POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM

Detalhes bibliográficos
Autor(a) principal: Marçolla Weber, Fernanda
Data de Publicação: 2023
Outros Autores: Schrage Lin, Rodrigo, Michelin, Lessandra
Tipo de documento: Artigo
Idioma: por
Título da fonte: Interfaces Científicas. Saúde e Ambiente (Online)
Texto Completo: https://periodicos.set.edu.br/saude/article/view/11350
Resumo: RNA viruses, such as influenza and respiratory syncytial virus (RSV), are common causes of lower airway infections. Rapid tests (antigen-based by immunochromatographic and molecular technique - RIT and RMT, respectively) with good diagnostic accuracy directly impacts the quality of patient care and hospitalization costs. This study aims to evaluate the implementation of point of care PCR compared to rapid antigen-based tests for influenza and RSV in the emergency department.Methods: Prospective cross section study in an Emergency Room (ER) from August to September 2019, where all patients with influenza like illness went through RIT and RMT. The patients were divided in a model of four clinical scenarios to evaluate cost and isolation time in the ER.Results: 424 patients were included in the study. RIT showed sensitivity of only 40% compared with RMT (100% specificity; PPV 100%; NPV 68,7%), causing 103 patients to mistakenly leave respiratory isolation, raising biological risk in the ER. Fast results from RMT led negative patients to leave isolation early (262:10 less hours of isolation), allowing cost reduction of USD 1.921,20. Nonetheless, RMT had higher cost than RIT in all clinical scenarios with an increase of USD 12.788,90 (69,9% of cost related to tests and isolation precautions). Conclusion: RIT was a more affordable test but can’t be used to exclude disease and was associated with higher biological risk to the hospital setting. RMT had better diagnostic performance with faster results, allowing for less isolation time per patient tested.
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spelling POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOMPCR EN EL PUNTO DE ATENCIÓN PARA LA GRIPE Y EL VIRUS RESPIRATORIO SINCITIAL: DEL LABORATORIO A URGENCIASPOINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOMRNA viruses, such as influenza and respiratory syncytial virus (RSV), are common causes of lower airway infections. Rapid tests (antigen-based by immunochromatographic and molecular technique - RIT and RMT, respectively) with good diagnostic accuracy directly impacts the quality of patient care and hospitalization costs. This study aims to evaluate the implementation of point of care PCR compared to rapid antigen-based tests for influenza and RSV in the emergency department.Methods: Prospective cross section study in an Emergency Room (ER) from August to September 2019, where all patients with influenza like illness went through RIT and RMT. The patients were divided in a model of four clinical scenarios to evaluate cost and isolation time in the ER.Results: 424 patients were included in the study. RIT showed sensitivity of only 40% compared with RMT (100% specificity; PPV 100%; NPV 68,7%), causing 103 patients to mistakenly leave respiratory isolation, raising biological risk in the ER. Fast results from RMT led negative patients to leave isolation early (262:10 less hours of isolation), allowing cost reduction of USD 1.921,20. Nonetheless, RMT had higher cost than RIT in all clinical scenarios with an increase of USD 12.788,90 (69,9% of cost related to tests and isolation precautions). Conclusion: RIT was a more affordable test but can’t be used to exclude disease and was associated with higher biological risk to the hospital setting. RMT had better diagnostic performance with faster results, allowing for less isolation time per patient tested.Influenza and respiratory syncytial virus (RSV) infection are common causes of lower airway diseases. Rapid tests (antigen-based by immunochromatographic and molecular technique - RIT and RMT, respectively) with good diagnostic accuracy directly impacts the quality of patient care and hospitalization costs. This study aims to evaluate the implementation of point of care PCR (RMT) compared to rapid antigen-based tests (RIT) for influenza and RSV in the emergency department.Prospective cross section study in an Emergency Room (ER) from August to September 2019, where all patients with influenza like illness went through RIT and RMT. The patients were divided in a model of four clinical scenarios to evaluate cost and isolation time in the ER. Four hundred and twenty fourpatients were included in the study. RIT showed sensitivity of only 40% compared with RMT (100% specificity; PPV 100%; NPV 68,7%), causing 103 patients to mistakenly leave respiratory isolation, raising biological risk in the ER. Fast results from RMT led negative patients to leave isolation early (262:10 less hours of isolation), allowing cost reduction of USD 1.921,20. Nonetheless, RMT had higher cost than RIT in all clinical scenarios with an increase of USD 12.788,90 (69,9% of cost related to tests and isolation precautions). RIT had a lower direct cost, and due to the variation in sensitivity, it should not be indicated to exclude viral respiratory diseases, which may result in biological risk for the hospital