a cluster of pneumonia cases-Wuhan, China 2019-2020. China CDC Weekly 2020; 2: 61-2.
[http://dx.doi.org/10.46234/ccdcw2020.017]
[5]
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020; 395(10223): 507-13.
[http://dx.doi.org/10.1016/S0140-6736(20)30211-7] [PMID: 32007143]
[6]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[7]
Guan WJ, Ni ZY, Hu Y, et al. PYNChen, J Xiang, NS Zhong. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1859-62.
[http://dx.doi.org/10.1056/NEJMoa2002032]
[8]
Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature 2020; 579(7798): 265-9.
[http://dx.doi.org/10.1038/s41586-020-2008-3] [PMID: 32015508]
[9]
Tayoun A, Loney T, Khansaheb H, et al. Whole genome sequencing and phylogenetic analysis of SARS-CoV-2 strains from the index and early patients with COVID-19 in Dubai, United Arab Emirates, 29 January to 18 March 2020 bioRxiv.
[10]
Eifan SA, Hanif A, AlJohani SM, Atif M. Respiratory tract viral infections and coinfections identified by anyplex™ II RV16 detection kit in pediatric patients at a riyadh tertiary care hospital. BioMed Res Int 2017; 20171928795
[http://dx.doi.org/10.1155/2017/1928795] [PMID: 29359144]
[11]
Pinky L, Dobrovolny HM. Coinfections of the respiratory tract: Viral competition for resources. PLoS One 2016; 11(5)e0155589
[http://dx.doi.org/10.1371/journal.pone.0155589] [PMID: 27196110]
[12]
Goka EA, Vallely PJ, Mutton KJ, Klapper PE. Single, dual and multiple respiratory virus infections and risk of hospitalization and mortality. Epidemiol Infect 2015; 143(1): 37-47.
[http://dx.doi.org/10.1017/S0950268814000302] [PMID: 24568719]
[13]
Baroudy NRE, Refay ASE, Hamid TAA, Hassan DM, Soliman MS, Sherif L. Respiratory viruses and atypical bacteria Co-infection in children with acute respiratory infection. Open Access Maced J Med Sci 2018; 6(9): 1588-93.
[http://dx.doi.org/10.3889/oamjms.2018.332] [PMID: 30337970]
[14]
Kim D, Quinn J, Pinsky B, Shah NH, Brown I. Rates of co-infection between SARS-CoV-2 and other respiratory pathogens. JAMA 2020; 323(20): 2085-6.
[http://dx.doi.org/10.1001/jama.2020.6266] [PMID: 32293646]
[15]
Xing Q, Li G, et al. Precautions are needed for COVID-19 patients with coinfection of common respiratory pathogens. MedRxiv 2020.
[http://dx.doi.org/10.1101/2020.02.29.20027698]
[16]
Wu X, Cai Y, Huang X, et al. Co-infection with SARS-CoV-2 and influenza a virus in patient with pneumonia, china. Emerg Infect Dis 2020; 26(6): 1324-6.
[http://dx.doi.org/10.3201/eid2606.200299] [PMID: 32160148]
[17]
Ding Q, Lu P. The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China. J Med Virol 2020; 1-7.
[18]
Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol 2020; 34(5): e212-3.
[http://dx.doi.org/10.1111/jdv.16387] [PMID: 32215952]
[19]
Lin L, Jiang X, Zhang Z, et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut 2020; 69(6): 997-1001.
[http://dx.doi.org/10.1136/gutjnl-2020-321013] [PMID: 32241899]
[20]
Wang S, Zhou X, Zhang T, Wang Z. The need for urogenital tract monitoring in COVID-19. Nat Rev Urol 2020; 17(6): 314-5.
[http://dx.doi.org/10.1038/s41585-020-0319-7] [PMID: 32313110]

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