• Raquel Almansa, Carmen Herrero-Rodríguez, Misericordia Martínez-Huélamo, Maria Del Pilar Vicente-Andres, Jose Angel Nieto-Barbero, Miryam Martín-Ballesteros, Maria Del Mar Rodilla-Carvajal, Amanda de la Fuente, Alicia Ortega, Maria Jesus Alonso-Ramos, James Wacker, Oliver Liesenfeld, Timothy E Sweeney, Jesús F Bermejo-Martin, Luis García-Ortiz, and PREVISE Study Group.
• Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia Regional de Salud, Salamanca, Spain.
• Eur. J. Clin. Invest. 2021 Dec 1; 51 (12): e13626.

BackgroundFever-7 is a test evaluating host mRNA expression levels of IFI27, JUP, LAX, HK3, TNIP1, GPAA1 and CTSB in blood able to detect viral infections. This test has been validated mostly in hospital settings. Here we have evaluated Fever-7 to identify the presence of respiratory viral infections in a Community Health Center.MethodsA prospective study was conducted in the "Servicio de Urgencias de Atención Primaria" in Salamanca, Spain. Patients with clinical signs of respiratory infection and at least one point in the National Early Warning Score were recruited. Fever-7 mRNAs were profiled on a Nanostring nCounter® SPRINT instrument from blood collected upon patient enrolment. Viral diagnosis was performed on nasopharyngeal aspirates (NPAs) using the Biofire-RP2 panel.ResultsA respiratory virus was detected in the NPAs of 66 of the 100 patients enrolled. Median National Early Warning Score was 7 in the group with no virus detected and 6.5 in the group with a respiratory viral infection (P > .05). The Fever-7 score yielded an overall AUC of 0.81 to predict a positive viral syndromic test. The optimal operating point for the Fever-7 score yielded a sensitivity of 82% with a specificity of 71%. Multivariate analysis showed that Fever-7 was a robust marker of viral infection independently of age, sex, major comorbidities and disease severity at presentation (OR [CI95%], 3.73 [2.14-6.51], P < .001).ConclusionsFever-7 is a promising host immune mRNA signature for the early identification of a respiratory viral infection in the community.© 2021 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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