Systematic Molecular Influenza A/B Screening Upon Hospital Admission in Belgium, January–April 2022: Positivity Ratios and Viral Loads According to Symptomatology, Age, and Vaccination Status
ABSTRACT Three hospitals implemented molecular point‐of‐care tests (POCTs) to screen patients for SARS‐CoV‐2 infection upon admission during the 2021/2022 influenza season, which in Belgium lasted from January to April 2022. The samples were simultaneously tested for influenza A/B. Influenza positiv...
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| creator | Huyghe, Evelyne Abrams, Steven André, Emmanuel Anseeuw, Kurt Bernaert, Eva Bruynseels, Peggy Cuypers, Lize De Schouwer, Pieter Hilkens, Petra Keyaerts, Els Laenen, Lies Maes, Justine Magerman, Koen Van de gaer, Otto Verdonck, Ann Verstrepen, Walter Ombelet, Sien Naesens, Reinout |
| description | ABSTRACT
Three hospitals implemented molecular point‐of‐care tests (POCTs) to screen patients for SARS‐CoV‐2 infection upon admission during the 2021/2022 influenza season, which in Belgium lasted from January to April 2022. The samples were simultaneously tested for influenza A/B. Influenza positivity at admission was examined in relation to patient characteristics and symptomatology. Influenza POCTs were performed on all patients requiring urgent hospitalization, regardless of the admission reason. A total of 9327 patients were included in the study, of which 411 (4.4%) tested positive for influenza A/B. Asymptomatic infection and mild illness accounted for respectively 11.2% (95% CI: 8.5%–14.6%), and 43.3% (95% CI: 38.6%–48.1%) of the cases. A total of 66% (95% CI: 60%–72%) of all patients in these symptom categories (asymptomatic and mild illness) showed a high viral load (cycle threshold [Ct] |
| doi_str_mv | 10.1002/jmv.70167 |
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Three hospitals implemented molecular point‐of‐care tests (POCTs) to screen patients for SARS‐CoV‐2 infection upon admission during the 2021/2022 influenza season, which in Belgium lasted from January to April 2022. The samples were simultaneously tested for influenza A/B. Influenza positivity at admission was examined in relation to patient characteristics and symptomatology. Influenza POCTs were performed on all patients requiring urgent hospitalization, regardless of the admission reason. A total of 9327 patients were included in the study, of which 411 (4.4%) tested positive for influenza A/B. Asymptomatic infection and mild illness accounted for respectively 11.2% (95% CI: 8.5%–14.6%), and 43.3% (95% CI: 38.6%–48.1%) of the cases. A total of 66% (95% CI: 60%–72%) of all patients in these symptom categories (asymptomatic and mild illness) showed a high viral load (cycle threshold [Ct] < 24). Only in 30 (7.3%, 95% CI: 5.2%–10.2%) of all cases and in two (4.4%, 95% CI: 1.2%–14.5%) of the asymptomatic cases, the symptomatology worsened during hospital stay. Coinfections with both influenza and SARS‐CoV‐2 occurred in 35 patients (8.5% of all influenza positive patients). There was no difference in symptomatology between patients with co‐infections and those with an influenza mono‐infection. Patients could not be reliably categorized into carriers with low versus high viral loads based on symptomatology, age, and vaccination status. More than half of the influenza‐positive individuals were either asymptomatic or had mild symptoms upon admission, while often carrying high viral loads. Our results show that without screening of patients at hospital admission, a considerable number of patients with a high viral load may be incorrectly classified as being not infectious.</description><identifier>ISSN: 0146-6615</identifier><identifier>ISSN: 1096-9071</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.70167</identifier><identifier>PMID: 39812123</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Asymptomatic ; Asymptomatic infection ; Belgium - epidemiology ; Child ; Child, Preschool ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - virology ; epidemiology ; Female ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Illnesses ; Immunization ; Infant ; Infections ; Influenza ; Influenza A ; Influenza A virus - genetics ; Influenza A virus - isolation & purification ; Influenza B virus - genetics ; Influenza B virus - isolation & purification ; Influenza, Human - diagnosis ; Influenza, Human - epidemiology ; Influenza, Human - virology ; LIAT ; Male ; Mass Screening - methods ; Middle Aged ; Patients ; POCT ; Point-of-Care Testing ; Public health ; SARS-CoV-2 - genetics ; SARS-CoV-2 - isolation & purification ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Vaccination ; Vaccination - statistics & numerical data ; Viral diseases ; Viral Load ; Young Adult</subject><ispartof>Journal of medical virology, 2025-01, Vol.97 (1), p.e70167-n/a</ispartof><rights>2025 