1. Detection of Viral Infection and Bacterial Coinfection and Superinfection in Coronavirus Disease 2019 Patients Presenting to the Emergency Department Using the 29-mRNA Host Response Classifier IMX-BVN-3: A Multicenter Study
- Author
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Bauer, Wolfgang, Gläser, Sven, Thiemig, Dorina, Wanner, Katrin, Peric, Alexander, Behrens, Steffen, Bialas, Johanna, Behrens, Angelika, Galtung, Noa, Liesenfeld, Oliver, Sun, Lisa, May, Larissa, Mace, Sharron, Ott, Sebastian, and Vesenbeckh, Silvan
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Infectious Diseases ,Clinical Trials and Supportive Activities ,2.2 Factors relating to the physical environment ,Aetiology ,Infection ,Good Health and Well Being ,bacterial infection ,coinfection ,COVID-19 ,PCR ,SARS-CoV-2 ,superinfection ,viral infection ,Clinical sciences ,Medical microbiology - Abstract
BackgroundIdentification of bacterial coinfection in patients with coronavirus disease 2019 (COVID-19) facilitates appropriate initiation or withholding of antibiotics. The Inflammatix Bacterial Viral Noninfected (IMX-BVN) classifier determines the likelihood of bacterial and viral infections. In a multicenter study, we investigated whether IMX-BVN version 3 (IMX-BVN-3) identifies patients with COVID-19 and bacterial coinfections or superinfections.MethodsPatients with polymerase chain reaction-confirmed COVID-19 were enrolled in Berlin, Germany; Basel, Switzerland; and Cleveland, Ohio upon emergency department or hospital admission. PAXgene Blood RNA was extracted and 29 host mRNAs were quantified. IMX-BVN-3 categorized patients into very unlikely, unlikely, possible, and very likely bacterial and viral interpretation bands. IMX-BVN-3 results were compared with clinically adjudicated infection status.ResultsIMX-BVN-3 categorized 102 of 111 (91.9%) COVID-19 patients into very likely or possible, 7 (6.3%) into unlikely, and 2 (1.8%) into very unlikely viral bands. Approximately 94% of patients had IMX-BVN-3 unlikely or very unlikely bacterial results. Among 7 (6.3%) patients with possible (n = 4) or very likely (n = 3) bacterial results, 6 (85.7%) had clinically adjudicated bacterial coinfection or superinfection. Overall, 19 of 111 subjects for whom adjudication was performed had a bacterial infection; 7 of these showed a very likely or likely bacterial result in IMX-BVN-3.ConclusionsIMX-BVN-3 identified COVID-19 patients as virally infected and identified bacterial coinfections and superinfections. Future studies will determine whether a point-of-care version of the classifier may improve the management of COVID-19 patients, including appropriate antibiotic use.
- Published
- 2022