Blood myxovirus resistance protein‐1 measurement in the diagnostic work‐up of suspected COVID‐19 infection in the emergency department

Tong‐Minh, Kirby; Hooijdonk, Samantha; Versnel, Marjan A.; Helden-Meeuwsen, Cornelia G van; Hagen, P. Martin van; Gorp, Eric C. M. Van; Endeman, Henrik; Does, Yuri van der; Dalm, Virgil A. S. H.; Dik, Willem A.

doi:10.1002/iid3.609

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…A recent study shows that MxA could be used as a part of COVID-19 diagnostics in patients with suspected COVID-19 infection. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

“…A recent study shows that MxA could be used as a part of COVID-19 diagnostics in patients with suspected COVID-19 infection. [10] Severe COVID-19 is associated with dysregulation of the interferon response [11]. Rapid recognition of viral RNA by Toll-like receptors 3 and 7 and RIG-I-like receptors induces a type I IFN response that may suppress viral replication, whereas activation of the cGAS-STING pathway by macrophages as a result from endothelial cell damage induces a prolonged elevation of type I IFNs which may induce aberrant inflammation and is associated with poor clinical outcome [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Association of human myxovirus resistance protein A with severity of COVID-19

et al. 2022

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Background In this retrospective cohort study, we explored the correlation of blood human myxovirus resistance protein A (MxA) level with severity of disease in hospitalized COVID-19 patients. Methods All 304 patients admitted for COVID-19 in our hospital until 30th of April 2021 were included in this study. MxA was measured from peripheral blood samples in 268 cases. Patients were divided into groups based on their level of MxA on admission. We studied baseline characteristics and severity of disease on admission based on clinical parameters and inflammatory biomarker levels in each group. Severity of disease during hospitalization was determined by the applied level of respiratory support, by the usage of corticosteroids and by the duration of hospitalization. Results Higher MxA levels on admission were associated with a shorter duration of symptoms before admission, and with more severe disease. Adjusted Odds Ratios for any respiratory support were 9.92 (95%CI 2.11–46.58; p = 0.004) in patients with MxA between 400 μg/L and 799 μg/L (p = 0.004) and 20.08 (95%CI 4.51–89.44; p < 0.001) in patients with MxA ≥ 800 μg/L in comparison with patients with initial MxA < 400 μg/L. The usage of corticosteroids was significantly higher in the high-MxA group (77%) in comparison with the intermediate-MxA group (62%, p = 0.013) and low-MxA group (47%, p < 0.001). Conclusions Higher initial levels of MxA were associated with more severe COVID-19. MxA may be a helpful additional biomarker to predict the severity of the disease.

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“…A recent study shows that MxA could be used as a part of COVID-19 diagnostics in patients with suspected COVID-19 infection. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of human myxovirus resistance protein A with severity of COVID-19

et al. 2022

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“…Although it is mechanistically conceivable that immunosuppressive therapy impairs the type I interferon immune response, previous studies demonstrated that MxA is a reliable marker for viral infections in immunocompromised children after allogenic stem cell transplantation or chemotherapy [ 23 , 24 ]. A recent report showed that MxA is also valuable for identifying SARS-CoV2-infected patients, regardless of their immune status [ 25 ]. In accordance with these results, we observed no difference in monocyte MxA expression in immunocompromised compared to immunocompetent adults with viral infections.…”

Section: Discussionmentioning

confidence: 99%

MxA for differentiating viral and bacterial infections in adults: a prospective, exploratory study

et al. 2023

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Purpose Inappropriate antibiotic prescription in patients with viral infections contributes to the surge of antibiotic resistance. Viral infections induce the expression of the antiviral protein MxA in monocytes, which is a promising biomarker to differentiate between viral and bacterial diseases. In this prospective, exploratory study, we aimed to determine the diagnostic value of monocyte MxA expression in adults with viral, bacterial or co-infections. Methods We measured monocyte MxA expression using flow cytometry in a cohort of 61 adults with various viral, bacterial and co-infections including patients receiving immunosuppressive therapy. Results Monocyte MxA expression in virus-infected patients was significantly higher compared to bacterial infections (83.3 [66.8, 109.4] vs. 33.8 [29.3, 47.8] mean fluorescence intensity [MFI]; p < 0.0001) but not co-infections (53.1 [33.9, 88.9] MFI). At a threshold of 62.2 MFI, the area under the ROC curve (AUC) to differentiate between viral and bacterial infections was 0.9, with a sensitivity and specificity of 92.3% and 84.6%, respectively. Immunosuppressive therapy did not affect monocyte MxA expression in virus-infected patients. Conclusion Our findings corroborate the diagnostic performance of MxA in differentiating viral and bacterial infections but also point to an important caveat of MxA in viral-bacterial co-infections. This study extends previous reports and indicates that MxA is also a useful biomarker in immunocompromised patients.

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“…In pediatric patients, MxA measurements in whole blood could differentiate patients with viral infections from non-infections and bacterial infections in the ED [ 9 , 10 ]. In ED patients suspected of COVID-19 infection, higher MxA levels were reported in patients with COVID-19 compared to those with other infections [ 10 , 11 ]. The integration of CRP for identifying bacterial infections and MxA for identifying viral infections into a unified diagnostic test holds the potential to reliably distinguish between bacterial and viral infections.…”

Section: Introductionmentioning

confidence: 99%

Performance of the FebriDx Rapid Point-of-Care Test for Differentiating Bacterial and Viral Respiratory Tract Infections in Patients with a Suspected Respiratory Tract Infection in the Emergency Department

Tong-Minh,

Daenen,

Endeman

et al. 2023

JCM

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FebriDx is a rapid point-of-care test combining qualitative measurements of C-reactive protein (CRP) and Myxovirus Resistance Protein A (MxA) using a disposable test device to detect and differentiate acute bacterial from viral respiratory tract infections. The goal of this study was to investigate the diagnostic accuracy of FebriDx in patients with suspected respiratory tract infections in the emergency department (ED). This was an observational cohort study, performed in the ED of an academic hospital. Patients were included if they had a suspected infection. The primary outcome was the presence of a bacterial or viral infection, determined by clinical adjudication by an expert panel. The sensitivity, specificity, and positive and negative predictive value of FebriDx for the presence of bacterial versus non-bacterial infections, and viral versus non-viral infections were calculated. Between March 2019 and November 2020, 244 patients were included. A bacterial infection was present in 41%, viral infection was present in 24%, and 4% of the patients had both viral and bacterial pathogens. FebriDx demonstrated high sensitivity in the detection of bacterial infection (87%), high NPV (91%) to rule out bacterial infection, and high specificity (94%) for viral infection in patients with a suspected infection in the ED.

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Blood myxovirus resistance protein‐1 measurement in the diagnostic work‐up of suspected COVID‐19 infection in the emergency department

Cited by 5 publications

References 20 publications

Association of human myxovirus resistance protein A with severity of COVID-19

Association of human myxovirus resistance protein A with severity of COVID-19

MxA for differentiating viral and bacterial infections in adults: a prospective, exploratory study

Performance of the FebriDx Rapid Point-of-Care Test for Differentiating Bacterial and Viral Respiratory Tract Infections in Patients with a Suspected Respiratory Tract Infection in the Emergency Department

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