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2437-ea880014a19a9db0c91478bec6c2e5c2d8bd5cd3e400eebb4b7257e157ad0d8b3</cites><orcidid>0000-0001-7397-6328</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.70167$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.70167$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39812123$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huyghe, Evelyne</creatorcontrib><creatorcontrib>Abrams, Steven</creatorcontrib><creatorcontrib>André, Emmanuel</creatorcontrib><creatorcontrib>Anseeuw, Kurt</creatorcontrib><creatorcontrib>Bernaert, Eva</creatorcontrib><creatorcontrib>Bruynseels, Peggy</creatorcontrib><creatorcontrib>Cuypers, Lize</creatorcontrib><creatorcontrib>De Schouwer, Pieter</creatorcontrib><creatorcontrib>Hilkens, Petra</creatorcontrib><creatorcontrib>Keyaerts, Els</creatorcontrib><creatorcontrib>Laenen, Lies</creatorcontrib><creatorcontrib>Maes, Justine</creatorcontrib><creatorcontrib>Magerman, Koen</creatorcontrib><creatorcontrib>Van de gaer, Otto</creatorcontrib><creatorcontrib>Verdonck, Ann</creatorcontrib><creatorcontrib>Verstrepen, Walter</creatorcontrib><creatorcontrib>Ombelet, Sien</creatorcontrib><creatorcontrib>Naesens, Reinout</creatorcontrib><title>Systematic Molecular Influenza A/B Screening Upon Hospital Admission in Belgium, January–April 2022: Positivity Ratios and Viral Loads According to Symptomatology, Age, and Vaccination Status</title><title>Journal of medical virology</title><addtitle>J Med Virol</addtitle><description>ABSTRACT
Three hospitals implemented molecular point‐of‐care tests (POCTs) to screen patients for SARS‐CoV‐2 infection upon admission during the 2021/2022 influenza season, which in Belgium lasted from January to April 2022. The samples were simultaneously tested for influenza A/B. Influenza positivity at admission was examined in relation to patient characteristics and symptomatology. Influenza POCTs were performed on all patients requiring urgent hospitalization, regardless of the admission reason. A total of 9327 patients were included in the study, of which 411 (4.4%) tested positive for influenza A/B. Asymptomatic infection and mild illness accounted for respectively 11.2% (95% CI: 8.5%–14.6%), and 43.3% (95% CI: 38.6%–48.1%) of the cases. A total of 66% (95% CI: 60%–72%) of all patients in these symptom categories (asymptomatic and mild illness) showed a high viral load (cycle threshold [Ct] < 24). Only in 30 (7.3%, 95% CI: 5.2%–10.2%) of all cases and in two (4.4%, 95% CI: 1.2%–14.5%) of the asymptomatic cases, the symptomatology worsened during hospital stay. Coinfections with both influenza and SARS‐CoV‐2 occurred in 35 patients (8.5% of all influenza positive patients). There was no difference in symptomatology between patients with co‐infections and those with an influenza mono‐infection. Patients could not be reliably categorized into carriers with low versus high viral loads based on symptomatology, age, and vaccination status. More than half of the influenza‐positive individuals were either asymptomatic or had mild symptoms upon admission, while often carrying high viral loads. Our results show that without screening of patients at hospital admission, a considerable number of patients with a high viral load may be incorrectly classified as being not infectious.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Asymptomatic</subject><subject>Asymptomatic infection</subject><subject>Belgium - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - virology</subject><subject>epidemiology</subject><subject>Female</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Immunization</subject><subject>Infant</subject><subject>Infections</subject><subject>Influenza</subject><subject>Influenza A</subject><subject>Influenza A virus - genetics</subject><subject>Influenza A virus - isolation & purification</subject><subject>Influenza B virus - genetics</subject><subject>Influenza B virus - isolation & purification</subject><subject>Influenza, Human - diagnosis</subject><subject>Influenza, Human - epidemiology</subject><subject>Influenza, Human - virology</subject><subject>LIAT</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>POCT</subject><subject>Point-of-Care Testing</subject><subject>Public health</subject><subject>SARS-CoV-2 - genetics</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Vaccination</subject><subject>Vaccination - statistics & numerical data</subject><subject>Viral diseases</subject><subject>Viral Load</subject><subject>Young Adult</subject><issn>0146-6615</issn><issn>1096-9071</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1u1DAYhiMEokNhwQWQJTYgTTq28-OEXVoBbTUViKHdRo79zcgjxw62UxRW3IETcRVOgqcpLJBYWbIfP9_PmyTPCT4hGNPVvr89YZiU7EGyILgu0xoz8jBZYJKXaVmS4ih54v0eY1zVlD5OjrK6IpTQbJH83Ew-QM-DEujKahCj5g5dmK0ewXzjqFmdoo1wAEaZHboerEHn1g8qcI0a2SvvVbxSBp2C3qmxX6JLbkbupl_ffzSDUxpRTOkb9NF6FdStChP6FItZj7iR6Ea56FlbLj1qhLBOHqoEizZTPwQb27La7qYlanawnH9wIZQ5GAzaBB5G_zR5tOXaw7P78zi5fvf289l5uv7w_uKsWaeC5hlLgVcVjgvhpOa17LCoSc6qDkQpKBSCyqqThZAZ5BgDdF3eMVowIAXjEsfH7Dh5NXsHZ7-M4EMbpxegNTdgR99mpCgYxTXDEX35D7q3ozOxuwNVlXXN7qjXMyWc9d7Bto376uPqWoLbQ65tzLW9yzWyL-6NY9eD_Ev-CTICqxn4qjRM_ze1l1c3s_I3UkKvrQ</recordid><startdate>202501</startdate><enddate>202501</enddate><creator>Huyghe, Evelyne</creator><creator>Abrams, Steven</creator><creator>André, Emmanuel</creator><creator>Anseeuw, Kurt</creator><creator>Bernaert, Eva</creator><creator>Bruynseels, Peggy</creator><creator>Cuypers, Lize</creator><creator>De