Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 13;19(6):e0303560.
doi: 10.1371/journal.pone.0303560. eCollection 2024.

Clinical impact of rapid molecular diagnostic tests in patients presenting with viral respiratory symptoms: A systematic literature review

Ali Mojebi  1 , Ping Wu  1 , Sam Keeping  1 , Braden Hale  1 , Jordan G Chase  2 , Anne Beaubrun  2
Affiliations

Clinical impact of rapid molecular diagnostic tests in patients presenting with viral respiratory symptoms: A systematic literature review

Ali Mojebi et al. PLoS One. .

Abstract

Background: Molecular tests can detect lower concentrations of viral genetic material over a longer period of respiratory infection than antigen tests. Delays associated with central laboratory testing can result in hospital-acquired transmission, avoidable patient admission, and unnecessary use of antimicrobials, all which may lead to increased cost of patient management. The aim of this study was to summarize comparisons of clinical outcomes associated with rapid molecular diagnostic tests (RMDTs) versus other diagnostic tests for viral respiratory infections.

Methods: A systematic literature review (SLR) conducted in April 2023 identified studies evaluating clinical outcomes of molecular and antigen diagnostic tests for patients suspected of having respiratory viral infections.

Results: The SLR included 21 studies, of which seven and 14 compared RMDTs (conducted at points of care or at laboratories) to standard (non-rapid) molecular tests or antigen tests to detect SARS-CoV-2 and influenza, respectively. In studies testing for SARS-CoV-2, RMDTs led to reductions in time to test results versus standard molecular tests (range of the reported medians: 0.2-3.8 hours versus 4.3-35.9 hours), with similar length of emergency department stay (3.2-8 hours versus 3.7-28.8 hours). Similarly, in studies testing for influenza, RMDTs led to reductions in time to test results versus standard molecular tests (1-3.5 hours versus 18.2-29.2 hours), with similar length of emergency department stay (3.7-11 hours versus 3.8-11.9 hours). RMDTs were found to decrease exposure time of uninfected patients, rate of hospitalization, length of stay at the hospitals, and frequency of unnecessary antiviral and antibacterial therapy, while improving patient flow, compared to other tests.

Conclusions: Compared to other diagnostic tests, RMDTs improve clinical outcomes, test turnaround time, and stewardship by decreasing unnecessary use of antibiotics and antivirals. They also reduce hospital admission and length of stay, which may, in turn, reduce unnecessary exposure of patients to hospital-acquired infections and their associated costs.

PubMed Disclaimer

Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: AM and SK are employees and shareholders of PRECISIONheor, which received funding from Cepheid for this work. PW and BH are employees of PRECISIONheor, which received funding from Cepheid for this work. JGC and AB are employees and shareholders of Cepheid, which provided funding for this work.

Figures

Fig 1
Fig 1. Study selection flow diagram of the systematic literature review.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, et al.. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2018;391(10127):1285–300. doi: 10.1016/S0140-6736(17)33293-2 - DOI - PMC - PubMed
    1. World Health Organization. Global influenza strategy 2019–2030. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. 2019 [Available from: https://apps.who.int/iris/bitstream/handle/10665/311184/9789241515320-en....
    1. World Health Organization. WHO Coronavirus (COVID‐19) Dashboard [Available from: https://covid19.who.int.
    1. Nelson PP, Rath BA, Fragkou PC, Antalis E, Tsiodras S, Skevaki C. Current and Future Point-of-Care Tests for Emerging and New Respiratory Viruses and Future Perspectives. Front Cell Infect Microbiol. 2020;10:181. doi: 10.3389/fcimb.2020.00181 - DOI - PMC - PubMed
    1. Kevadiya BD, Machhi J, Herskovitz J, Oleynikov MD, Blomberg WR, Bajwa N, et al.. Diagnostics for SARS-CoV-2 infections. Nat Mater. 2021;20(5):593–605. doi: 10.1038/s41563-020-00906-z - DOI - PMC - PubMed

Publication types

MeSH terms