Evaluation of a multiplex genomic point-of-care strategy for rapid support of older people with respiratory infection in a geriatric hospital over a full winter season.

Background: In older patients, it is important to rapidly identify those infected by a significant pathogen in order to implement isolation measures and prescribe appropriate specific treatments when available and indicated. The objective of this study was to evaluate a multiplex genomic point-of-care (POC) strategy detecting four viruses, SARS-CoV-2, influenza virus (IV) A and B and respiratory syncytial virus (RSV), in a geriatric setting located 7 km from the central laboratory of the hospital.

Methods: This prospective monocentric study was conducted during the 2022-2023 winter season in two geriatric wards of the University Hospital of Saint-Etienne, France. Two automated quantitative reverse transcription polymerase chain reaction (RT-qPCR) tests were compared, the reference test at the central laboratory and the POC test performed by nurses. The main outcome was the saved time to result (TTR) by the clinician with the POC technology. Additional objectives included testing performance, health-economic considerations and healthcare workers' acceptability.

Results: From 69 included infectious episodes, the reference test identified 18 viral infections (7 for SARS-CoV-2, 8 for RSV, 2 for both viruses, 1 for IVA). The POC test yielded similar performance with reference test (overall concordance of 98.55 % for SARS-CoV-2 and RSV). The POC strategy showed a gain of 10.43 ( ± 6.92) hours on TTR and a cumulative time of isolation of 488.27 hours in case of negative result. Further results showed economic savings and a strong acceptability by healthcare workers in favor of the POC strategy.

Conclusions: This pilot study illustrates the benefits of a genomic POC test to identify current respiratory viral infections in older people within a geriatric setting remote from the central laboratory during a winter season with multiple viral outbreaks.