Protecting younger patients with point-of-care respiratory molecular diagnostics

December 16, 2024
 

The onslaught of respiratory virus season brings mounting concerns over preventing serious illness in high-risk populations. Infants and young children are among the most vulnerable, with an estimated 58,000 to 80,000 children under age five hospitalized due to respiratory syncytial virus (RSV) and up to 27,000 hospitalized with influenza-related complications each year.¹

Urgent-care and emergency-department (ED) settings are an integral source of care for patients and parents looking to address illness quickly and flexibly, enabling access to providers beyond the limits of normal business hours. Acute respiratory infections represent nearly a quarter of diagnoses in urgent-care settings, but it’s not always a straightforward picture.² Symptoms of typically mild issues, such as the common cold, overlap with more serious illnesses like influenza, RSV and COVID-19. While parents are seeking clear guidance, these common symptoms can make it challenging for clinicians to confidently discern between viruses and provide that information based on observation alone. Respiratory co-infections are also more common among pediatric patients than adults, further complicating diagnosis.³

Bringing answers and results to the bedside 

Efficient and accessible point-of-care (POC) testing for pediatric respiratory infections can give parents peace of mind while arming clinicians with the information they need to determine the best course of treatment. Over the last five years, the use of respiratory pathogen panel testing has increased in pediatric ED settings.⁴ Despite this progression, traditional rapid antigen tests continue to be used and present notable limitations. For example, RSV antigen tests have shown a sensitivity of only 74% in pediatric patients.⁵ In other words, one in every four children with RSV may receive a negative result and go on to spread the virus further or experience complications. Fortunately, molecular diagnostic panels are increasingly available at the point of care and set a much higher standard for sensitivity and accuracy, while maintaining speed and efficiency.⁶ PCR tests, the gold standard for routine laboratory infectious disease diagnostics, can now deliver results in 15 to 20 minutes at the point of care.⁷ The rapid turnaround of molecular POC respiratory virus panels empowers providers to diagnose and treat patients within a single visit, without guesswork or the logistical challenges of a follow-up visit. 

The power of timely therapeutic interventions

Multiplex respiratory virus panels offer more than just efficiency in time and resources; by enabling more comprehensive assessment from a single sample rather than requiring a sample for each pathogen tested, they can limit the potentially stressful experience of repeated nasopharyngeal swabbing or nasal swabs for young children. More importantly, molecular POC diagnostics inform appropriate treatment, such as the prescription of antiviral therapies, and enable escalated intervention when it matters most. 

Because antiviral treatments for influenza are most effective when administered within the first one to two days of symptoms, rapid and accurate diagnosis and intervention are vital to reducing illness severity and preventing complications.⁷ Molecular respiratory virus panels can also play a role in supporting antibiotic stewardship efforts. Research in ambulatory-care settings suggests that, while upper respiratory infections represent the largest proportion of diagnoses resulting in antibiotic prescription, roughly 30% of antibiotic prescriptions may be unnecessary.⁸ By enabling accurate diagnosis of respiratory pathogens for more judicious antibiotic use, timely point-of-care testing can be a valuable strategy in preserving the efficacy of these essential drugs – a core pillar of global health.

As respiratory virus season approaches, parents are faced with the daunting prospect of navigating an inevitable siege of illnesses among infants and children. Many parents and patients turn to urgent-care centers and emergency departments to address acute respiratory infections but overlapping symptoms between the common cold, allergies, and more potentially risky conditions such as RSV and influenza, can complicate care decisions. By supporting accurate and sensitive diagnosis of respiratory illness, molecular POC diagnostics offer the potential to mitigate unnecessary antibiotic use, guide appropriate intervention, and offer parents greater peace of mind. While RSV and influenza present risks to young patients, molecular testing at the point of care can help connect vulnerable infants and children with the care they need.

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