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Benefits to Multiplex Testing: Molecular & Immunoassay-Based Techniques
Multiplex testing and syndromic panels save significant time and resources by testing for multiple diseases using a single sample. Flu, COVID-19, RSV and other respiratory diseases cause similar symptoms and differential diagnosis is not possible without a laboratory test. Combination testing provides physicians the unique opportunity to quickly and accurately diagnose a patient and provide the right treatment. This is important for respiratory infections such as COVID-19, RSV and flu, which require different treatments and put different patient groups, such as babies or the elderly, at risk from serious complications if mistreated or left untreated.
Several assay techniques are used for multiplex testing including immunoassay-based rapid antigen detection and nucleic acid amplification using molecular methods. Throughout the COVID-19 pandemic, molecular testing remained the predominant test used for diagnosis due to its high sensitivity and specificity. However, molecular tests require a laboratory to perform, involve complex logistics for sample transportation and are vulnerable to bottlenecks in machine capacities and reagent supplies, all impacting the turn-around-times which can be up to several days. In contrast, rapid antigen assays are highly
scalable, can be used at the point of care (such as a school or airport) and can provide a result in 10-15 minutes. Yet their sensitivity is lower (>80% as compared to RT-PCR) (CDC 2021) or more, they are prone to cross-reactivity, and they have a higher incidence of false positive and false negative results compared to molecular tests. Depending on the available resources, accuracy required and level of urgency, one testing method may prove to be more useful than another for a given situation.
Figure 1. Targets for Viral Detection Methods
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