Diagnostic accuracy of a rapid antigen triple test (SARS-CoV-2, respiratory syncytial virus, and influenza) using anterior nasal swabs versus multiplex RT-PCR in children in an emergency department

Salim Ferrani; Thierry Prazuck; Stéphane Béchet; Fabien Lesne; Robert Cohen; Corinne Levy

doi:10.1016/j.idnow.2023.104769

Diagnostic accuracy of a rapid antigen triple test (SARS-CoV-2, respiratory syncytial virus, and influenza) using anterior nasal swabs versus multiplex RT-PCR in children in an emergency department

Infect Dis Now. 2023 Oct;53(7):104769. doi: 10.1016/j.idnow.2023.104769. Epub 2023 Aug 10.

Authors

Salim Ferrani¹, Thierry Prazuck², Stéphane Béchet³, Fabien Lesne⁴, Robert Cohen⁵, Corinne Levy⁶

Affiliations

¹ Service de pédiatrie, CHR Orleans Orleans, France.
² Service des maladies infectieuses, CHR Orleans, France.
³ ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.
⁴ Département de biologie, CHR Orleans, Orleans, France.
⁵ ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, France; AFPA, Association Française de Pédiatrie Ambulatoire, Paris, France; Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, France; GEMINI, Groupe de Recherche Clinique-Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Créteil, France.
⁶ ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, France; AFPA, Association Française de Pédiatrie Ambulatoire, Paris, France; Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, France; GEMINI, Groupe de Recherche Clinique-Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Créteil, France. Electronic address: [email protected].

PMID: 37572988
DOI: 10.1016/j.idnow.2023.104769

Abstract

Background: In children, respiratory infections such as SARS-CoV-2, respiratory syncytial virus (RSV), and influenza share similar clinical signs and symptoms. Here we compared the performance of a rapid antigen diagnostic test using a self-collected anterior nasal swab (COVID-VIRO ALL IN TRIPLEX) and multiplex RT-PCR.

Methods: From October to December 2022, in the emergency pediatrics unit of Orleans Hospital, France, we evaluated the diagnostic accuracy of the triplex test.

Results: For the 263 children, sensitivity of the test was 88.9% (95%CI 51.8-99.7), 79.1% (95%CI 64.0-90.0), and 91.6% (95%CI 84.1-96.3), for SARS-CoV-2, RSV, and influenza, respectively. Specificity was 100% for each virus. For RT-PCR with cycle threshold < 32, sensitivity was 100.0% [95%CI 59.0-100.0], 87.2% [95%CI 72.6-95.7] and 92.3% [95%CI 84.896.9] for SARS-CoV-2, RSV, and influenza respectively.

Conclusions: This easy-to-perform triplex test is a considerable advance, allowing clinicians to obtain an accurate diagnosis in most cases of respiratory infection. More data are needed to validate this test in different contexts and across several seasons.

Keywords: Children; Influenza; Rapid antigen test; Respiratory syncytial virus; SARS-CoV-2.

MeSH terms

COVID-19 Testing
COVID-19* / diagnosis
Child
Humans
Influenza, Human* / diagnosis
Respiratory Syncytial Virus, Human* / genetics
Respiratory Tract Infections*
Reverse Transcriptase Polymerase Chain Reaction
SARS-CoV-2
Sensitivity and Specificity