Point-of-Care Nucleic Acid Amplification Tests for Respiratory Syncytial Virus Detection in Children and Adults: A...

Rapid point-of-care (PoC) nucleic acid amplification tests (NAATs), including reverse-transcriptase polymerase chain reaction (RT-PCR), provide timely detection of respiratory syncytial virus (RSV) closer to patient care. We conducted a systematic review to summarize the characteristics and performance of PoC NAATs for RSV in comparison to standard laboratory RT-PCR diagnostics.

We systematically searched Embase, MEDLINE, and gray literature (2018-2024) for studies evaluating PoC RT-PCR and other NAATs for RSV, without language restrictions. Eligible studies were identified, and data on test characteristics and performance were extracted (PROSPERO-CRD42024611164).

Of 3939 articles identified, 74 studies were included, evaluating 39 distinct PoC assays, comprising 18 RT-PCR-based platforms and 21 other NAAT methods (e.g., loop-mediated isothermal amplification). Only 8% of studies were conducted exclusively in adults and 18% in children, while 37% included both age groups; age was not specified in the rest. Most studies originated from the Western Pacific region (n = 29, 39%), Europe (n = 22, 30%), and the Americas (n = 19, 26%). Compared to laboratory-based RT-PCR, PoC NAATs had high specificity (median 100% in all age groups) but variable sensitivity. Median sensitivities were 96% (range 73-100%) in children, 91% (63-100%) in adults, and 99% (67-100%) in mixed-age groups.

PoC RSV NAATs offer high specificity, with a modest sensitivity reduction compared with laboratory RT-PCR (notably in adult populations). Wider availability of reliable, affordable PoC testing could facilitate rapid and accurate RSV diagnosis, improve disease surveillance and patient management, and guide public health interventions such as vaccination.