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Kang VJW, Huang YS, Chen MC, Chiang PY, Sheng WH, Wang HC, Wang TC, Chang YC. CT findings of 144 in-hospital patients with influenza pneumonia: A retrospective analysis. J Formos Med Assoc 2024; 123:381-389. [PMID: 37640653 DOI: 10.1016/j.jfma.2023.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/08/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND/PURPOSE Patients with influenza infection during their period of admission may have worse computed tomography (CT) manifestation according to the clinical status. This study aimed to evaluate the CT findings of in-hospital patients due to clinically significant influenza pneumonia with correlation of clinical presentations. METHODS In this retrospective, single center case series, 144 patients were included. All in-hospital patients were confirmed influenza infection and underwent CT scan. These patients were divided into three groups according to the clinical status of the most significant management: (1) without endotracheal tube and mechanical ventilator (ETTMV) or extracorporeal membrane oxygenation (ECMO); (2) with ETTMV; (3) with ETTMV and ECMO. Pulmonary opacities were scored according to extent. Spearman rank correlation analysis was used to evaluate the correlation between clinical parameters and CT scores. RESULTS The predominant CT manifestation of influenza infection was mixed ground-glass opacity (GGO) and consolidation with both lung involvement. The CT scores were all reach significant difference among all three groups (8.73 ± 6.29 vs 12.49 ± 6.69 vs 18.94 ± 4.57, p < 0.05). The chest CT score was correlated with age, mortality, and intensive care unit (ICU) days (all p values were less than 0.05). In addition, the CT score was correlated with peak lactate dehydrogenase (LDH) level and peak C-reactive protein (CRP) level (all p values were less than 0.05). Concomitant bacterial infection had higher CT score than primary influenza pneumonia (13.02 ± 7.27 vs 8.95 ± 5.99, p < 0.05). CONCLUSION Thin-section chest CT scores correlated with clinical and laboratory parameters in in-hospital patients with influenza pneumonia.
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Affiliation(s)
| | - Yu-Sen Huang
- Department of Medical Imaging, National Taiwan University, Taipei, Taiwan.
| | - Mei-Chi Chen
- Department of Medical Imaging, National Taiwan University, Taipei, Taiwan.
| | - Pin-Yi Chiang
- Department of Medical Imaging, National Taiwan University, Taipei, Taiwan.
| | - Wang-Huei Sheng
- Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University College of Medicine, Taiwan.
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University College of Medicine, Taiwan; Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Teh-Chen Wang
- Department Medical Imaging, Taipei City Hospital Yang-Ming Branch, Taipei, Taiwan.
| | - Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University, Taipei, Taiwan; Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan.
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Phetcharakupt V, Pasomsub E, Kiertiburanakul S. Clinical manifestations of influenza and performance of rapid influenza diagnostic test: A university hospital setting. Health Sci Rep 2021; 4:e408. [PMID: 34622032 PMCID: PMC8485631 DOI: 10.1002/hsr2.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Rapid influenza diagnostic test (RIDT) is a diagnostic tool that detects the influenza virus nucleoprotein antigen. The RIDT is widely used in clinical practice because it is simple and cost-effective, and provides results within 10-15 minutes. OBJECTIVE We aimed at evaluating the sensitivity and specificity of the Sofia® RIDT compared with the Luminex® multiplex polymerase chain reaction (PCR). The other goal was to determine the predicting factors for diagnosing influenza among individuals with influenza-like illness (ILI). METHOD Patients with ILI who had the results of both tests were retrospectively reviewed. We determined the performances of the RIDT. RESULTS A total of 473 patients were included with a median age of 58 (interquartile range 41-74) years. Of these, 47.1% were male, and 16.2% were diagnosed with influenza by the RIDT or RT-PCR's positive test. For influenza A, the RIDT showed a sensitivity of 76.3% (95% confidence interval [CI] 59.8-88.6) and a specificity of 97.9% (95% CI 96.1-99.0), whereas for influenza B, it showed a sensitivity of 47.1% (95% CI 23.0-72.2) and a specificity of 97.1% (95% CI 95.2-98.5). Patients with influenza were more likely to present with fever (81.8% vs 63.1%), cough (81.8% vs 66.1%), and rhinorrhea (41.6% vs 26.5%) compared to those without influenza (P < 0.05, all), and had a higher proportion of pneumonia (19.5% vs 10.6%, P = 0.029) and acute respiratory distress syndrome (5.2% vs 1.5%, P = 0.063). The predicting factors for influenza among patients presented with ILI were cough (odds ratio [OR] 2.77; 95% CI 0.21-0.81, P = 0.010), rhinorrhea (OR 1.87; 95% CI 1.03-3.36, P = 0.037), and higher body temperature (OR 1.64; 95% CI 1.23-2.19, P = 0.001). CONCLUSIONS The sensitivity of the RIDT for the diagnosis of influenza is fair in contrast to the specificity. Among patients with ILI, cough, rhinorrhea, and higher body temperature might be factors for predicting influenza.
