scholarly journals Prognosis of hospitalized children under 2 years of age with co-detection of influenza A and respiratory syncytial virus at the healthcare facility

2021 ◽  
Vol 21 (2) ◽  
pp. 531-537
Author(s):  
Elisa Teixeira Mendes ◽  
Hadassa L. Paranhos ◽  
Isabela C. M. Santos ◽  
Lais Bomediano de Souza ◽  
José Luis Braga de Aquino ◽  
...  
Keyword(s):  
Influenza A ◽  
Point Of Care ◽  
Rapid Test ◽  
Healthcare Facility ◽  
Orotracheal Intubation ◽  
Younger Age ◽  
Co Detection ◽  
Syncytial Virus ◽  
The Impact ◽  
Mean Time

Abstract Objectives: the aim of this study is to evaluate the impact of co-detection of Flu A and RSV using rapid immunochromatographic tests at the point of care, in pediatric patients under 2 years of age in a general hospital. Methods: a retrospective cohort study was conducted to analyze clinical outcomes in hospitalized infants with viral respiratory disease with positive results of rapid immunochromatographic test for RSV and/or Flu-A, from 2013 to 2018. A logistic regression model was adjusted to analyze predictors of orotracheal intubation during hospitalization. Results: we analyzed 220 cases: RSV (192), Flu-A (9), co-detection (19). Lethality rate was 1.8% (2 cases), and 88% (194) were under 1 year of age. Mean time of hospitalizations was higher in patients with co-detection. Variables significantly associated with orotracheal intubation were: younger age in months, comorbidities, RSV and Flu-A co-detection, and bacterial pneumonia during hospitalization. Conclusions: RSV and Flu-Aco-detection was associated with the least favorable clinical prognoses in this study. Rapid test diagnosis may provide important information at the point of care, because molecular panels are not widely accessible in general hospitals. Rapid diagnosis allows timely evaluation and treatment.

scholarly journals Imunocromatografic Tests Improving Point-of-Care Management of Respiratory Virus Infection in Children

2020 ◽  
Vol 41 (S1) ◽  
pp. s291-s291
Author(s):  
Elisa Teixeira Mendes ◽  
Hadassa Louback Paranhos ◽  
Isabela Cristina Moreira Santos ◽  
Nathália Reis Sartori Barbosa ◽  
Raquel Vieira da Silva ◽  
...  
Keyword(s):  
Point Of Care ◽  
Rapid Test ◽  
Orotracheal Intubation ◽  
Public Hospitals ◽  
Diagnostic Methods ◽  
Intensive Intervention ◽  
Treatment Implementation ◽  
Younger Age ◽  
Rapid Tests ◽  
Syncytial Virus

Background: Respiratory syncytial virus (RSV) and influenza virus (flu) contribute substantially to the overall burden of severe respiratory tract infection in children. However, the molecular etiological diagnostic methods of viral infection are still insufficiently accessible in public hospitals. Rapid immunochromatographic tests can add important information at the point of care, including antiviral or antibiotic indication, viral , and effective precaution measures to prevent outbreaks. The aim of this study was to evaluate this impact for pediatric patients under 5 years of age in our hospital. Methods: We conducted a retrospective, observational study of clinical outcomes of children under 5 years requiring hospitalization from 2013 to 2018 for viral respiratory disease, and who had positive RSV and/or flu immunochromatographic rapid test results. Results: In total, we identified 221 cases: RSV, 193; flu, 6; codetections, 19. (Table 1). The mortality rate was 1.8% (2 cases), and 88% of our patients were <1 year of age. Variables significantly associated with orotracheal intubation, the most intensive intervention, were younger age in months, comorbidities, RSV and flu codetection, and bacterial pneumonia diagnosis during hospitalization. Conclusions: In the multivariate analysis, RSV and flu codetection was associated with the least favorable clinical prognoses. Rapid test diagnosis may provide important information at the point of care, and molecular panels are not yet widely accessible in public hospitals. Hence, we believe that immunochromatographic rapid tests represent a valuable and feasible diagnostic alternative facilitating timely evaluation and treatment implementation.Funding: NoneDisclosures: None

scholarly journals Rapid disappearance of influenza following the implementation of COVID-19 mitigation measures in Hamilton, Ontario

