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Point-of-care respiratory multiplex tests: emerging landscape of respiratory tests

After more than three years of Covid-19, people have learned how to live with the respiratory virus. More people have started to choose point-of-care (POC) respiratory tests to identify the exact pathogens that cause symptoms such as a cough or running nose. POC respiratory multiplex tests gained popularity due to their ability to rapidly test for multiple respiratory infections at the same time, including Covid-19, respiratory syncytial virus (RSV), influenza A, and influenza B. As the Northern Hemisphere is entering into another influenza season soon, the use of POC respiratory multiplex tests is expected to continue increasing throughout the remainder of 2023 and into 2024.

According to GlobalData premium SKU products, the total volume of POC multiplex respiratory tests rose 18.5% from 2021 to 2022 in the US. Unlike the downward pricing trend seen with singleplex respiratory tests, the average selling prices of POC respiratory multiplex tests increased 10.4% in the same period.

Respiratory multiplex assays are used to detect or diagnose pathogens causing respiratory infections. The most common types of pathogens causing respiratory infections are influenza virus, adenovirus, enterovirus, coronavirus, and streptococcus. Popular product lines such as Cepheid’s XPERT XPRESS target Covid-19, RSV, and influenza virus, while bioMerieux SA’s BIOFIRE can test for as many as 19 pathogens. Methods used by the assays include nucleic acid amplification tests (NAATs), enzyme immunoassays (EIAs), or enzyme-linked immunosorbent assays (ELISAs). The gold standard method to diagnose respiratory virus infections is by NAATs due to their high sensitivity and specificity compared to antigen-based tests or cultures.

POC testing (POCT), also known as bedside testing, involves any type of diagnostic test that is not conducted in the laboratory. More specifically, this type of testing is performed as close as possible to the patient, such as at their bedside. POCT is considered more efficient than traditional lab tests. POC respiratory multiplex tests are expected to gain more shares in the respiratory disease tests market in the next five years. POC respiratory multiplex tests are useful in settings such as emergency departments where physicians need information quickly in order to guide patient care. As Covid-19 cases are treated differently than other respiratory diseases, POC respiratory multiplex tests help physicians provide treatments efficiently and prevent hospital-acquired infections. Additionally, people with underlying medical conditions may benefit from multiplex tests, as the test results might change how doctors manage the diseases. According to a 2022 randomised controlled trial conducted by Bibby and colleagues in Canada and published in BMC Infectious Diseases, POC respiratory multiplex tests were shown to improve the use of oseltamivir, antibiotics, diagnostic tests, and hospital bed utilisation in both paediatric and adult populations.

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