Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy.
Pediatric Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
Ital J Pediatr. 2022 Aug 26;48(1):155. doi: 10.1186/s13052-022-01343-1.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has been challenging health care systems and made it necessary to use rapid and cost-effective testing methods, particularly in Emergency Department (ED) settings. Rapid Antigen Diagnostic Tests (RADTs) are a valid alternative to the gold standard RT-PCR, even in pediatric populations. This retrospective observational study has been conducted on a pediatric cohort afferent to the ED of the San Giovanni di Dio and Ruggi d'Aragona University Hospital in Salerno, tested at Point of Care with RADT Panbio® (Abbott), from September 1, 2021 to February 28, 2022, analyzing the positivity rate and clinical features of the cohort, also in reference to the rise of positive cases observed in the aforementioned period, and to the introduction in Italy of SARS-CoV-2 vaccination for children and teens on December 16, 2021.
Data regarding access to the pediatric ED were extracted from the hospital's electronic database system. Parallel to this, we conducted a narrative literature search using PubMed database focusing on the use of RADT in pediatric ED and compared our data with the national pandemic trend.
During the observation period, 1890 patients were tested for the presence of SARS-CoV-2 with RADT and the 2.7% of children resulted positive, with a peak in January 2022. The main symptoms in positive patients were: fever (n = 34; 66.7%), cough (n = 11; 21.5%), headache (n = 4; 7.8%), chest pain (n = 2; 3.9%) and abdominal pain (n = 1; 2%). Patients were divided into three different age groups (A, B, C) basing on the different access timing to vaccination; no statistically significant difference was detected in the distribution of positivity in these three groups (p > 0.05). Number of positive children in group A was greater in the post-vaccine group. Our data are concordant with the national trend of the pandemic showing a fourth wave peak in January 2022.
The use of RADT as a first point-of-care screening may be helpful, time-saving and cost-sparing. Our study shows that, during the observation period, most children admitted to the ED for fever, actually tested positive for SARS-CoV-2 with a statistically greater difference than negative children. Instead, number of patients admitted for cough was statistically higher among negative than positive ones, probably due to the circulation of other respiratory viruses in children.
严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 大流行对医疗保健系统构成了挑战，因此有必要使用快速且具有成本效益的检测方法，尤其是在急诊部 (ED) 环境中。快速抗原诊断检测 (RADT) 是 RT-PCR 金标准的有效替代方法，即使在儿科人群中也是如此。本回顾性观察性研究针对的是 2021 年 9 月 1 日至 2022 年 2 月 28 日期间在萨勒诺圣乔瓦尼迪迪奥和鲁吉德拉古纳大学医院 ED 就诊并在就诊时使用 Panbio® (雅培) RADT 进行检测的儿科患者队列，分析了队列的阳性率和临床特征，同时还参考了上述期间观察到的阳性病例增加情况，以及 2021 年 12 月 16 日意大利为儿童和青少年接种 SARS-CoV-2 疫苗的情况。
从医院的电子数据库系统中提取了有关儿科 ED 就诊的数据。与此同时，我们使用 PubMed 数据库进行了叙述性文献检索，重点关注 RADT 在儿科 ED 的使用，并将我们的数据与全国大流行趋势进行了比较。
在观察期间，1890 名患者接受了 RADT 检测以检测 SARS-CoV-2 的存在，其中 2.7%的儿童检测结果呈阳性，阳性率在 2022 年 1 月达到峰值。阳性患者的主要症状有：发热 (n=34; 66.7%)、咳嗽 (n=11; 21.5%)、头痛 (n=4; 7.8%)、胸痛 (n=2; 3.9%)和腹痛 (n=1; 2%)。根据接种疫苗的不同时间，患者被分为三个不同的年龄组 (A、B、C)；在这三组中，阳性的分布没有统计学上的显著差异 (p>0.05)。接种疫苗后，A 组中阳性儿童的数量更多。我们的数据与全国大流行趋势一致，显示 2022 年 1 月出现了第四波高峰。
将 RADT 作为一线即时检测可能有助于节省时间和成本。我们的研究表明，在观察期间，大多数因发热而就诊于 ED 的儿童实际上通过 SARS-CoV-2 检测呈阳性，与阴性儿童相比差异具有统计学意义。然而，因咳嗽就诊的患者中，阴性者比阳性者更多，这可能是因为儿童中其他呼吸道病毒的流行。