2021 ◽  
Vol 47 (04) ◽  
pp. 202-208
Author(s):  
Kevin Zhang ◽  
Avika Misra ◽  
Patrick J Kim ◽  
Seyed M Moghadas ◽  
Joanne M Langley ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza A ◽  
Respiratory Virus ◽  
Respiratory Viruses ◽  
Mitigation Measures ◽  
Nasopharyngeal Swab ◽  
Health Measures ◽  
Bayesian Linear Regression ◽  
Syncytial Virus ◽  
The Impact

Background: Public health measures, such as physical distancing and closure of schools and non-essential services, were rapidly implemented in Canada to interrupt the spread of the coronavirus disease 2019 (COVID-19). We sought to investigate the impact of mitigation measures during the spring wave of COVID-19 on the incidence of other laboratory-confirmed respiratory viruses in Hamilton, Ontario. Methods: All nasopharyngeal swab specimens (n=57,503) submitted for routine respiratory virus testing at a regional laboratory serving all acute-care hospitals in Hamilton between January 2010 and June 2020 were reviewed. Testing for influenza A and B, respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus, and rhinovirus/enterovirus was done routinely using a laboratory-developed polymerase chain reaction multiplex respiratory viral panel. A Bayesian linear regression model was used to determine the trend of positivity rates of all influenza samples for the first 26 weeks of each year from 2010 to 2019. The mean positivity rate of Bayesian inference was compared with the weekly reported positivity rate of influenza samples in 2020. Results: The positivity rate of influenza in 2020 diminished sharply following the population-wide implementation of COVID-19 interventions. Weeks 12–26 reported 0% positivity for influenza, with the exception of 0.1% reported in week 13. Conclusion: Public health measures implemented during the COVID-19 pandemic were associated with a reduced incidence of other respiratory viruses and should be considered to mitigate severe seasonal influenza and other respiratory virus pandemics.

scholarly journals Influenza and RSV incidence during COVID-19 pandemic—an observational study from in-hospital point-of-care testing

2021 ◽  
Author(s):  
Paul Stamm ◽  
Ingo Sagoschen ◽  
Kerstin Weise ◽  
Bodo Plachter ◽  
Thomas Münzel ◽  
...  
Keyword(s):  
Emergency Room ◽  
Influenza A ◽  
Point Of Care ◽  
Respiratory Viruses ◽  
Pediatric Emergency ◽  
Influenza B ◽  
Complete Suppression ◽  
Emergency Room Patients ◽  
Syncytial Virus ◽  
Point Of Care Tests

AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has forced the implementation of unprecedented public health measures strategies which might also have a significant impact on the spreading of other viral pathogens such as influenza and Respiratory Syncytial Virus (RSV) . The present study compares the incidences of the most relevant respiratory viruses before and during the SARS-CoV-2 pandemic in emergency room patients. We analyzed the results of in total 14,946 polymerase chain reaction point-of-care tests (POCT-PCR) for Influenza A, Influenza B, RSV and SARS-CoV-2 in an adult and a pediatric emergency room between December 1, 2018 and March 31, 2021. Despite a fivefold increase in the number of tests performed, the positivity rate for Influenza A dropped from 19.32% (165 positives of 854 tests in 2018/19), 14.57% (149 positives of 1023 in 2019–20) to 0% (0 positives of 4915 tests) in 2020/21. In analogy, the positivity rate for Influenza B and RSV dropped from 0.35 to 1.47%, respectively, 10.65–21.08% to 0% for both in 2020/21. The positivity rate for SARS-CoV2 reached 9.74% (110 of 1129 tests performed) during the so-called second wave in December 2020. Compared to the two previous years, seasonal influenza and RSV incidence was eliminated during the COVID-19 pandemic. Corona-related measures and human behavior patterns could lead to a significant decline or even complete suppression of other respiratory viruses such as influenza and RSV.

