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. 2023 Dec 7;11(1):ofad617.
doi: 10.1093/ofid/ofad617. eCollection 2024 Jan.

Use of Rapid Antigen Triple Test Nasal Swabs (COVID-VIRO ALL-IN TRIPLEX: Severe Acute Respiratory Syndrome Coronavirus 2, Respiratory Syncytial Virus, and Influenza) in Children With Respiratory Symptoms: A Real-life Prospective Study

Robert Cohen  1   2   3   4   5 , Hervé Haas  5   6 , Olivier Romain  5 , Stéphane Béchet  1   4 , Catherine Romain  5 , Camille de Truchis de Lays  5   7 , Alain Wollner  1   4 , Cécile Guiheneuf  4 , Loic de Pontual  5   7 , Corinne Levy  1   2   3   4   5
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Use of Rapid Antigen Triple Test Nasal Swabs (COVID-VIRO ALL-IN TRIPLEX: Severe Acute Respiratory Syndrome Coronavirus 2, Respiratory Syncytial Virus, and Influenza) in Children With Respiratory Symptoms: A Real-life Prospective Study

Robert Cohen et al. Open Forum Infect Dis. .

Abstract

Background: In autumn 2022, the epidemics due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), and influenza overlapped, and these diseases can present with the same symptomatology. The use of a triple antigen test (SARS-CoV-2 + influenza A/B + RSV) seems crucial for accurate viral diagnosis in the context of implementing long-acting monoclonal antibody vaccination against RSV in the upcoming RSV season.

Methods: We assessed the usefulness of the triple test in real life in this prospective study performed from October 2022 to May 2023 and involving 116 pediatricians (2 emergency department pediatricians and 114 ambulatory pediatricians). Children <15 years old with flu-like illness (with fever), bronchiolitis (dyspnea ± wheezing), otitis, and croup were enrolled and sampled with a nasal triple test.

Results: For 8329 children with flu-like illness (65.3%), bronchiolitis (17.9%), otitis (8.8%), and croup (6.3%), the use of the triple test led to a viral diagnosis in 47.9% of cases. The highest RSV positivity occurred in children with bronchiolitis (32.9%). The highest influenza A and B positivity (24.6% and 19.6%) occurred in children with flu-like illness. A succession of 3 epidemics (RSV and influenza A and B) occurred over time with several overlap periods.

Conclusions: The triple test allowed for a viral diagnosis in half of our cases. The upcoming introduction of RSV prevention will emphasize the need for active surveillance with viral results both in ambulatory settings and hospitals. Clinical Trials Registration. NCT0441231.

Keywords: RSV; children; influenza; rapid antigen test; respiratory tract infection.

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Conflict of interest statement

Potential conflicts of interest. R. C. reports personal fees and nonfinancial support from Pfizer and personal fees from GSK, Merck, Pfizer, and Sanofi, outside the submitted work. C. L. reports personal fees and nonfinancial support from Pfizer and personal fees from MSD, outside the submitted work. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Number of tests and positivity (+) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), and influenza A and B during the study period for overall respiratory symptoms.
See this image and copyright information in PMC

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