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Meta-Analysis
. 2023 May;86(5):462-475.
doi: 10.1016/j.jinf.2023.03.005. Epub 2023 Mar 9.

Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: Results of a systematic review and meta-analysis

Tristan W Clark  1 , Kristina Lindsley  2 , Tara B Wigmosta  3 , Anil Bhagat  4 , Rachael B Hemmert  5 , Jennifer Uyei  6 , Tristan T Timbrook  7
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Free article
Meta-Analysis

Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: Results of a systematic review and meta-analysis

Tristan W Clark et al. J Infect. 2023 May.
Free article

Abstract

Objectives: The clinical impact of rapid sample-to-answer "syndromic" multiplex polymerase chain reaction (PCR) testing for respiratory viruses is not clearly established. We performed a systematic literature review and meta-analysis to evaluate this impact for patients with possible acute respiratory tract infection in the hospital setting.

Methods: We searched EMBASE, MEDLINE, and Cochrane databases from 2012 to present and conference proceedings from 2021 for studies comparing clinical impact outcomes between multiplex PCR testing and standard testing.

Results: Twenty-seven studies with 17,321 patient encounters were included in this review. Rapid multiplex PCR testing was associated with a reduction of - 24.22 h (95% CI -28.70 to -19.74 h) in the time to results. Hospital length of stay was decreased by -0.82 days (95% CI -1.52 to -0.11 days). Among influenza positive patients, antivirals were more likely to be given (RR 1.25, 95% CI 1.06-1.48) and appropriate infection control facility use was more common with rapid multiplex PCR testing (RR 1.55, 95% CI 1.16-2.07).

Conclusions: Our systematic review and meta-analysis demonstrates a reduction in time to results and length of stay for patients overall along with improvements in appropriate antiviral and infection control management among influenza-positive patients. This evidence supports the routine use of rapid sample-to-answer multiplex PCR testing for respiratory viruses in the hospital setting.

Keywords: COVID-19; Clinical impact; Influenza; Multiplex PCR; Rapid test; Respiratory virus; Syndromic panel.

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Conflict of interest statement

Declaration of Competing Interest TWC has received speaker fees, honoraria, consultancy fees, travel reimbursement, and equipment and consumables free of charge for the purposes of research outside of this submitted study, from BioFire diagnostics and BioMerieux. He has received speaker fees and discounted equipment and consumables from QIAGEN. He has received consultancy fees from, Shionogi, Synairgen research, Roche and Janssen. He has been a member of advisory boards for Roche, Janssen, Cepheid, Shionogi, Sanofi and Seqirus. He is a member of an independent data monitoring committees for a trial sponsored by Roche. He has acted as the UK chief investigator for a trial sponsored by Janssen. TBW, RBH, and TTT are employees of bioMerieux, the sponsor of this study. KL, AB, and JU are employees of IQVIA, which received funding from bioMerieux to conduct this study.

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