scholarly journals Detection of Influenza A and B Viruses and Respiratory Syncytial Virus by Use of Clinical Laboratory Improvement Amendments of 1988 (CLIA)-Waived Point-of-Care Assays: a Paradigm Shift to Molecular Tests

2018 ◽  
Vol 56 (7) ◽  
Author(s):  
Marwan M. Azar ◽  
Marie L. Landry
Keyword(s):  
Respiratory Syncytial Virus ◽  
Antiviral Therapy ◽  
Influenza A ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
The United States ◽  
Nucleic Acid Amplification ◽  
Molecular Tests ◽  
Syncytial Virus ◽  
Clinical Laboratory Improvement Amendments

ABSTRACT An accurate laboratory diagnosis of influenza, respiratory syncytial virus (RSV), and other respiratory viruses can help to guide patient management, antiviral therapy, infection prevention strategies, and epidemiologic monitoring. Influenza has been the primary driver of rapid laboratory testing due to its morbidity and mortality across all ages, the availability of antiviral therapy, which must be given early to have an effect, and the constant threat of new pandemic strains. Over the past 30 years, there has been an evolution in viral diagnostic testing, from viral culture to rapid antigen detection, and more recently, to highly sensitive nucleic acid amplification tests (NAAT), as well as a trend to testing at the point of care (POC). Simple rapid antigen immunoassays have long been the mainstay for POC testing for influenza A and B viruses and respiratory syncytial virus (RSV) but have been faulted for low sensitivity. In 2015, the first POC NAAT for the detection of influenza was approved by the Food and Drug Administration (FDA), ushering in a new era. In 2017, the FDA reclassified rapid influenza diagnostic tests (RIDTs) from class I to class II devices with new minimum performance standards and a requirement for annual reactivity testing. Consequently, many previously available RIDTs can no longer be purchased in the United States. In this review, recent developments in Clinical Laboratory Improvement Amendments of 1988 (CLIA)-waived testing for respiratory virus infections will be presented, with the focus on currently available FDA-cleared rapid antigen and molecular tests primarily for influenza A and B viruses and RSV.

scholarly journals Impact of a multiplex PCR point-of-care test for influenza A/B and respiratory syncytial virus on an acute pediatric hospital ward

2018 ◽  
Vol 91 (4) ◽  
pp. 331-335 ◽  
Author(s):  
Andres I. Vecino-Ortiz ◽  
Simon D. Goldenberg ◽  
Sam T. Douthwaite ◽  
Chih-Yuan Cheng ◽  
Rebecca E. Glover ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Multiplex Pcr ◽  
Influenza A ◽  
Point Of Care ◽  
Hospital Ward ◽  
Pediatric Hospital ◽  
Point Of Care Test ◽  
Syncytial Virus

scholarly journals Performance of a Novel Point-of-Care Molecular Assay for Detection of Influenza A and B Viruses and Respiratory Syncytial Virus (Enigma MiniLab) in Children with Acute Respiratory Infection

2015 ◽  
Vol 54 (1) ◽  
pp. 212-215 ◽  
Author(s):  
Sam T. Douthwaite ◽  
Charlotte Walker ◽  
Elisabeth J. Adams ◽  
Catherine Mak ◽  
Andres Vecino Ortiz ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Respiratory Virus ◽  
Point Of Care ◽  
Influenza B Virus ◽  
Influenza B ◽  
Molecular Assay ◽  
B Virus ◽  
Syncytial Virus ◽  
Virus Influenza

The performance of the Enigma MiniLab assay for influenza A and B viruses and respiratory syncytial virus (RSV) was compared to a centralized laboratory respiratory virus panel. The positive and negative percent agreement for influenza A virus, influenza B virus, and RSV were 79.2% (95% confidence interval [95% CI], 57.8 to 92.9%) and 99.4% (95% CI, 98.4 to 99.9), 100% (95% CI, 47.8 to 100%) and 100% (95% CI, 99.3 to 100%), 98.5% (95% CI, 94.6 to 99.8%) and 94.5% (95% CI, 91.9 to 96.4%), respectively.

scholarly journals Diagnostic and economic evaluation of a point-of-care test for respiratory syncytial virus

