Point-of-care diagnostics for respiratory viral infections

Abstract

Successful treatment outcomes for viral respiratory tract infections presenting from primary health care to quaternary hospitals will only be achieved with rapid, sensitive and specific identification of pathogens to allow effective pathogen-specific antiviral therapy and infection control measures. Areas covered: This review aims to explore the different point-of-care tests currently available to diagnose viral respiratory tract infections, discuss the advantages and limitations of point-of-care testing, and provide insights into the future of point-of-care tests. The following databases were searched: Medline (January 1996 to 30 September 2017) and Embase (1988 to 30 September 2017), using the following keywords: 'point of care', 'respiratory virus', 'influenza', 'RSV', 'diagnostics', 'nucleic acid test' and 'PCR'. Expert commentary: Viral respiratory tract infections cause significant morbidity and mortality worldwide, and point-of-care tests are facilitating the rapid identification of the pathogen responsible given the similarities in clinical presentation.

Viral and atypical respiratory co‐infections in COVID‐19: a systematic review and meta‐analysis

“…Although RT‐PCR was used to detect viruses in 17 included studies, these tests have not shown a consistent level of accuracy in detecting viral pathogens. Basile et al 63 reviewed point‐of‐care diagnostic tests including RT‐PCR for respiratory infections and found that sensitivity for viral pathogens varied from 20%–94% depending on the type of test, the individual viruses analyzed, the manufacturer, and the specific technique used. Zhang et al 64 combined serology (antibody testing) with RT‐PCR to analyze the additive diagnostic yield with a combined testing approach.…”

Outcome Prediction of Higher-Risk Brief Resolved Unexplained Events

“…A positive result in an asymptomatic patient should be cautiously interpreted because it may reflect residual shedding or viral persistence. 19 The exact role of respiratory viruses in higher-risk BRUE therefore remains unclear. As we continue to develop our understanding of patients with a higher-risk BRUE, our findings align with the tiered pathway for the evaluation of a higher-risk BRUE, in which a rapid viral respiratory panel is included in the initial evaluation.…”

Current and Future Point-of-Care Tests for Emerging and New Respiratory Viruses and Future Perspectives

“…Any ideal POCT should fulfill the ASSURED criteria of the World Health Organization to be applicable in resource-limited settings (Mabey et al, 2004). Currently, this is most likely true for tests based on lateral flow immunochromatography but coming improvements e.g., in miniaturization and battery capacity may facilitate the use of other test principles (Basile et al, 2018).…”

“…In contrast to lab-based tests, point-of-care tests (POCTs) are performed at the site of sample collection (e.g., bedside, physician's office, or emergency department) and provide results usually in <2 h (Basile et al, 2018;Vos et al, 2019). Furthermore, they require only little hands-on time and no specific laboratory training as most critical steps are automated in a single device.…”