key: cord-0981997-7rvc9nms
authors: Chen, Yu-Chih; Lai, Huei-Wen; Hou, I-Lun; Hsieh, Pei-You; Wang, Po-Yu; Ni, Ting-Yuan; Chou, Chu-Chung; Lin, Yan-Ren
title: Rapid respiratory panel test for non-COVID-19 pathogen examinations among frontline medical personnel in Taiwan
date: 2021-02-13
journal: Environ Health Prev Med
DOI: 10.1186/s12199-021-00945-1
sha: e640d41ba331cdc798d8c62dd2c49120a2ba9291
doc_id: 981997
cord_uid: 7rvc9nms

nan

Yu-Chih Chen 1 , Huei-Wen Lai 2 , I-Lun Hou 2 , Pei-You Hsieh 1 , Po-Yu Wang 3 , Ting-Yuan Ni 1 , Chu-Chung Chou 1,4,5 and Yan-Ren Lin 1,4,5* To the Editor:

Handling over 100 million COVID-19 cases, frontline medical personnel are threatened due to the high risk of cross-infection. Several studies have recommended that medical personnel with suspicious symptoms (including fever, cough, diarrhea, muscle pain, and loss of smell) clearly receive SARS-CoV-2 testing and at least 14 days of quarantine (close contact with COVID-19 patients without appropriate infection prevention) [1] . Lacking personnel would slow down the hospital operation and further impact patient safety. Notably, we agree that COVID-19 should be excluded first. However, early identification of "non-COVID-19" pathogens would also be beneficial for adjusting the length of quarantine and the policy of workforce resupply. For example, medical personnel with rhinovirus infection might not need 14day quarantine. Unfortunately, information regarding non-COVID-19 pathogens (including coinfections) among frontline medical personnel is not well known, and we aim to present our experience in Taiwan.

From 1 March to 30 June 2020, a total of 1272 patients were reported to the Taiwan CDC for testing COVID-19 (SARS-CoV-2) in our hospital. Among them, 115 (9%) were frontline medical personnel (handling or facing patients). In addition, 105 of them (91.3%) received rapid respiratory panel test (BIOFIRE® FILMARRAY® Respiratory Panels) in the emergency department (ED) ( Table 1) . All of them were negative for COVID-19. However, 26 (24.7%) of them tested positive for non-COVID pathogens, including 18 (17.1%) who were positive for human rhinovirus/enterovirus RNA, 2 (1.9 %) who were positive for coronavirus OC43 RNA, and 2 (1.9%) who were positive for coronavirus NL63 RNA (Table 2) . Three (2.9%) patients had coinfections (2 or > 2 categories of virus). The first was coinfected with coronavirus OC43 RNA and human rhinovirus/enterovirus RNA, the second was coinfected with adenovirus DNA and human rhinovirus/enterovirus RNA, and the last was coinfected with parainfluenza virus 4 RNA and respiratory syncytial virus RNA.

Among the medical personnel (with suspected symptoms), our results demonstrated that 24.7% tested positive for non-COVID pathogens. Rhinoviruses and enteroviruses were the leading non-COVID-19 pathogens during the pandemic period. When facing workforce insufficiency, long-term quarantine for medical personnel might not be necessary when their COVID-19 and non-COVID-19 pathogens are both confirmed early. In one testing model, the chance of post-quarantine transmission might obviously decrease after 7 days of quarantine [2] . A rapid respiratory panel test in the ED might be effective for early detection. Finally, we recommend that the quarantine period should be at least 7 days for (suspected symptoms) medical personnel who are negative for all pathogens (including COVID-19 and FILMARRAY Respiratory Panels). 

The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application

None. 

Authors' contributions Y-CC and Y-RL conceptualized and designed the study. Y-CC and H-WL helped draft the manuscript. I-LH and P-YH collected the data and prepared the table. P-YW and T-YN reviewed and provided conceptual advice for the manuscript. Y-RL and C-CC revised the manuscript. The author(s) read and approved the final manuscript.

Availability of data and materials Not applicable.Ethics approval and consent to participate Institutional Review Board of Changhua Christian Hospital permission number 200409.

Not applicable.

The authors declare that they have no competing interests.