2020 ◽  
Vol 6 (3) ◽  
pp. 00018-2020
Author(s):  
A. Joy Allen ◽  
Andrea Gonzalez-Ciscar ◽  
Clare Lendrem ◽  
Jana Suklan ◽  
Karen Allen ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Diagnostic Accuracy ◽  
Influenza A ◽  
Diagnostic Yield ◽  
Point Of Care ◽  
Cost Savings ◽  
Sample Type ◽  
Standard Laboratory ◽  
Point Of Care Test ◽  
Syncytial Virus

Respiratory syncytial virus is a common cause of bronchiolitis. Historically, point-of-care tests have involved antigen detection technology with limited sensitivity. The aim of this study was to prospectively evaluate the diagnostic accuracy and model the economic impact of the Roche cobas® Liat® point-of-care influenza A/B and respiratory syncytial virus test.The “DEC-RSV” study was a multi-centre, prospective, observational study in children under 2 years presenting with viral respiratory symptoms. A nasopharyngeal aspirate sample was tested using the point-of-care test and standard laboratory-based procedures. The primary outcome was accuracy of respiratory syncytial virus detection. The cost implications of adopting a point-of-care test were modelled using study data.A total of 186 participants were recruited, with both tests performed on 177 samples. The point-of-care test was invalid for 16 samples (diagnostic yield 91%) leaving 161 available for primary analysis. After resolving discrepancies, the cobas® Liat® respiratory syncytial virus test had 100.00% (95% CI 96.07%–100.00%) sensitivity and 98.53% (95% CI 92.08%–99.96%) specificity. Median time to result was 0.6 h (interquartile range (IQR) 0.5–1) for point-of-care testing and 28.9 h (IQR 26.3–48.1) for standard laboratory testing. Estimated non-diagnostic cost savings for 1000 patients, based on isolation decision-making on point-of-care test result, were £57 010, which would increase to £94 847 when cohort nursing is used.In young children the cobas® Liat® point-of-care respiratory syncytial virus test has high diagnostic accuracy using nasopharyngeal aspirates (currently an off-licence sample type). Time to result is clinically important and was favourable compared to laboratory-based testing. The potential exists for cost savings when adopting the point-of-care test.

scholarly journals Molecular point-of-care testing for influenza A/B and respiratory syncytial virus: comparison of workflow parameters for the ID Now and cobas Liat systems

2019 ◽  
Author(s):  
Stephen Young ◽  
Jamie Phillips ◽  
Christen Griego-Fullbright ◽  
Aaron Wagner ◽  
Patricia Jim ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Point Of Care ◽  
Turnaround Time ◽  
Walk Away ◽  
Molecular Tests ◽  
Syncytial Virus ◽  
Improve Patient Management ◽  
Parallel Workflow ◽  
Improve Patient

ABSTRACTAimsPoint-of-care (POC) tests for influenza and respiratory syncytial virus (RSV) offer the potential to improve patient management and antimicrobial stewardship. Studies have focused on performance; however, no workflow assessments have been published comparing POC molecular tests. This study compared the Liat and ID Now systems workflow, to assist end-users in selecting an influenza and/or RSV POC test.MethodsStaffing, walk-away, and turnaround time (TAT) of the Liat and ID Now systems were determined using 40 nasopharyngeal samples, positive for influenza or RSV. The ID Now system requires separate tests for influenza and RSV, so parallel (two instruments) and sequential (one instrument) workflows were evaluated.ResultsThe ID Now ranged 4.1–6.2 minutes for staffing, 1.9–10.9 minutes for walk-away and 6.4–15.8 minutes for TAT per result. The Liat ranged 1.1–1.8 minutes for staffing, 20.0–20.5 minutes for walk-away and 21.3–22.0 minutes for TAT. Mean walk-away time comprised 38.0% (influenza positive) and 68.1% (influenza negative) of TAT for ID Now and 93.7% (influenza/RSV) for Liat. The ID Now parallel workflow resulted in medians of 5.9 minutes for staffing, 9.7 minutes for walk-away, and 15.6 minutes for TAT. Assuming prevalence of 20% influenza and 20% RSV, the ID Now sequential workflow resulted in medians of 9.4 minutes for staffing, 17.4 minutes for walk-away, and 27.1 minutes for TAT.ConclusionsThe ID Now and Liat systems offer different workflow characteristics. Key considerations for implementation include value of both influenza and RSV results, clinical setting, staffing capacity, and instrument(s) placement.

