Baghdadi Jonathan D, Tung Chih Chun, Johnson J Kristie, Morgan Daniel J, Harris Anthony D
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
University of Maryland - Institute for Health Computing, North Bethesda, MD, USA.
Infect Control Hosp Epidemiol. 2024 Oct 10:1-6. doi: 10.1017/ice.2024.163.
COVID-19 changed the epidemiology of community-acquired respiratory viruses. We explored patterns of respiratory viral testing to understand which tests are most clinically useful in the postpandemic era.
We conducted a retrospective observational study of discharge data from PINC-AI (formerly Premier), a large administrative database. Use of multiplex nucleic acid amplification respiratory panels in acute care, including small (2-5 targets), medium (6-11), and large panels (>11), were compared between the early pandemic (03/2020-10/2020), late pandemic (11/2020-4/2021), and prepandemic respiratory season (11/2019 - 02/2020) using ANOVA.
A median of 160.5 facilities contributed testing data per quarter (IQR 155.5-169.5). Prepandemic, facilities averaged 103 respiratory panels monthly (sd 138), including 79 large (sd 126), 7 medium (sd 31), and 16 small panels (sd 73). Relative to prepandemic, utilization decreased during the early pandemic (62 panels monthly/facility; sd 112) but returned to the prepandemic baseline by the late pandemic (107 panels monthly/facility; sd 211). Relative to prepandemic, late pandemic testing involved more small panel use (58 monthly/facility, sd 156) and less large panel use (47 monthly/facility, sd 116). Comparisons among periods demonstrated significant differences in overall testing ( < 0.0001), large panel use ( < 0.0001), and small panel use ( < 0.0001).
Postpandemic, clinical use of respiratory panel testing shifted from predominantly large panels to predominantly small panels. Factors driving this change may include resource availability, costs, and the clinical utility of targeting important pathogenic viruses instead of testing "for everything."
新型冠状病毒肺炎（COVID-19）改变了社区获得性呼吸道病毒的流行病学。我们探讨了呼吸道病毒检测模式，以了解在疫情后时代哪些检测在临床上最有用。
我们对大型管理数据库PINC-AI（原Premier）的出院数据进行了一项回顾性观察研究。使用方差分析比较了疫情早期（2020年3月至2020年10月）、疫情后期（2020年11月至2021年4月）和疫情前呼吸道疾病季节（2019年11月至2020年2月）在急性护理中使用的多重核酸扩增呼吸道检测板，包括小型（2 - 5个靶点）、中型（6 - 11个）和大型检测板（>11个）。
每季度中位数为160.5个机构提供检测数据（四分位间距155.5 - 169.5）。疫情前，各机构每月平均进行103次呼吸道检测板检测（标准差138），包括79次大型检测（标准差126）、7次中型检测（标准差31）和16次小型检测（标准差73）。与疫情前相比，疫情早期检测利用率下降（每月每个机构62次检测板检测；标准差112），但到疫情后期恢复到疫情前基线水平（每月每个机构107次检测板检测；标准差211）。与疫情前相比，疫情后期检测更多地使用小型检测板（每月58次/机构，标准差156），而大型检测板使用较少（每月47次/机构，标准差116）。各时期之间的比较显示，总体检测（<0.0001）、大型检测板使用（<0.0001）和小型检测板使用（<0.0001）存在显著差异。
疫情后，呼吸道检测板检测的临床应用从主要使用大型检测板转向主要使用小型检测板。推动这一变化的因素可能包括资源可用性、成本以及针对重要致病病毒而非“全面检测”的临床实用性。
