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Cohen R, Haas H, Romain O, Béchet S, Romain C, de Lays CDT, Wollner A, Guiheneuf C, de Pontual L, Levy C. 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. Open Forum Infect Dis 2024; 11:ofad617. [PMID: 38173847 PMCID: PMC10764097 DOI: 10.1093/ofid/ofad617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
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.
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Affiliation(s)
- Robert Cohen
- Pediatric Department, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique, Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, Créteil, France
- Pediatric Department, Association Française de Pédiatrie Ambulatoire, Orléans, France
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Hervé Haas
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
- Service de pédiatrie, Hôpital Princesse Grace, Monaco
| | - Olivier Romain
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Stéphane Béchet
- Pediatric Department, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Pediatric Department, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - Catherine Romain
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Camille de Truchis de Lays
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
- Service de pédiatrie, Hôpital Avicenne, Assistance Publique–Hôpitaux de Paris, Bondy, France
| | - Alain Wollner
- Pediatric Department, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Pediatric Department, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - Cécile Guiheneuf
- Pediatric Department, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - Loic de Pontual
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
- Service de pédiatrie, Hôpital Avicenne, Assistance Publique–Hôpitaux de Paris, Bondy, France
| | - Corinne Levy
- Pediatric Department, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique, Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, Créteil, France
- Pediatric Department, Association Française de Pédiatrie Ambulatoire, Orléans, France
- Pediatric Department, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
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