scholarly journals Clinical impact of the rapid molecular detection of RSV and influenza A and B virus in the emergency room

2021 ◽  
Author(s):  
Nicolas Yin ◽  
Marc Van Nuffelen ◽  
Magali Bartiaux ◽  
Thierry Preseau ◽  
Inge Roggen ◽  
...  
Keyword(s):  
Emergency Room ◽  
Clinical Management ◽  
Diagnostic Tests ◽  
Influenza A ◽  
Point Of Care ◽  
Antibiotic Use ◽  
Rapid Diagnostic Tests ◽  
Analytical Performance ◽  
Molecular Test ◽  
The Impact

Introduction: Using respiratory viruses' rapid diagnostic tests in the emergency room (ER) could allow a better and faster clinical management. Point-of-care PCR instruments provide now results in less than 30 minutes. The objective of this study was to assess the impact of the use of the cobas® Influenza A/B & RSV Assay for use on Roche's cobas® Liat® instrument on the clinical management of ER patients. Methods: Patients (adults and children) requiring admission or suffering from an underlying condition at risk of respiratory complication were prospectively recruited in the ER of four hospitals in the Brussels region. Physician's intentions regarding admission, isolation, antibiotic and antiviral use were collected before and after performing a cobas® Influenza A/B & RSV molecular test. Additionally, a comparison of the analytical performance of this test against antigen rapid tests and viral culture was performed as well as a time-to-result evaluation. Results: PCR yielded twice more positive results than antigen rapid diagnostic tests. It allowed a decrease in the overall need for isolation and treatment by limiting the isolation of negative patients and the antibiotic use for positive patients. Meanwhile, antiviral treatments better targeted patients with a positive influenza PCR. Conclusion: The use of a rapid influenza and RSV molecular test improves the clinical management of patients admitted to the ER by providing a fast and reliable result. Their additional cost compared to antigen tests should be balanced with the benefit of their analytical performance, leading to efficient reductions in the need of isolation and antibiotic use.

scholarly journals Epidemiological and virological characteristics of respiratory tract infections in children during COVID-19 outbreak

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yueling Zhu ◽  
Wei Li ◽  
Binbin Yang ◽  
Ruiying Qian ◽  
Fang Wu ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Influenza A ◽  
Respiratory Tract Infections ◽  
Respiratory Viruses ◽  
Influenza B ◽  
Protective Measures ◽  
Outpatient Visits ◽  
Syncytial Virus ◽  
Tract Infections ◽  
The Impact

Abstract Background To investigate the impact of protective measures and isolation on respiratory tract infections in children during the COVID-19 outbreak. Methods We extracted data on outpatient visits and respiratory infection visits, and tests of respiratory viruses (adenovirus (ADV), influenza A (FluA), influenza B (FluB) and respiratory syncytial virus (RSV)) from electronic healthcare records in Children’s Hospital, Zhejiang University School of Medicine during the COVID-19 outbreak (January–April, 2020), compared with those in 2018 and 2019 during the same periods. Results We found that outpatient visits in January, 2020 was comparable with those in 2018 and 2019, but decreased by 59.9% (288,003 vs. 717,983) and 57.4% (288,003 vs. 676,704), respectively during the period of February-April, 2020, as compared with the same periods in 2018 and 2019. The total number of respiratory tract infections from January to April 2020 decreased by 65.7% (119,532 vs.348,762) and 59.0% (119,532 vs.291,557), respectively compared with the same periods in 2018 and 2019. The proportion of respiratory tract infections during the outbreak also dropped compared with the same periods in 2018 and 2019 (P<0.001). We also found significantly decreased number of completed tests for respiratory viruses and positive cases of ADV, FluA, FluB, and RSV during February-April, 2020. Conclusions In this study, we found that outpatient visits and respiratory tract infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent respiratory virus infections in children.

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