environment. RMT had better diagnostic performance with faster results, allowing for less isolation time per patient tested.Editora Universitária Tiradentes2023-05-18info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicos.set.edu.br/saude/article/view/1135010.17564/2316-3798.2023v9n2p232-244Interfaces Científicas - Saúde e Ambiente; v. 9 n. 2 (2023): Fluxo Contínuo; 232-2442316-37982316-331310.17564/2316-3798.2023v9n2reponame:Interfaces Científicas. Saúde e Ambiente (Online)instname:Universidade Tiradentes (UNIT)instacron:UNITporhttps://periodicos.set.edu.br/saude/article/view/11350/5332Copyright (c) 2023 Interfaces Científicas - Saúde e Ambientehttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessMarçolla Weber, FernandaSchrage Lin, Rodrigo Michelin, Lessandra2023-12-05T13:10:24Zoai:ojs.emnuvens.com.br:article/11350Revistahttps://periodicos.set.edu.br/saudePRIhttps://periodicos.set.edu.br/index.php/saude/oai||crismporto@gmail.com||interfaces_saude_editor@yahoo.com.br2316-37982316-3313opendoar:2023-12-05T13:10:24Interfaces Científicas. Saúde e Ambiente (Online) - Universidade Tiradentes (UNIT)false
dc.title.none.fl_str_mv POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
PCR EN EL PUNTO DE ATENCIÓN PARA LA GRIPE Y EL VIRUS RESPIRATORIO SINCITIAL: DEL LABORATORIO A URGENCIAS
POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
title POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
spellingShingle POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
Marçolla Weber, Fernanda
title_short POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
title_full POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
title_fullStr POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
title_full_unstemmed POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
title_sort POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM
author Marçolla Weber, Fernanda
author_facet Marçolla Weber, Fernanda
Schrage Lin, Rodrigo
Michelin, Lessandra
author_role author
author2 Schrage Lin, Rodrigo
Michelin, Lessandra
author2_role author
author
dc.contributor.author.fl_str_mv Marçolla Weber, Fernanda
Schrage Lin, Rodrigo
Michelin, Lessandra
description RNA viruses, such as influenza and respiratory syncytial virus (RSV), are common causes of lower airway infections. Rapid tests (antigen-based by immunochromatographic and molecular technique - RIT and RMT, respectively) with good diagnostic accuracy directly impacts the quality of patient care and hospitalization costs. This study aims to evaluate the implementation of point of care PCR compared to rapid antigen-based tests for influenza and RSV in the emergency department.Methods: Prospective cross section study in an Emergency Room (ER) from August to September 2019, where all patients with influenza like illness went through RIT and RMT. The patients were divided in a model of four clinical scenarios to evaluate cost and isolation time in the ER.Results: 424 patients were included in the study. RIT showed sensitivity of only 40% compared with RMT (100% specificity; PPV 100%; NPV 68,7%), causing 103 patients to mistakenly leave respiratory isolation, raising biological risk in the ER. Fast results from RMT led negative patients to leave isolation early (262:10 less hours of isolation), allowing cost reduction of USD 1.921,20. Nonetheless, RMT had higher cost than RIT in all clinical scenarios with an increase of USD 12.788,90 (69,9% of cost related to tests and isolation precautions). Conclusion: RIT was a more affordable test but can’t be used to exclude disease and was associated with higher biological risk to the hospital setting. RMT had better diagnostic performance with faster results, allowing for less isolation time per patient tested.
publishDate 2023
dc.date.none.fl_str_mv 2023-05-18
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://periodicos.set.edu.br/saude/article/view/11350
10.17564/2316-3798.2023v9n2p232-244
url https://periodicos.set.edu.br/saude/article/view/11350
identifier_str_mv 10.17564/2316-3798.2023v9n2p232-244
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://periodicos.set.edu.br/saude/article/view/11350/5332
dc.rights.driver.fl_str_mv Copyright (c) 2023 Interfaces Científicas - Saúde e Ambiente
https://creativecommons.org/licenses/by-nc/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 Interfaces Científicas - Saúde e Ambiente
https://creativecommons.org/licenses/by-nc/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Editora Universitária Tiradentes
publisher.none.fl_str_mv Editora Universitária Tiradentes
dc.source.none.fl_str_mv Interfaces Científicas - Saúde e Ambiente; v. 9 n. 2 (2023): Fluxo Contínuo; 232-244
2316-3798
2316-3313
10.17564/2316-3798.2023v9n2
reponame:Interfaces Científicas. Saúde e Ambiente (Online)
instname:Universidade Tiradentes (UNIT)
instacron:UNIT
instname_str Universidade Tiradentes (UNIT)
instacron_str UNIT
institution UNIT
reponame_str Interfaces Científicas. Saúde e Ambiente (Online)
collection Interfaces Científicas. Saúde e Ambiente (Online)
repository.name.fl_str_mv Interfaces Científicas. Saúde e Ambiente (Online) - Universidade Tiradentes (UNIT)
repository.mail.fl_str_mv ||crismporto@gmail.com||interfaces_saude_editor@yahoo.com.br
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