BioFire FilmArray Pneumonia Panel and SARS-CoV-2 Detection
No, the original BioFire FilmArray Pneumonia Panel does not detect SARS-CoV-2, but the newer BioFire FilmArray Respiratory Panel 2.1 (RP2.1) does include SARS-CoV-2 as a specific target. 1, 2
Understanding the Different BioFire Panels
The confusion arises because BioFire Diagnostics manufactures multiple respiratory testing panels with different target pathogens:
BioFire FilmArray Pneumonia Panel
- Does NOT include SARS-CoV-2 as a target 1
- Designed for lower respiratory tract specimens (BAL fluid, endotracheal aspirates) 1
- Detects multiple bacterial pathogens and select atypical bacteria, plus some respiratory viruses 1
- Used primarily for pneumonia diagnosis in hospitalized patients 3, 4
BioFire FilmArray Respiratory Panel 2.1 (RP2.1)
- Does include SARS-CoV-2 as a specific target 2, 5, 6
- This is an expansion of the original Respiratory Panel 2 (RP2) specifically to add SARS-CoV-2 detection 6
- Designed for upper respiratory tract specimens (nasopharyngeal swabs) 2, 5
- Detects SARS-CoV-2 with 97-98% positive percent agreement compared to reference RT-PCR 2, 6
- Has a limit of detection for SARS-CoV-2 at approximately 50 copies/mL 5
Clinical Performance for SARS-CoV-2 Detection
When the RP2.1 panel is used:
- Sensitivity for SARS-CoV-2 is 98% with specificity of 94% in pediatric populations 2
- Positive percent agreement is 98.4% (95% CI: 91.4-99.7%) in multicenter evaluations 6
- Negative percent agreement is 98.9% (95% CI: 97.5-99.5%) 6
- Can simultaneously detect coinfections with other respiratory viruses in 7.6% of cases 2
Important Distinctions About "Coronavirus" Detection
Critical caveat: Some older respiratory panels detect "coronavirus" generically, but this refers to common human coronaviruses (229E, NL63, OC43, HKU1) that cause mild upper respiratory infections, NOT SARS-CoV-2 1, 7. SARS-CoV-2 is a distinct betacoronavirus that shares only 76.9% genetic homology with SARS-CoV-1 and requires specific primers for detection 7, 8.
Practical Clinical Guidance
For SARS-CoV-2 detection, you must specifically order:
- BioFire FilmArray Respiratory Panel 2.1 (RP2.1) - which includes SARS-CoV-2 2, 5, 6
- NOT the standard Pneumonia Panel, which lacks this target 1
When interpreting results:
- The RP2.1 provides rapid results (approximately 45 minutes) suitable for point-of-care testing 2
- Excellent negative predictive value makes it useful to rule out SARS-CoV-2 infection 4
- Discordant results typically occur when viral load is near the limit of detection 6
- Human rhinovirus/enterovirus is detected 4-fold more frequently than SARS-CoV-2 in pediatric patients (0-18 years), while SARS-CoV-2 predominates in adults 6