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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...

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Autores principales: 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
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
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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.
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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
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