Use of the FebriDx point-of-care test for the exclusion of SARS-CoV-2 diagnosis in a population with acute respiratory infection during the second (COVID-19) wave in Italy

Lagi, Filippo; Trevisan, Sasha; Piccica, Matteo; Graziani, Lucia; Basile, Gregorio; Mencarini, Jessica; Borchi, Beatrice; Menicacci, Lorenzo; Vaudo, Micol; Scotti, Valentina Rita; Fabbri, Alessia; Bandini, Giulia; Tozzetti, Camilla; Berni, Andrea; Aiezza, Noemi; Pestelli, Giulia; Turchi, Valerio; Pignone, Alberto Moggi; Poggesi, Loredana; Nozzoli, Carlo; Morettini, A; Rossolini, Gian María; Bartoloni, Alessandro

doi:10.1016/j.ijid.2021.04.065

Cited by 14 publications

(13 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With its ease of use and faster time to generating results, the FebriDx has several advantages over lateral flow tests. Our finding of high FebriDx sensitivity as compared to RT-PCR in adults hospitalised with suspected COVID-19 is supported by other, smaller studies [ 23 – 25 ].…”

Section: Discussionsupporting

confidence: 88%

Combined RT-PCR and Host Response Point-of-Care Testing in Patients Hospitalised with Suspected COVID-19: A Prospective Diagnostic Accuracy Study

Brendish

2022

Infect Dis Ther

View full text Add to dashboard Cite

Introduction RT-PCR has suboptimal sensitivity for the diagnosis of COVID-19. A composite reference standard comprising RT-PCR plus radiological and clinical features has been recommended for diagnostic accuracy studies. The FebriDx finger prick point-of-care test detects an antiviral host response protein (MxA) in 10 min. We evaluated the diagnostic accuracy of FebriDx and RT-PCR compared to a composite reference standard. Methods Adults presenting to hospital with suspected COVID-19 were tested by FebriDx and RT-PCR. A composite reference standard was used to classify patients as having COVID-19 based on RT-PCR positivity, or RT-PCR negativity with COVID-19 radiological findings or other clinical criteria. Measures of accuracy were calculated for MxA alone, RT-PCR alone, and both combined. This study is registered with the ISRCTN (ISRCTN14966673) and has completed. Results A total of 478 patients were tested, with valid results in 475. Of these 475 patients, 222 (46.7%) were classified as having COVID-19; 192 (40.4%) were RT-PCR positive, and 30 (6.3%) were RT-PCR negative and diagnosed on radiological/clinical criteria. Sensitivity of FebriDx MxA vs the composite reference standard was 186/222 (83.8%, 95% CI 78.3–88.4) and was similar to the sensitivity of RT-PCR (192/222 (86.5%, 95% CI 81.3–90.7), (difference of 2.7%, 95% CI − 3.9 to 9.3, p = 0.42). The sensitivity of combined FebriDx and RT-PCR was 208/222 (93.7%) which was superior to both RT-PCR alone (difference of 9.9, 95% CI 4.1–15.9; p = 0.001) and FebriDx MxA alone (difference of 7.2, 95% CI 1.6–12.9; p = 0.011). Conclusion Sensitivity of combined FebriDx and RT-PCR testing was superior to each alone for the detection of COVID-19 in hospital and may improve infection control and treatment decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00646-4.

show abstract

Section: Discussionsupporting

confidence: 88%

Combined RT-PCR and Host Response Point-of-Care Testing in Patients Hospitalised with Suspected COVID-19: A Prospective Diagnostic Accuracy Study

Brendish

2022

Infect Dis Ther

View full text Add to dashboard Cite

show abstract

“…One of the identified items was not included in our analysis as it was a review article [ 16 ], whilst one other article only reported data on MxA [ 17 ]. Thus, five studies, totalling 2309 patients, could be finally included in our analysis [ [18] , [19] , [20] , [21] , [22] ], as summarized in Table 1 . Two included studies were published by the same team of authors, on different cohorts [ 18 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

FebriDx for rapid screening of patients with suspected COVID-19 upon hospital admission: systematic literature review and meta-analysis

Lippi

Nocini

Mattiuzzi³

et al. 2022

Journal of Hospital Infection

View full text Add to dashboard Cite

“… 12 In COVID‐19 patients, MxA has been investigated by several studies. 13 , 14 A study by Lagi et al 15 investigated FebriDx in hospitalized patients and found a sensitivity of 97.8% and specificity of 95.3% on a confirmed COVID‐19 infection. The cut‐off point of MxA in the FebriDx test is 20 ng/ml, which is lower than the optimal cut‐off point we found in our study.…”

Section: Discussionmentioning

confidence: 99%

“…This difference can be explained by the different settings of the studies. The study of Lagi et al 15 included patients which were already diagnosed with COVID‐19 or an alternative diagnosis in the hospital's infectious wards. In contrast, in our study, patients were included before the final diagnosis was made.…”

Section: Discussionmentioning

confidence: 99%

Blood myxovirus resistance protein‐1 measurement in the diagnostic work‐up of suspected COVID‐19 infection in the emergency department

Tong‐Minh

Hooijdonk

Versnel

et al. 2022

Immunity Inflam & Disease

View full text Add to dashboard Cite

Introduction: Myxovirus resistance protein 1 (MxA) is a biomarker that is elevated in patients with viral infections. The goal of this study was to evaluate the diagnostic value of MxA in diagnosing COVID-19 infections in the emergency department (ED) patients. Methods: This was a single-center prospective observational cohort study including patients with a suspected COVID-19 infection. The primary outcome of this study was a confirmed COVID-19 infection by RT-PCR test. MxA was assessed using an enzyme immunoassay on whole blood and receiver operating chart and area under the curve (AUC) analysis was conducted. Sensitivity, specificity, negative predictive value, and positive predictive value of MxA on diagnosing COVID-19 at the optimal cut-off of MxA was determined. Results: In 2021, 100 patients were included. Of these patients, 77 patients had COVID-19 infection and 23 were non-COVID-19. Median MxA level was significantly higher (p < .001) in COVID-19 patients compared to non-COVID-19 patients, respectively 1933 and 0.1 ng/ml. The AUC of MxA on a confirmed COVID-19 infection was 0.941 (95% CI: 0.867-1.000). The optimal cut-off point of MxA was 252 ng/ml. At this cut-off point, the sensitivity of MxA on a confirmed COVID-19 infection was 94% (95% CI: 85%-98%) and the specificity was 91% (95% CI: 72%-99%). Conclusion: MxA accurately distinguishes COVID-19 infections from bacterial infections and noninfectious diagnoses in the ED in patients with a suspected COVID-19 infection. If the results can be validated, MxA could improve the diagnostic workup and patient flow in the ED.

show abstract

Use of the FebriDx point-of-care test for the exclusion of SARS-CoV-2 diagnosis in a population with acute respiratory infection during the second (COVID-19) wave in Italy

Cited by 14 publications

References 12 publications

Combined RT-PCR and Host Response Point-of-Care Testing in Patients Hospitalised with Suspected COVID-19: A Prospective Diagnostic Accuracy Study

Combined RT-PCR and Host Response Point-of-Care Testing in Patients Hospitalised with Suspected COVID-19: A Prospective Diagnostic Accuracy Study

FebriDx for rapid screening of patients with suspected COVID-19 upon hospital admission: systematic literature review and meta-analysis

Blood myxovirus resistance protein‐1 measurement in the diagnostic work‐up of suspected COVID‐19 infection in the emergency department

Contact Info

Product

Resources

About