2785. Respiratory Viral Panel Testing in Intensive Care Units: Effects on Outcomes

Abstract

BackgroundAcute respiratory viral illnesses cause significant morbidity and mortality leading to high healthcare costs. Delayed viral pathogen diagnosis likely contributes to increases in morbidity and mortality. We aimed to analyze: (1) the use of respiratory viral panel (RVP) testing in adults hospitalized to intensive care units (ICUs) with acute respiratory illness (ARI) during flu season; and (2) if RVP testing is associated with improved outcomes.MethodsData from adults hospitalized to the ICU with ARI during the 2015–2016, 2016–2017, and 2017–2018 influenza seasons at 3 hospitals participating in the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) study was analyzed. Details of disease severity, underlying health status, and vaccination status were obtained through enrollment interviews and medical records. Clinical RVP results were recorded. Research swabs for influenza (CDC PCR) were performed in all patients who did not have a clinical sample. Multivariate regression was used to estimate the associations between RVP and in-hospital complications.Results397 patients were enrolled; 263 (66%) had a clinical RVP done. 25% of patients with ≥ 1 CDC-defined high-risk condition for influenza complications did not have an RVP. 36 (9%) of patients had a positive RVP for flu (1 H1N1, 28 H3, 1 A no subtype, and 6 B). Mean time from onset of symptoms to RVP was 2.25 ± 2.24 days and mean time from ICU admission to RVP was 0.85 ± 1.27 days. 11 (8%) of patients who had only a research swab were positive for flu (1 A no subtype, others H3). 4 (36%) of these patients received oseltamivir. Use of antivirals was significantly more common in patients who had RVPs (68 vs 1%, pConclusionOne-third of patients admitted to the ICU with ARI during the flu season did not have an RVP, including 25% of patients with ≥ 1 high-risk condition for influenza complications. Influenza was present in 8% of patients who did not undergo clinical testing and 64% of these patients did not receive antivirals. There is room for improvement in ordering of RVPs in ICUs.Disclosures All authors: No reported disclosures.