Emergency Department point-of-care antiviral host response testing is accurate during periods of multiple respiratory virus co-circulation.

Autor: Brendish NJ; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Electronic address: n.brendish@soton.ac.uk., Davis C; Clinical Informatics Research Unit, NHS Blood and Transplant Southampton, Southampton, UK., Chapman ME; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Borca F; Clinical Informatics Research Unit, NHS Blood and Transplant Southampton, Southampton, UK., Waddington D; Department of Emergency Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Hill C; Department of Emergency Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK., White N; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Clark TW; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Jazyk: angličtina
Zdroj: The Journal of infection [J Infect] 2024 Jan; Vol. 88 (1), pp. 41-47. Date of Electronic Publication: 2023 Nov 15.
DOI: 10.1016/j.jinf.2023.11.003
Abstrakt: Objectives: FebriDx is a CE-marked, FDA-approved point-of-care test that detects the antiviral host response protein Myxovirus Resistance Protein A (MxA), in addition to C-reactive protein, using finger-prick blood. FebriDx MxA detection had a high negative predictive value for COVID-19 in symptomatic adults presenting to hospital in the first waves of the pandemic and was used subsequently as a 'rule out' triage tool in Emergency departments. The diagnostic accuracy of FebriDx MxA in the current context of co-circulation of influenza, SARS-CoV-2, and Respiratory Syncytial Virus (RSV), and in the era of COVID-19 vaccination, is unknown.
Methods: We retrospectively evaluated the diagnostic performance of FebriDx MxA in adults with acute respiratory symptoms presenting to the Emergency Department (ED) of a large UK teaching hospital using Reverse Transcription Polymerase Chain Reaction (RT-PCR) as the reference standard (Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV).
Results: Between March 9th 2022 and March 8th 2023, 5426 patients had both FebriDx and RT-PCR testing with valid results. 999 (18.4%) of patients had influenza detected, 520 (9.6%) SARS-CoV-2, and 190 (3.5%) RSV. Negative Predictive Value (NPV) of MxA detection by FebriDx was 97.5% (96.9-98.0) for influenza, 97.1% (96.4-97.7) for SARS-CoV-2, 98.1% (97.5-98.6) for RSV, and 92.8% (91.8-93.7) for all viruses combined.
Conclusions: In symptomatic adults, FebriDx MxA had a high NPV for influenza and RSV, and retained a high NPV for SARS-CoV-2, in the context of virus co-circulation and widespread COVID-19 vaccination. FebriDx continues to be a useful 'rule out' triage tool in the ED and could potentially be scaled to provide a national triage solution for future viral pandemics.
Competing Interests: Declaration of Competing Interest TWC has received equipment and consumables at discount or free of charge for the purposes independent of research, outside of this submitted study, from BioFire diagnostics, BioMerieux, QIAGEN, and SenseBio. He has received travel re-imbursement and speaker fees from BioFire diagnostics, BioMerieux, and QIAGEN. He has received consultancy fees from Cepheid, Synairgen research, Roche, Sanofi, BioMerieux, and Biofire diagnostics. He has received honoraria for participation in advisory boards from Cepheid, Roche, Janssen, GSK, Shionogi, Seqirus and Sanofi. He is a member of an independent data monitoring committee for a trial sponsored by Roche. He has acted as the UK chief investigator for a study sponsored by Janssen. He owns shares in Synairgen research. All other authors declare no competing interests.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: