Using a 29-mRNA Host Response Classifier To Detect Bacterial Coinfections and Predict Outcomes in COVID-19 Patients Presenting to the Emergency Department
2022; American Society for Microbiology; Volume: 10; Issue: 6 Linguagem: Inglês
10.1128/spectrum.02305-22
ISSN2165-0497
AutoresNikhil Ram-Mohan, Angela J. Rogers, Catherine A. Blish, Kari C. Nadeau, Elizabeth J. Zudock, David Kim, James Quinn, Lixian Sun, Oliver Liesenfeld, Samuel Yang, M Hashemi, Kristel C. Tjandra, Jennifer A. Newberry, Andra L. Blomkalns, Ruth O’Hara, Euan A. Ashley, Rosen Mann, Anita Visweswaran, Thanmayi Ranganath, Jonasel Roque, Monali Manohar, Hena Din, Komal Kumar, Kathryn Jee, Brigit Noon, Jill Anderson, Bethany Fay, Donald Schreiber, Nancy Q. Zhao, Rosemary Vergara, Julia L. McKechnie, Aaron J. Wilk, Lauren de la Parte, Kathleen D. Press, Maureen Ty, Nimish Kathale, Arjun Rustagi, Giovanny J. Martínez-Colón, Geoffrey T. Ivison, Ruoxi Pi, Maddie Lee, Rachel Brewer, Taylor Hollis, Andrea Baird, Michele Ugur, Drina Bogusch, Georgie Nahass, Kazim Haider, Kim Q.T. Tran, Laura J. Simpson, Michal Caspi Tal, Iris Chang, Evan Do, Andrea Fernandes, Allie Lee, Neera Ahuja, Theo Snow, James Krempski,
Tópico(s)Antimicrobial Resistance in Staphylococcus
ResumoClinicians in the emergency department (ED) face challenges in concurrently assessing patients with suspected COVID-19 infection, detecting bacterial coinfection, and determining illness severity since current practices require separate workflows. Here, we explore the accuracy of the IMX-BVN-3/IMX-SEV-3 29 mRNA host response classifiers in simultaneously detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and bacterial coinfections and predicting clinical severity of COVID-19. A total of 161 patients with PCR-confirmed COVID-19 (52.2% female; median age, 50.0 years; 51% hospitalized; 5.6% deaths) were enrolled at the Stanford Hospital ED. RNA was extracted (2.5 mL whole blood in PAXgene blood RNA), and 29 host mRNAs in response to the infection were quantified using Nanostring nCounter. The IMX-BVN-3 classifier identified SARS-CoV-2 infection in 151 patients with a sensitivity of 93.8%. Six of 10 patients undetected by the classifier had positive COVID tests more than 9 days prior to enrollment, and the remaining patients oscillated between positive and negative results in subsequent tests. The classifier also predicted that 6 (3.7%) patients had a bacterial coinfection. Clinical adjudication confirmed that 5/6 (83.3%) of the patients had bacterial infections, i.e., Clostridioides difficile colitis (
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