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What is the role of rapid molecular testing for seniors and other at-risk adults with respiratory syncytial virus infections?
- Source :
- Journal of Clinical Virology. 117:27-32
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Lower respiratory tract infections are a leading cause of hospitalization and viruses are important causal pathogens, especially in the elderly, immunocompromised patients and those with respiratory or cardiovascular comorbidities. Respiratory syncytial virus (RSV) is recognized as comprising a substantial burden of morbidity and mortality in older and at-risk adults, and the emergence of rapid point-of-care molecular testing has made it possible to confirm an RSV diagnosis accurately, in a clinically actionable timeframe. RSV patients have significantly higher healthcare resource use (including hospital stays and emergency room/urgent care visits) than non-RSV matched controls, especially if aged ≥65 years, a longer length of hospitalization than those with influenza, and associated costs nearly three times higher. We found no direct clinical outcome data specific to rapid molecular testing for RSV in adults and very little in children. There is very limited evidence that prompt diagnosis may reduce hospital length of stay but this and other outcome parameters need confirmation in larger, prospective clinical trials. Regarding reducing inappropriate antibiotic prescribing, the picture is mixed and testing alone is unlikely to change entrenched habits. There is little incentive for clinicians to order routine RSV tests in adults given the absence of a specific antiviral therapy. However, with numerous vaccine and antiviral candidates in clinical development, we believe it is good practice to plan and start establishing standardized testing protocols – perhaps as part of outcome studies. For especially vulnerable patients, e.g., immunocompromised and transplant patients, prompt accurate RSV diagnosis may prevent disease spread and save lives.
- Subjects :
- Adult
0301 basic medicine
medicine.medical_specialty
Point-of-Care Systems
Point-of-care testing
030106 microbiology
Respiratory Syncytial Virus Infections
Disease
Antiviral Agents
Virus
03 medical and health sciences
0302 clinical medicine
Virology
Health care
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Respiratory system
Child
Intensive care medicine
Aged
Respiratory tract infections
business.industry
Viral Vaccines
Length of Stay
Anti-Bacterial Agents
Community-Acquired Infections
Hospitalization
Patient Outcome Assessment
Clinical trial
Infectious Diseases
Molecular Diagnostic Techniques
Transplant patient
business
Subjects
Details
- ISSN :
- 13866532
- Volume :
- 117
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Virology
- Accession number :
- edsair.doi.dedup.....bf9761dc380c79ce2123d7b22cd25f3e