Relative Contribution of Diagnostic Testing to the Diagnosis of Respiratory Syncytial Virus in Hospitalized Adults in the United States.

Publication date: Dec 16, 2024

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illness (ARI) in older adults. Optimizing diagnosis could improve understanding of RSV burden. We enrolled adults ≥50 years of age hospitalized with ARI and adults of any age hospitalized with congestive heart failure or chronic obstructive pulmonary disease exacerbations at 2 hospitals during 2 respiratory seasons (2018-2020). We collected nasopharyngeal (NP) and oropharyngeal (OP) swabs (n = 1558), acute and convalescent sera (n = 568), and expectorated sputum (n = 153) from participants, and recorded standard-of-care (SOC) NP results (n = 805). We measured RSV antibodies by 2 immunoassays and performed BioFire testing on respiratory specimens. Of 1558 eligible participants, 92 (5. 9%) tested positive for RSV by any diagnostic method. Combined NP/OP polymerase chain reaction (PCR) testing yielded 58 positives, while separate NP and OP testing identified 11 additional positives (18. 9% increase). Compared to study NP/OP PCR alone, the addition of paired serology increased RSV detection by 42. 9% (28 vs 40) among those with both specimen types, while the addition of SOC swab PCR increased RSV detection by 25. 9% (47 vs 59). The addition of paired serology testing, SOC swab results, and separate testing of NP and OP swabs improved RSV diagnostic yield in hospitalized adults.

Concepts Keywords
Adults Adult
Biofire Aged
Hospitals Aged, 80 and over
Oropharyngeal Antibodies, Viral
Antibodies, Viral
BioFire
Congestive heart failure
Diagnostic Tests, Routine
Female
Hospitalization
Humans
Male
Middle Aged
Nasopharynx
Oropharynx
Respiratory Tract Infections
RSV
serology
Sputum
sputum
United States

Semantics

Type Source Name
disease MESH congestive heart failure
disease MESH chronic obstructive pulmonary disease
disease MESH Respiratory Syncytial Virus Infections
disease MESH Respiratory Tract Infections

Original Article

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