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The Need for Broader Testing of COVID-19 Patients

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Diagnostic testing is playing a crucial role in global efforts to tackle the COVID-19 pandemic. By identifying infected individuals, efficient isolation and contact tracing can take place. However, what role could broader testing of COVID-19 patients have?

To understand the importance of testing patients for co-infections and drug resistance markers, and to learn how this could be achieved, Technology Networks recently spoke with Oliver Schacht, CEO of OpGen.

Anna MacDonald (AM): Why is there a need for broader testing of COVID-19 patients? What significance do co-infections have on patient outcome?

Oliver Schacht (OS):
Testing is critical to controlling the COVID-19 pandemic – This includes both the focus on the direct health emergency and diagnosis of the SARS-CoV-2 virus as well as consideration of secondary bacterial infections that attack the weakened immune system and can have severe consequential effects on the patient and the hospital. The latter must not be overlooked.

The lessons learned from the 1918
influenza pandemic and the 2009 H1N1 pandemic demonstrated that most people who die during viral disease outbreaks actually die from secondary drug-resistant bacterial infections such as bacterial pneumonia. An estimated 50 million people died during the 1918 Spanish flu pandemic; most deaths were attributable to secondary bacterial pneumonia. In the 2009 H1N1 pandemic, more than one third of people hospitalized for H1N1 suffered from secondary bacterial (28%) and viral (6%) infections and 29-55% of deaths were also attributed to secondary pneumonia as reported by the CDC.

We are seeing similar trends with COVID-19. A recent study published in The Lancet
found that 50% of patients that died from COVID-19 had secondary infections. These drug-resistant secondary infections will contribute to the mortality of the COVID-19 pandemic. Therefore, it is important to incorporate the broader testing into the priority of current pandemic response planning to enable rapid diagnosis, and earlier treatment of these secondary bacterial infections, and minimize the downstream avalanche that is mounting if testing goes ignored.

AM: How can readily available testing panels be incorporated into COVID-19 diagnosis and treatment?

Bacterial co-infections in COVID-19 patients increase morbidity, mortality and antimicrobial resistance (AMR) threat. Rapid diagnostic tests are critical in this public health response. FDA-cleared commercially available multiplex molecular diagnostic panels that can rapidly and comprehensively evaluate for bacterial and fungal respiratory tract infections and antibiotic resistance genes in SARS-CoV-2 positive hospitalized patients can play a crucial role in the fight against the pandemic and contribute to improving the outcomes of COVID-19 patients.

Can you tell us more about the Unyvero LRT panel? What can it detect?

The FDA-cleared Unyvero LRT and LRT BAL panels rapidly detect 19 clinically-relevant bacterial pathogens and 10 antibiotic resistance markers associated with lower respiratory tract infections such as pneumonia in less than five hours directly from native specimen with only about two minutes of hands-on time. Additionally, the Unyvero LRT BAL panel also includes Pneumocystis jirovecii, which makes it the only syndromic FDA-cleared lower respiratory tract infection panel that can rapidly rule in or rule out Pneumocystis pneumonia.

What advantages does this method have over traditional means of pathogen identification?

Routine bacterial cultures can take up to several days for confirmatory pathogen identification and antimicrobial susceptibility testing results, and in the meantime, patients are treated with empiric broad spectrum antibiotics that can have adverse or toxic side effects and give rise to even more drug-resistant bacteria also known as “superbugs”. The Unyvero LRT panels can provide clear direction by rapid detection of pathogens and antibiotic resistance markers in under five hours and may help guide earlier targeted antibiotic treatment decisions for these critically ill patients.

AM: What difference can early detection of co-infections have on the treatment of COVID-19 patients?

Early diagnosis of secondary bacterial infections can limit adverse COVID-19 outcomes by informing timely and appropriate antibiotic treatment, protecting high-risk patients, and limiting super-spreading in healthcare facilities. The importance of broader testing for secondary bacterial infections in hospitalized COVID-19 patients should not be underestimated.

Oliver Schacht, PhD, was speaking to Anna MacDonald, Science Writer, Technology Networks.

Oliver Schacht is CEO of
OpGen, a pioneering informatics and genomic analysis company providing complete solutions for patient, hospital, and network-wide infection prevention and treatment.