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Is it COVID or the Flu or some other infection?

Case Number 1: A 42-year-old female shows symptoms like fever, cough, weight loss, and dyspnoea(difficulty breathing). Clinically, it seemed to be Viral Pneumonia, possibly COVID-19 related to Organising pneumonia. The doctor started steroids and antihistamines. However, the condition did not improve. Hence a BioFire Respiratory Panel was prescribed. On diagnosis, the Result came positive for Mycoplasma and Adenovirus. She was then treated as a case of atypical pneumonia and started with Clarithromycin and Steroids. Case Number 2: An 85-year-old lady living with her 57-year-old Cousin: Former presented with Fever, Cough, Hemoptysis(blood in sputum) & later showed abdominal pain and body ache The Doctor Ordered an RT-PCR test for COVID-19. However, the results were negative. The doctors suspected Tuberculosis and were about to start therapy with AKT. They ordered a GenXpert test which came negative. Post which for further diagnosis they ordered a BIOFIRE Respiratory panel This time, the reports tested positive with H1N1 Swine flu Infection detected We thus recommend a BioFire RESPIRATORY PANEL if a SARS RT-PCR is negative and the patient has moderate to severe symptoms or needs hospitalization. Method of Diagnosis to differentiate between COVID or the Flu or other bacterial\viral infections: Method used for diagnosis in BioFire Panel is Multiplex Nucleic Acid Detection Test: checking traces of 20 organisms that can cause these flu-like symptoms. Here are some pathogens listed below -

  • Adenovirus

  • Coronavirus HKU1, NL63, 229E, OC4

  • Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2),

  • Human Meta pneumonia virus,

  • Human Rhinovirus/Enterovirus,

  • Influenza A & B,

  • Parainfluenza virus 1,2,3 and 4,

  • Respiratory Syncytial virus,

  • Bordetella pertussis,

  • Bordetella parapertussis,

  • Chlamydophila pneumonia and

  • Mycoplasma pneumonia.

Sample Type BioFire Respiratory Panel - Nasopharyngeal swab, throat swab, sputum, endotracheal secretion, or BAL in a VTM (Viral Transport Medium) On the other hand, flu is a highly contagious infection of the nose, throat, and lungs. The clinical symptoms observed in Flu-like cases are mild to moderate fever, sore throat, body ache, lethargy, muscle pain, runny nose, loss of smell sensation, headache, or cough with expectoration similar to COVID-19 Investigations: 1.Sputum smear study 2.Culture and sensitivity testing for organisms from throat or lung 3.Multiplex PCR testing with BioFire: sensitive (97.1%), specific (99.3%), results within 1.5 hours. The rapid respiratory PCR test results may enable better-informed and quick diagnosis and treatment of patients. Quick turnaround on a broad menu of pathogens may also help clinicians make vital decisions regarding admission, isolation, and additional diagnostic testing. It is clear from the above case scenarios that the Biofire respiratory panel is important in deciding the line of TARGETED THERAPY as it identifies the organism responsible for infection and decrease in days of antibiotic use (2.6 days per patient)[2]. Why is a Flu vaccine important? 1.Flu is a highly contagious illness. A variety of viruses cause the Flu. Hence, the best prevention is to get oneself vaccinated every year. 2.CDC reports, between 140,000 and 810,000 people are hospitalized annually with flu. 3..Seasonal flu and COVID are similar in their clinical presentations. 4.These Flu viruses usually cause the most severe illness during colder months. Thus taking the dose 3-6 months before the Flu Season is advisable. 5.The flu vaccine will protect oneself and protect the people and community around by forming antibodies. 6.Since elderly people, babies, and people with health conditions like asthma are more at risk-taking flu vaccine will help them fight the infection better. 7.The Flu vaccine also turns to be Possible protection against COVID-19 in children: It is seen that flu vaccination can offer some protection to children against COVID by “viral interference -i.e. growth of one virus can be inhibited by previous viral infection, in this case, an inactivated flu virus vaccine.[4] Types of Flu Vaccines In India 2 types of Flu vaccines are available