How Rapid RSV Testing Shapes Clinical Decisions and Patient Outcomes

New study findings presented at IDWeek 2025, which took place from October 19 to 22, 2025, in Atlanta, Georgia, explored how the expansion of multiplex respiratory virus testing during the COVID-19 pandemic influenced clinical practices in community hospital settings. In a quantitative analysis, researchers examined the detection of RSV cases that previously may have gone unnoticed, highlighting how broader diagnostic capabilities can shape decision-making and patient management in real-world clinical environments.¹

Diagnostic Approaches for Detecting RSV

Symptoms of RSV commonly overlap with other viral respiratory infections and bacterial infections, making it difficult to diagnose without a laboratory test. These symptoms include runny nose, cough, sneezing, and fever, which could present as a common cold with mild symptoms.²

Before the COVID-19 pandemic, testing for respiratory viruses other than influenza was uncommon in immunocompetent adults and had limited impact on clinical care. With the pandemic came a widespread of rapid, in-house, and point-of-care platforms that tested for SARS-CoV-2, influenza A and B, and RSV.1

According to the CDC, several types of tests are available to confirm RSV infections that could be performed on the upper and lower respiratory specimens. The main laboratory methods for diagnosing RSV are nucleic acid amplification tests (NAATs), including real-time reverse transcription-polymerase chain reaction (rRT-PCR), and antigen detection tests. NAATs are highly sensitive, while antigen tests offer faster but less sensitive results. Some tests can distinguish between RSV subtypes A and B, though the clinical relevance of this distinction is unclear.³

The CDC recommends health care providers consult laboratory experts to determine the most appropriate specimen type, to interpret results accurately, and to understand the performance of the chosen test.³

How Did Incidental RSV Detection Influence Clinical Decision-Making in a Community Hospital?

In the study, researchers assessed how incidental RSV detection from COVID-19 testing influenced clinical decisions in a community teaching hospital that lacked RSV-specific protocols. A total of 1694 positive RSV cases from January 2023 to March 2025 were included in the quantitative analysis and in-depth chart review, which were tested using the Cepheid GeneXpert multiplex PCR platform. The testing technology provides PCR results in less than 1 hour for COVID-19, influenza, and RSV with minimal hands-on time and walk-away capabilities.^1,4

The study identified 155 RSV cases, along with influenza A, influenza B, and SARS-CoV-2 infections, including 21 coinfections. Researchers analyzed ICU admissions, mortality, and clinical responses to RSV results, with a focus on provider acknowledgment, antibiotic adjustments, isolation changes, and discharge decisions.¹

The results demonstrated that care was influenced among individuals who received a positive RSV test. Specifically, 82% of patients had provider acknowledgement of the result, and for 70% of patients, the positive test resulted in stopping or avoiding antibiotics. Among RSV-tested patients in the emergency department, 39% were discharged after receiving results, ICU admissions were low at 5%, and mortality was rare. The median test turnaround time was over an hour.¹

The findings suggest that rapid PCR detection of RSV influenced clinical management by reducing unnecessary imaging and consultations. Overall, integrating RSV testing into COVID-19 screening improved antimicrobial stewardship, discharge efficiency, and provider confidence. The study authors noted that this demonstrated a clear clinical value even without RSV-specific treatments.¹

REFERENCES

1. Arora S, Colgrove R. Effects of RSV Testing in a Community Hospital Setting: Quantitative and Narrative Analysis. Presented at: IDWeek 2025; October 21, 2025; Atlanta, GA. Accessed November 4, 2025, via IDWeek’s online conference platform.

2. Mayo Clinic. RSV. News release. October 4, 2023. Accessed November 4, 2025. https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

3. Diagnostic Testing for RSV. CDC. News release. August 30, 2024. Accessed November 4, 2025. https://www.cdc.gov/rsv/hcp/clinical-overview/diagnostic-testing.html

4. Cepheid-Gene-Xpert-System-Brochure-10-color-US-IVD-0112. Cepheid. Accessed November 4, 2025. https://www.afmssc.com/images/AFMS/Documents_pdfs/Cepheid-Gene-Xpert-System-Brochure-10-color-US-IVD-0112-English-HIR.pdf