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
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
3a3b1f32-e067-43d0-9bc7-85d1229412fe
Daniel, Waddington
1d8a8b02-7faa-45f0-88f7-9e35096489d5
Clark, Tristan
712ec18e-613c-45df-a013-c8a22834e14f
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
3a3b1f32-e067-43d0-9bc7-85d1229412fe
Daniel, Waddington
1d8a8b02-7faa-45f0-88f7-9e35096489d5
Clark, Tristan
712ec18e-613c-45df-a013-c8a22834e14f
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
Additional Information:
Publisher Copyright:
©
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
Catalogue record
Date deposited: 04 Feb 2022 17:56
Last modified: 21 Nov 2024 05:03
Export record
Altmetrics
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
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
