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.