Real-world use of multiplex point-of-care molecular testing or laboratory-based molecular testing for influenza-like illness in a 2021 to 2022 US outpatient sample

PLoS One. 2024 Nov 11;19(11):e0313660. doi: 10.1371/journal.pone.0313660. eCollection 2024.

Abstract

While molecular testing is recommended for symptomatic patients suspected of having coronavirus disease 2019 (COVID-19), limited data are available examining real-world use of tests for severe acute respiratory syndrome coronavirus (SARS-CoV-2) and the impact of SARS-CoV-2 testing on patient outcomes. In this retrospective cohort study using de-identified administrative claims data in the Optum Labs Data Warehouse, we identified 2 groups of patients with ≥1 outpatient claims with a procedure code for SARS-CoV-2 testing between January 2021 and September 2022. Group 1 had ≥1 claims with CPT code 0240U or 0241U ("Xpert Xpress") (N = 51,602); Group 2 had ≥1 claims for laboratory-based molecular testing (N = 317,192). Outcomes assessed on the identification date and through the 90-day follow-up included claims evidence of use of SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) tests, diagnosis of active COVID-19, influenza, or RSV, and use of treatments (antivirals for COVID-19, influenza, and RSV and other treatments for COVID-19 and RSV). Patients in Group 1 had fewer tests for SARS-CoV-2, influenza, or RSV (mean ± standard deviation 1.6±1.4 versus 2.6±2.6, standardized difference -0.45), faster time to diagnosis of COVID-19 (median 0 versus 4 days, standardized difference -0.27) or influenza (median 0 versus 5 days, standardized difference -0.74), and faster time to treatment of COVID-19, influenza, or RSV (median 1 versus 5 days, standardized difference 0.16) than patients in Group 2. In this nationwide real-world study of outpatient testing, use of point-of-care molecular multiplex SARS-CoV-2 testing resulted in fewer claims for SARS-CoV-2, influenza, and RSV tests, faster time to diagnosis, and faster time to treatment than laboratory-based molecular testing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 Testing / methods
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / virology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Influenza, Human* / diagnosis
  • Influenza, Human* / epidemiology
  • Influenza, Human* / virology
  • Male
  • Middle Aged
  • Outpatients*
  • Point-of-Care Testing*
  • Retrospective Studies
  • SARS-CoV-2* / genetics
  • SARS-CoV-2* / isolation & purification
  • United States
  • Young Adult

Grants and funding

This study was funded by Cepheid. KMS, JT, JMC, and LB are employees of Optum, which received research funding from Cepheid, and own stock in UnitedHealth Group. AB and JC are employees and shareholders of Cepheid, which provided funding for this work. The authors do not have any other competing interests to declare. The competing interests declared above do not alter our adherence to journal policies. Cepheid provided funding for this work to Optum. Authors AB and JC are employees of Cepheid and participated in study design, data collection and analysis, decision to publish, and preparation of the manuscript.