Figures
- FIGURE 1
Study process. UTM: universal transport medium; RSV: respiratory syncytial virus.
- FIGURE 2
Testing process and results. RSV: respiratory syncytial virus.
Tables
- TABLE 1
Participant demographics
All sites (n=185) Great North Children's Hospital (n=104) Sunderland Royal Hospital (n=81) Age months Mean (standard deviation) 5.7 (5.4) 5.8 (5.5) 5.7 (5.4) Median (IQR) 4 (1–9.5) 4 (1–10.75) 4 (2–9) Length of stay hours Mean (standard deviation) 146.2 (486.5) 215.3 (640.7) 57.8 (52.6) Median (IQR) 63.3 (34.4–133.3) 90.8 (51.0–184.3) 45.6 (22.1–68.1) Admission diagnosis Bronchiolitis 126 (68.1%) 64 (61.5%) 62 (76.5%) Lower respiratory tract infection 17 (9.2%) 15 (14.4%) 2 (2.5%) Viral-induced wheeze 14 (7.6%) 7 (6.7%) 7 (8.6%) Viral illness 5 (2.7%) 5 (4.8%) 0 (0.0%) Other 23 (12.4%) 13 (12.5%) 10 (12.3%) Antibiotic prescription Yes, before laboratory result available 73 (39.5%) 47 (45.2%) 26 (32.1%) Yes, after laboratory result available 2 (1.1%) 1 (1.0%) 1 (1.2%) No 109 (58.9%) 55 (52.9%) 54 (66.7%) Not recorded 1 (0.5%) 1 (1.0%) 0 (0%) Antiviral prescription Yes, before laboratory result available 2 (1.1%) 1 (1.0%) 1 (1.2%) Yes, after laboratory result available 0 (0.0%) 0 (0.0%) 0 (0.0%) No 183 (98.9%) 103 (99.0%) 80 (98.8%) Discharge diagnosis Bronchiolitis 115 (62.1%) 65 (62.5%) 50 (61.7%) Lower respiratory tract infection 29 (15.6%) 20 (19.2%) 9 (11.1%) Viral-induced wheeze 9 (4.9%) 3 (2.9%) 6 (7.4%) Viral illness 17 (9.7%) 8 (7.7%) 9 (11.1%) Not recorded 5 (2.3%) 5 (4.8%) 0 (0.0%) Other 10 (5.4%) 3 (2.9%) 7 (9%) Data are presented as n (% of total recorded), unless otherwise stated; IQR: interquartile range.
- TABLE 2
Diagnostic performance for respiratory syncytial virus (RSV) detection. Initial, or if necessary repeat, cobas® Liat® test, no discrepancy analysis
Laboratory PCR RSV result Positive Negative cobas® Liat® RSV result Test positive 90 4 94 Test negative 1 66 67 91 70 161 - TABLE 3
Diagnostic performance for respiratory syncytial virus (RSV) detection. Initial, or if necessary repeat, cobas® Liat® test, after discrepancy analysis
Laboratory PCR RSV result Positive Negative cobas® Liat® RSV result Test positive 92 1 93 Test negative 0 67 67 92 68 160 - TABLE 4
Concordance for influenza A. Initial, or if necessary repeat, cobas® Liat® test, no discrepancy analysis
Laboratory PCR influenza A result Positive Negative cobas® Liat® influenza A result Test positive 6 1 7 Test negative 0 153 153 6 154 160 - TABLE 5
Concordance for influenza B. Initial, or if necessary repeat, cobas® Liat® test, no discrepancy analysis
Laboratory PCR influenza B result Positive Negative cobas® Liat® influenza B result Test positive 0 1 1 Test negative 0 159 159 0 160 160 - TABLE 6
Time and cost analysis of the standard testing and point-of-care (POC) testing strategies for a cohort of 1000 patients, <2 years old, presenting to UK National Health Service (NHS) paediatric departments with acute viral respiratory infection symptoms
Standard testing strategy POC testing strategy Incremental difference (standard strategy – POC testing strategy) POC informing use of isolation facilities Time to result (days) 1.24 0.15 1.09 Time in single room isolation (days) 1.62 1.15 0.47 Time in general bed (days) 0.28 0.75 −0.47 Cost of bed days £1 068 400.00 £1 020 000.00 £48 400.00 Cost of barrier nursing £38 310.00 £29 700.00 £8610.00 Treatment costs £440.00 £440.00 £0.00 Total costs £1 107 150.00 £1 050 140.00 £57 010.00 POC informing cohort nursing of respiratory syncytial virus (RSV) positive patients Cost of bed days £1 068 400.00 £924 238.74 £144 161.26 Cost of barrier nursing £38 310.00 £30 613.40 £7696.60 Treatment costs £440.00 £440.00 £0.00 Total costs £1 107 150.00 £955 292.14 £151 857.86 Results are presented for two different strategies: 1) when the POC test informs the use of isolation facilities and 2) when the POC test informs cohort nursing of RSV positive patients. Costs are in GBP.
Supplementary Material
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Supplementary material 00018-2020.supp
