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 14-day 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).
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References
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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.
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Chen, YC., Lai, HW., Hou, IL. et al. Rapid respiratory panel test for non-COVID-19 pathogen examinations among frontline medical personnel in Taiwan. Environ Health Prev Med 26, 22 (2021). https://doi.org/10.1186/s12199-021-00945-1
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DOI: https://doi.org/10.1186/s12199-021-00945-1