Distribution of Viral Respiratory Infections during the COVID-19 Pandemic Using the FilmArray Respiratory Panel

Abstract

This study was conducted to evaluate the distribution of respiratory viral pathogens in the emergency department during the coronavirus disease 2019 (COVID-19) pandemic. Between May 2020 and September 2022, patients aged between 0.1 and 98 years arrived at the emergency department of Asia University Hospital, and samples from nasopharyngeal swabs were tested by the FilmArrayTM Respiratory Panel (RP). SARS-CoV-2 positivity was subsequently retested by the cobas Liat system. There were 804 patients for whom the FilmArrayTM RP was tested, and 225 (27.9%) of them had positive results for respiratory viruses. Rhinovirus/enterovirus was the most commonly detected pathogen, with 170 (61.8%) cases, followed by adenovirus with 38 (13.8%), SARS-CoV-2 with 16 (5.8%) cases, and coronavirus 229E, with 16 (5.8%) cases. SARS-CoV-2 PCR results were positive in 16 (5.8%) cases, and there were two coinfections of SARS-CoV-2 with adenovirus and rhinovirus/enterovirus. A total of 43 (5.3%) patients were coinfected; the most coinfection was adenovirus plus rhinovirus/enterovirus, which was detectable in 18 (41.9%) cases. No atypical pathogens were found in this study. Intriguingly, our results showed that there was prefect agreement between the detection of SARS-CoV-2 conducted with the cobas Liat SARS-CoV-2 and influenza A/B nucleic acid test and the FilmArrayTM RP. Therefore, the FilmArrayTM RP assay is a reliable and feasible method for the detection of SARS-CoV-2. In summary, FilmArrayTM RP significantly broadens our capability to detect multiple respiratory infections due to viruses and atypical bacteria. It provides a prompt evaluation of pathogens to enhance patient care and clinical selection strategies in emergency departments during the COVID-19 pandemic.

Acute Respiratory Tract Infections (ARTIs) in Children after COVID-19-Related Social Distancing: An Epidemiological Study in a Single Center of Southern Italy

“…However, the three most frequently identified viruses in children's respiratory infections in the literature are HRV/EV, RSV, and If A [19,32,33]; this pattern was similarly affirmed in our study.…”

Assessing respiratory viral exclusion and affinity interactions through co-infection incidence in a pediatric population during the 2022 resurgence of influenza and RSV

“…Most studies have found comparably low rates of viral co-infection in adult populations as those we present here. For example, Chen and Er (2022) characterized FilmArray™ RP results from 804 Emergency Department patients in Taiwan, with 27.9% having positive results, 5.3% of patients having co-infection, but only two co-infections involving SARS-CoV-2, with the plurality of co-infections involving Adenovirus and Rhino/Enterovirus (42%) ( Chen and Er, 2022 ). However, these authors did little to examine the rates of specific viral co-infections relative to the frequency each virus was encountered, or to explore correlations between the incidence of specific viral co-infections.…”

“…Horemheb-Rubio et al (2022) conducted such an examination of respiratory viral interactions from 2010-2019 in Europe found relatively few synergistic viral interactions, such as between influenza H3N2 and parainfluenza virus 4 or HCoV-NL63 and parainfluenza virus 1, and predominantly viral exclusion between influenza and RSV, rhinovirus and most parainfluenza viruses (Horemheb-Rubio et al, 2022). However, such an analysis has not been conducted on a pediatric population, which have been shown to have higher rates of respiratory viral co-infection (Dao et al, 2021;Chen and Er, 2022;Krumbein et al, 2023), in general, nor been conducted since the beginning of the COVID-19 pandemic and therefore systematically assessed such viral co-infection dynamics in patients with SARS-CoV-2. The resurgence of respiratory viruses seen over the past two Northern Hemisphere winter seasons represents a unique opportunity to study their co-infection rates normalized to background mono-infection.…”

Impact of Nested Multiplex Polymerase Chain Reaction Assay in the management of pediatric patients with acute respiratory tract infections: a single center experience

“…Specimens were cultured on Blood agar, Chocolate agar, MacConkey agar and two Sabouraud dextrose agar (SDA) plates (Oxoid, UK) by semi-quantitative technique, plates were incubated aerobically for 24-48 hours at 37°C, one plate of SDA was incubated at 28°C and the other at 37°C, both were examined each other day up to two weeks. Sputum, ETA and BAL cultures were considered positive if ≥10 6 , ≥10 5 and ≥10 4 CFU/mL were detected respectively. Presence of mixed growth of Neisseria spp., diphtheroids, alpha-hemolytic streptococci, or staphylococci was considered as normal flora.…”

“…Therefore, prompt identification of causative agents and initiation of proper antimicrobial therapy are urgently needed to improve the patient's prognosis. Nucleic acid detection tests have gained popularity because of the rapid turnaround as well as the wide panel of pathogens that can be detected [4,5]. On this basis, syndromic testing has been implemented in most microbiology laboratories worldwide, where multiple agents are tested simultaneously through a single test.…”