Viral respiratory tract infections diagnosis: a Spanish survey and consensus approach

Respiratory tract infections (RTI) rank second cause of adult and paediatric morbidity and mortality worldwide. Clinical symptoms of acute respiratory infections (ARIs) do not allow to differentiate one from another. The etiological diagnosis of viral respiratory infections has undergone changes throughout the 21st century pandemics. In Spain there is still no consensus on the use of molecular tools for the diagnosis of viral RTI.

A panel of specialists from various Spanish Scientific Societies was gathered to discuss about the application of diagnostic techniques for respiratory viruses. A Delphi panel was conducted throughout 3 rounds, respondents being asked to rate their agreement level to provide evidence-based consensus methods to enable rapid and accurate diagnosis of viral RTI.

The Delphi panel of experts reached a strong consensus that viral infections are the main cause of ARI, with Influenza, RSV, and SARS-CoV-2 identified as the most significant pathogens. These viruses are also the leading cause of ARI-related complications in vulnerable patients with risk factors for severe disease. In hospital settings, all symptomatic ARI patients should undergo rapid PCR testing for these three viruses, a measure of critical importance for immunocompromised individuals, the very elderly, and those with comorbidities that may worsen clinical outcomes.

Experts main concern was directed towards the need to inform and familiarize non-specialists about the relevance of specific viral diagnosis result of this diagnostic approach would be the reduction of antibiotic use for hospital and primary health providers.