Schouwer, Pieter</creator><creator>Hilkens, Petra</creator><creator>Keyaerts, Els</creator><creator>Laenen, Lies</creator><creator>Maes, Justine</creator><creator>Magerman, Koen</creator><creator>Van de gaer, Otto</creator><creator>Verdonck, Ann</creator><creator>Verstrepen, Walter</creator><creator>Ombelet, Sien</creator><creator>Naesens, Reinout</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7397-6328</orcidid></search><sort><creationdate>202501</creationdate><title>Systematic Molecular Influenza A/B Screening Upon Hospital Admission in Belgium, January–April 2022: Positivity Ratios and Viral Loads According to Symptomatology, Age, and Vaccination Status</title><author>Huyghe, Evelyne ; Abrams, Steven ; André, Emmanuel ; Anseeuw, Kurt ; Bernaert, Eva ; Bruynseels, Peggy ; Cuypers, Lize ; De Schouwer, Pieter ; Hilkens, Petra ; Keyaerts, Els ; Laenen, Lies ; Maes, Justine ; Magerman, Koen ; Van de gaer, Otto ; Verdonck, Ann ; Verstrepen, Walter ; Ombelet, Sien ; Naesens, Reinout</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2437-ea880014a19a9db0c91478bec6c2e5c2d8bd5cd3e400eebb4b7257e157ad0d8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Asymptomatic</topic><topic>Asymptomatic infection</topic><topic>Belgium - 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Three hospitals implemented molecular point‐of‐care tests (POCTs) to screen patients for SARS‐CoV‐2 infection upon admission during the 2021/2022 influenza season, which in Belgium lasted from January to April 2022. The samples were simultaneously tested for influenza A/B. Influenza positivity at admission was examined in relation to patient characteristics and symptomatology. Influenza POCTs were performed on all patients requiring urgent hospitalization, regardless of the admission reason. A total of 9327 patients were included in the study, of which 411 (4.4%) tested positive for influenza A/B. Asymptomatic infection and mild illness accounted for respectively 11.2% (95% CI: 8.5%–14.6%), and 43.3% (95% CI: 38.6%–48.1%) of the cases. A total of 66% (95% CI: 60%–72%) of all patients in these symptom categories (asymptomatic and mild illness) showed a high viral load (cycle threshold [Ct] < 24). Only in 30 (7.3%, 95% CI: 5.2%–10.2%) of all cases and in two (4.4%, 95% CI: 1.2%–14.5%) of the asymptomatic cases, the symptomatology worsened during hospital stay. Coinfections with both influenza and SARS‐CoV‐2 occurred in 35 patients (8.5% of all influenza positive patients). There was no difference in symptomatology between patients with co‐infections and those with an influenza mono‐infection. Patients could not be reliably categorized into carriers with low versus high viral loads based on symptomatology, age, and vaccination status. More than half of the influenza‐positive individuals were either asymptomatic or had mild symptoms upon admission, while often carrying high viral loads. Our results show that without screening of patients at hospital admission, a considerable number of patients with a high viral load may be incorrectly classified as being not infectious.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39812123</pmid><doi>10.1002/jmv.70167</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-7397-6328</orcidid></addata></record> |
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| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Asymptomatic Asymptomatic infection Belgium - epidemiology Child Child, Preschool COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - virology epidemiology Female Hospitalization - statistics & numerical data Hospitals Humans Illnesses Immunization Infant Infections Influenza Influenza A Influenza A virus - genetics Influenza A virus - isolation & purification Influenza B virus - genetics Influenza B virus - isolation & purification Influenza, Human - diagnosis Influenza, Human - epidemiology Influenza, Human - virology LIAT Male Mass Screening - methods Middle Aged Patients POCT Point-of-Care Testing Public health SARS-CoV-2 - genetics SARS-CoV-2 - isolation & purification Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Vaccination Vaccination - statistics & numerical data Viral diseases Viral Load Young Adult |
| title | Systematic Molecular Influenza A/B Screening Upon Hospital Admission in Belgium, January–April 2022: Positivity Ratios and Viral Loads According to Symptomatology, Age, and Vaccination Status |
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