FebriDx host response point-of-care testing improves patient triage for coronavirus disease 2019 (COVID-19) in the emergency department
FebriDx host response point-of-care testing improves patient triage for coronavirus disease 2019 (COVID-19) in the emergency department
Objectives: Patients presenting to hospital with suspected coronavirus disease 2019 (COVID-19), based on clinical symptoms, are routinely placed in a cohort together until polymerase chain reaction (PCR) test results are available. This procedure leads to delays in transfers to definitive areas and high nosocomial transmission rates. FebriDx is a finger-prick point-of-care test (PoCT) that detects an antiviral host response and has a high negative predictive value for COVID-19. We sought to determine the clinical impact of using FebriDx for COVID-19 triage in the emergency department (ED).
Design: We undertook a retrospective observational study evaluating the real-world clinical impact of FebriDx as part of an ED COVID-19 triage algorithm.
Setting: Emergency department of a university teaching hospital.
Patients: Patients presenting with symptoms suggestive of COVID-19, placed in a cohort in a 'high-risk' area, were tested using FebriDx. Patients without a detectable antiviral host response were then moved to a lower-risk area.
Results: Between September 22, 2020, and January 7, 2021, 1,321 patients were tested using FebriDx, and 1,104 (84%) did not have a detectable antiviral host response. Among 1,104 patients, 865 (78%) were moved to a lower-risk area within the ED. The median times spent in a high-risk area were 52 minutes (interquartile range [IQR], 34-92) for FebriDx-negative patients and 203 minutes (IQR, 142-255) for FebriDx-positive patients (difference of -134 minutes; 95% CI, -144 to -122; P < .0001). The negative predictive value of FebriDx for the identification of COVID-19 was 96% (661 of 690; 95% CI, 94%-97%).
Conclusions: FebriDx improved the triage of patients with suspected COVID-19 and reduced the time that severe acute respiratory coronavirus virus 2 (SARS-CoV-2) PCR-negative patients spent in a high-risk area alongside SARS-CoV-2-positive patients.
Accuracy, COVID-19, Emergency department, FebriDx, Myxovirus resistance protein, Triage
979-986
Mansbridge, Christopher
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Tanner, Alex
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Beard, Kate
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Borca, Florina
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Phan, Hang Thi Thu
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Brendish, Nathan
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Poole, Stephen
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Hill, Christopher
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Kuber, Michael
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Crouch, Robert
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Daniel, Waddington
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Clark, Tristan
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1 August 2022
Mansbridge, Christopher
a33c33a8-f813-46d2-92a0-ecde2233514a
Tanner, Alex
cac6d816-602b-4dcf-961e-22f2cbdc501d
Beard, Kate
85604fec-3541-48cb-9abf-a76c2a32c3f1
Borca, Florina
31fc3965-6bcf-4fd6-85bc-8b0f99f62473
Phan, Hang Thi Thu
2811b94c-62b7-459d-9cc1-c88057008e3b
Brendish, Nathan
a8a4189e-01eb-4ab3-933e-a24cd188a4d7
Poole, Stephen
440d7904-ab72-469c-892b-c910cd1cb19b
Hill, Christopher
def6a386-4862-415a-92b8-5d33754f131e
Kuber, Michael
022451e7-2ec2-47d3-a867-e3356d85a90a
Crouch, Robert
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Daniel, Waddington
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Clark, Tristan
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Mansbridge, Christopher, Tanner, Alex, Beard, Kate, Borca, Florina, Phan, Hang Thi Thu, Brendish, Nathan, Poole, Stephen, Hill, Christopher, Kuber, Michael, Crouch, Robert, Daniel, Waddington and Clark, Tristan
(2022)
FebriDx host response point-of-care testing improves patient triage for coronavirus disease 2019 (COVID-19) in the emergency department.
Infection Control and Hospital Epidemiology, 43 (8), .
(doi:10.1017/ice.2021.531).
Abstract
Objectives: Patients presenting to hospital with suspected coronavirus disease 2019 (COVID-19), based on clinical symptoms, are routinely placed in a cohort together until polymerase chain reaction (PCR) test results are available. This procedure leads to delays in transfers to definitive areas and high nosocomial transmission rates. FebriDx is a finger-prick point-of-care test (PoCT) that detects an antiviral host response and has a high negative predictive value for COVID-19. We sought to determine the clinical impact of using FebriDx for COVID-19 triage in the emergency department (ED).
Design: We undertook a retrospective observational study evaluating the real-world clinical impact of FebriDx as part of an ED COVID-19 triage algorithm.
Setting: Emergency department of a university teaching hospital.
Patients: Patients presenting with symptoms suggestive of COVID-19, placed in a cohort in a 'high-risk' area, were tested using FebriDx. Patients without a detectable antiviral host response were then moved to a lower-risk area.
Results: Between September 22, 2020, and January 7, 2021, 1,321 patients were tested using FebriDx, and 1,104 (84%) did not have a detectable antiviral host response. Among 1,104 patients, 865 (78%) were moved to a lower-risk area within the ED. The median times spent in a high-risk area were 52 minutes (interquartile range [IQR], 34-92) for FebriDx-negative patients and 203 minutes (IQR, 142-255) for FebriDx-positive patients (difference of -134 minutes; 95% CI, -144 to -122; P < .0001). The negative predictive value of FebriDx for the identification of COVID-19 was 96% (661 of 690; 95% CI, 94%-97%).
Conclusions: FebriDx improved the triage of patients with suspected COVID-19 and reduced the time that severe acute respiratory coronavirus virus 2 (SARS-CoV-2) PCR-negative patients spent in a high-risk area alongside SARS-CoV-2-positive patients.
Text
FebriDx paper ICHE accepted version 07-01-21
- Accepted Manuscript
More information
Accepted/In Press date: 20 December 2021
e-pub ahead of print date: 31 January 2022
Published date: 1 August 2022
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Publisher Copyright:
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Keywords:
Accuracy, COVID-19, Emergency department, FebriDx, Myxovirus resistance protein, Triage
Identifiers
Local EPrints ID: 454280
URI: http://eprints.soton.ac.uk/id/eprint/454280
ISSN: 0899-823X
PURE UUID: d8d69562-a989-4fdf-8337-b77ba258868b
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Date deposited: 04 Feb 2022 17:56
Last modified: 29 Jun 2024 04:03
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Contributors
Author:
Christopher Mansbridge
Author:
Alex Tanner
Author:
Kate Beard
Author:
Florina Borca
Author:
Hang Thi Thu Phan
Author:
Stephen Poole
Author:
Christopher Hill
Author:
Michael Kuber
Author:
Waddington Daniel
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