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Affiliation(s)
- Varistha Phetcharakupt
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Ekawat Pasomsub
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand
| | - Sasisopin Kiertiburanakul
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand
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Lee J, Song JU, Kim YH. Diagnostic Accuracy of the Quidel Sofia Rapid Influenza Fluorescent Immunoassay in Patients with Influenza-like Illness: A Systematic Review and Meta-analysis. Tuberc Respir Dis (Seoul) 2021; 84:226-236. [PMID: 33979987 PMCID: PMC8273023 DOI: 10.4046/trd.2021.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Although the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) is widely used to identify influenza A and B, the diagnostic accuracy of this test remains unclear. Thus, the objective of this study was to determine the diagnostic performance of this test compared to reverse transcriptase-polymerase chain reaction. Methods A systematic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and a hierarchical summary receiver-operating characteristic curve (HSROC) of this test for identifying influenza A and B were determined using meta-analysis. A sensitivity subgroup analysis was performed to identify potential sources of heterogeneity within selected studies. Results We identified 17 studies involving 8,334 patients. Pooled sensitivity, specificity, and DOR of the Quidel Sofia rapid influenza FIA for identifying influenza A were 0.78 (95% confidence interval [CI], 0.71–0.83), 0.99 (95% CI, 0.98–0.99), and 251.26 (95% CI, 139.39–452.89), respectively. Pooled sensitivity, specificity, and DOR of this test for identifying influenza B were 0.72 (95% CI, 0.60–0.82), 0.98 (95% CI, 0.96–0.99), and 140.20 (95% CI, 55.92–351.54), respectively. The area under the HSROC for this test for identifying influenza A was similar to that for identifying influenza B. Age was considered a probable source of heterogeneity. Conclusion Pooled sensitivities of the Quidel Sofia rapid influenza FIA for identifying influenza A and B did not quite meet the target level (≥80%). Thus, caution is needed when interpreting data of this study due to substantial between-study heterogeneity.
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Affiliation(s)
- Jonghoo Lee
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Jae-Uk Song
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yee Hyung Kim
- Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea
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KARALI E, SEBİT T, ARSLAN N. Akut Solunum Yolu Enfeksiyonu Olan Hastalarda Hızlı İnfluenza Tanı Testi ile İnfluenza A ve B Antijenlerinin Araştırılması. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.755738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Li W, Liu L, Chen L, Shang S. Evaluation of a Commercial Colloidal Gold Assay for Detection of Influenza A and B Virus in Children's Respiratory Specimens. Fetal Pediatr Pathol 2020; 39:93-98. [PMID: 31304835 DOI: 10.1080/15513815.2019.1639088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To evaluate the clinical diagnostic value of colloidal gold assay for detection of influenza A and B virus. Methods: Results were compared for colloidal gold assay for influenza antigen detection and real-time RT-PCR for RNA detection. Results: By performing the colloidal gold assay, the positive rate was 25.67% (105/409) for influenza A virus and 8.56% (35/409) for influenza B virus. While tested by real-time RT-PCR, 107(26.2%) were positive for influenza A virus and 35(8.6%) for influenza B virus. Using real-time RT-PCR as the gold standard, the sensitivity and specificity of the colloidal gold assay were 84.1% and 95.0%, respectively, for influenza A virus and 85.7% and 98.7% for influenza B virus. Conclusion: This colloidal gold assay may be one of the viable tools for the rapid screening for influenza viruses in an outpatient clinical practice.
