Cargando…
Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019
BACKGROUND: We aimed to examine the delay in antiviral initiation in rapid antigen test (RAT) false-negative children with influenza virus infection and to explore the clinical outcomes. We additionally conducted a medical cost-benefit analysis. METHODS: This single-center, retrospective study inclu...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Academy of Medical Sciences
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723894/ https://www.ncbi.nlm.nih.gov/pubmed/34981679 http://dx.doi.org/10.3346/jkms.2022.37.e3 |
_version_ | 1784625819349417984 |
---|---|
author | Lee, Ji Young Baek, Seung Hwan Ahn, Jong Gyun Yoon, Seo Hee Kim, Moon Kyu Kim, Soo Yeon Kim, Kyung Won Sohn, Myung Hyun Kang, Ji-Man |
author_facet | Lee, Ji Young Baek, Seung Hwan Ahn, Jong Gyun Yoon, Seo Hee Kim, Moon Kyu Kim, Soo Yeon Kim, Kyung Won Sohn, Myung Hyun Kang, Ji-Man |
author_sort | Lee, Ji Young |
collection | PubMed |
description | BACKGROUND: We aimed to examine the delay in antiviral initiation in rapid antigen test (RAT) false-negative children with influenza virus infection and to explore the clinical outcomes. We additionally conducted a medical cost-benefit analysis. METHODS: This single-center, retrospective study included children (aged < 10 years) with influenza-like illness (ILI), hospitalized after presenting to the emergency department during three influenza seasons (2016–2019). RAT-false-negativity was defined as RAT-negative and polymerase chain reaction-positive cases. The turnaround time to antiviral treatment (TAT) was from the time when RAT was prescribed to the time when the antiviral was administered. The medical cost analysis by scenarios was also performed. RESULTS: A total of 1,430 patients were included, 7.5% were RAT-positive (n = 107) and 2.4% were RAT-false-negative (n = 20). The median TAT of RAT-false-negative patients was 52.8 hours, significantly longer than that of 4 hours in RAT-positive patients (19.2–100.1, P < 0.001). In the multivariable analysis, TAT of ≥ 24 hours was associated with a risk of severe influenza infection and the need for mechanical ventilation (odds ratio [OR], 6.8, P = 0.009 and OR, 16.2, P = 0.033, respectively). The medical cost varied from $11.7–187.3/ILI patient. CONCLUSION: Antiviral initiation was delayed in RAT-false-negative patients. Our findings support the guideline that children with influenza, suspected of having severe or progressive infection, should be treated immediately. |
format | Online Article Text |
id | pubmed-8723894 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Academy of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-87238942022-01-11 Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 Lee, Ji Young Baek, Seung Hwan Ahn, Jong Gyun Yoon, Seo Hee Kim, Moon Kyu Kim, Soo Yeon Kim, Kyung Won Sohn, Myung Hyun Kang, Ji-Man J Korean Med Sci Original Article BACKGROUND: We aimed to examine the delay in antiviral initiation in rapid antigen test (RAT) false-negative children with influenza virus infection and to explore the clinical outcomes. We additionally conducted a medical cost-benefit analysis. METHODS: This single-center, retrospective study included children (aged < 10 years) with influenza-like illness (ILI), hospitalized after presenting to the emergency department during three influenza seasons (2016–2019). RAT-false-negativity was defined as RAT-negative and polymerase chain reaction-positive cases. The turnaround time to antiviral treatment (TAT) was from the time when RAT was prescribed to the time when the antiviral was administered. The medical cost analysis by scenarios was also performed. RESULTS: A total of 1,430 patients were included, 7.5% were RAT-positive (n = 107) and 2.4% were RAT-false-negative (n = 20). The median TAT of RAT-false-negative patients was 52.8 hours, significantly longer than that of 4 hours in RAT-positive patients (19.2–100.1, P < 0.001). In the multivariable analysis, TAT of ≥ 24 hours was associated with a risk of severe influenza infection and the need for mechanical ventilation (odds ratio [OR], 6.8, P = 0.009 and OR, 16.2, P = 0.033, respectively). The medical cost varied from $11.7–187.3/ILI patient. CONCLUSION: Antiviral initiation was delayed in RAT-false-negative patients. Our findings support the guideline that children with influenza, suspected of having severe or progressive infection, should be treated immediately. The Korean Academy of Medical Sciences 2021-11-30 /pmc/articles/PMC8723894/ /pubmed/34981679 http://dx.doi.org/10.3346/jkms.2022.37.e3 Text en © 2022 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Ji Young Baek, Seung Hwan Ahn, Jong Gyun Yoon, Seo Hee Kim, Moon Kyu Kim, Soo Yeon Kim, Kyung Won Sohn, Myung Hyun Kang, Ji-Man Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 |
title | Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 |
title_full | Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 |
title_fullStr | Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 |
title_full_unstemmed | Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 |
title_short | Delayed Influenza Treatment in Children With False-Negative Rapid Antigen Test: A Retrospective Single-Center Study in Korea 2016–2019 |
title_sort | delayed influenza treatment in children with false-negative rapid antigen test: a retrospective single-center study in korea 2016–2019 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723894/ https://www.ncbi.nlm.nih.gov/pubmed/34981679 http://dx.doi.org/10.3346/jkms.2022.37.e3 |
work_keys_str_mv | AT leejiyoung delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT baekseunghwan delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT ahnjonggyun delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT yoonseohee delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT kimmoonkyu delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT kimsooyeon delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT kimkyungwon delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT sohnmyunghyun delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 AT kangjiman delayedinfluenzatreatmentinchildrenwithfalsenegativerapidantigentestaretrospectivesinglecenterstudyinkorea20162019 |