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Affiliation(s)
- Wei Li
- Clinical Laboratory, Zhejiang University School of Medicine Children's Hospital, Hangzhou, China
| | - Lifang Liu
- Zhejiang University School of Medicine Children's Hospital, Hangzhou, China
| | - Luyan Chen
- Zhejiang University School of Medicine Children's Hospital, Hangzhou, China
| | - Shiqiang Shang
- Zhejiang University School of Medicine Children's Hospital, Hangzhou, China
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Yoo SJ, Shim HS, Yoon S, Moon HW. Evaluation of high-throughput digital lateral flow immunoassays for the detection of influenza A/B viruses from clinical swab samples. J Med Virol 2019; 92:1040-1046. [PMID: 31696947 DOI: 10.1002/jmv.25626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/05/2019] [Indexed: 12/24/2022]
Abstract
We evaluated the performance of new high-throughput digital lateral flow immunoassays (LFIAs) detecting influenza antigens and compared them with those of the widely used digital LFIA and the rapid nucleic acid amplification test (NAAT). We tested 199 clinical nasopharyngeal (nasal) swab samples using three LFIA tests (BD Veritor Plus, STANDARD F Influenza A/B FIA, and ichroma TRIAS) and the rapid NAAT (ID NOW Influenza A & B2). Agreements and clinical performances (sensitivity and specificity) were evaluated based on the results of reverse transcriptase-polymerase chain reaction (RT-PCR) and verification panel. The agreement of each test with RT-PCR was moderate to almost perfect. The sensitivity of ID NOW was significantly higher than that of LFIAs (P = .0005, .0044, and .0026 for influenza A and P = .0044, .0026, and .0044 for influenza B, respectively). The specificities were not significantly different between the four tests (P > .05). However, the reference panel suggests that ichroma TRIAS test is more sensitive than the other two LFIA tests. All three LFIA assays performed similarly with no false positives against influenza A. For influenza B, ichroma TRIAS had 2 of 166 false positives whereas there were no false positives for the other two LFIA tests. Influenza antigen digital LFIAs have advantages in terms of the workflow when simultaneous tests are required. Rapid NAAT has higher sensitivity, while new antigen LFIAs are efficient and high-throughput. It is recommended that users select appropriate methods and algorithms according to the number of specimens and laboratory conditions in each clinical laboratory.
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Affiliation(s)
- Soo J Yoo
- Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University, Seoul, Korea
| | - Hee S Shim
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Sumi Yoon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hee-Won Moon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
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Song JY, Noh JY, Lee JS, Wie SH, Kim YK, Lee J, Jeong HW, Kim SW, Lee SH, Park KH, Choi WS, Cheong HJ, Kim WJ. Effectiveness of repeated influenza vaccination among the elderly population with high annual vaccine uptake rates during the three consecutive A/H3N2 epidemics. Vaccine 2019; 38:318-322. [PMID: 31690467 DOI: 10.1016/j.vaccine.2019.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Annually, about 80% of the Korean elderly aged ≥65 years receive influenza vaccination. Repeated annual vaccination has been suggested as an important factor of poor influenza vaccine effectiveness (VE), though reported conflicting results. METHODS During the consecutive A/H3N2-dominant influenza seasons between 2012 and 2015, we comparatively evaluated the VE (repeated vs. current season only) against laboratory-confirmed influenza, pneumonia and hospitalization in the elderly aged ≥65 years with influenza-like illness (ILI). Clinical and demographic data were collected prospectively, and vaccination status of prior and current seasons was verified using the immunization registry data of Korean Centers for Disease Control and Prevention. RESULTS During the first A/H3N2-dominant season in 2012-2013, influenza vaccine showed statistically significant effectiveness against influenza A infection only and when vaccinated in the current season only (VE 53%, 95% CI 15-77). In the latter two seasons (2013-2015 years), the adjusted VE for influenza A was indistinguishable between repeated vaccination and vaccination in the current season only. CONCLUSION During consecutive influenza A/H3N2 epidemics, poor influenza vaccine effectiveness may be more pronounced among the elderly population with a high annual vaccine uptake rate.
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Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Seong-Heon Wie
- Division of Infectious Diseases, Department of Internal Medicine, Catholic University Medical College, St. Vincent's Hospital, Suwon, South Korea
| | - Young Keun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, South Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Shin Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Sun Hee Lee
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Pusan, South Korea
| | - Kyung-Hwa Park
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea; Asian Pacific Influenza Institute (APII), Seoul, South Korea.
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