Evidence map›Paper›PMID 36991360›Full record

Observational studyBMC infectious diseases2023

Factors associated with viral RNA shedding and evaluation of potential viral infectivity at returning to school in influenza outpatients after treatment with baloxavir marboxil and neuraminidase inhibitors during 2013/2014-2019/2020 seasons in Japan: an observational study.

Jiaming Li, Keita Wagatsuma, Yuyang Sun, Isamu Sato, Takashi Kawashima, Tadashi Saito, Yasushi Shimada, Yasuhiko Ono, Fujio Kakuya, Nobuo Nagata and 10 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 4 institutions in 1 country.

Jiaming LiDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan. lijiaming@med.niigata-u.ac.jp.
Keita WagatsumaDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan.
Yuyang SunDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan.
Isamu SatoYoiko Pediatric Clinic, Niigata, Japan.
Takashi KawashimaKawashima Internal Medicine Clinic, Gunma, Japan.
Tadashi SaitoTako Central Hospital, Chiba, Japan.
Yasushi ShimadaShimada Children's Clinic, Kumamoto, Japan.
Yasuhiko OnoOno Pediatric Clinic, Nagasaki, Japan.
Fujio KakuyaFurano Kyokai Hospital, Hokkaido, Japan.
Nobuo NagataHiraoka-Kouen Pediatric Clinic, Hokkaido, Japan.
Michiyoshi MinatoMinato Pediatric Clinic, Tokyo, Japan.
Naoki KodoKodo Pediatric Clinic, Kyoto, Japan.
Eitaro SuzukiSuzuki Pediatric Clinic, Yamaguchi, Japan.
Akito KitanoKitano Pediatric Clinic, Kumamoto, Japan.
Toshihiro TanakaShizuoka Welfare Hospital, Shizuoka, Japan.
Satoshi AokiAoki Pediatric Clinic, Nara, Japan.
Irina ChonDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan.
Wint Wint PhyuDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan.
Hisami WatanabeDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan.
Reiko SaitoDivision of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, 951-8510, Japan.
Niigata University · JPMinamiaoyama Eye Clinic · JPOno Clinic · JPSuzuki (Japan) · JP

Funding

Community Medical Research Grant by the Niigata City Medical Association GC03220213Grants-in-Aid for Scientific Research (KAKENHI) 22J23183Health and Labor Sciences Research Grants, Ministry of Health, Labor and Welfare, Japan H30-Shinkougyousei-Shitei-002, H30-Shinkougyousei-Shitei-004Japan Initiative for Global Research Network on Infectious Diseases 15fm0108009h0001-21wm0125005h0002KAKENHI 21K10414Tsukada Medical Research Grant grant number not available
6 · The paper itself

Abstract

backgroundThis study assessed the differences in daily virus reduction and the residual infectivity after the recommended home stay period in Japan in patients infected with influenza and treated with baloxavir (BA), laninamivir (LA), oseltamivir (OS), and zanamivir (ZA).

methodsWe conducted an observational study on children and adults at 13 outpatient clinics in 11 prefectures in Japan during seven influenza seasons from 2013/2014 to 2019/2020. Virus samples were collected twice from influenza rapid test-positive patients at the first and second visit 4-5 days after the start of treatment. The viral RNA shedding was quantified using quantitative RT-PCR. Neuraminidase (NA) and polymerase acidic (PA) variant viruses that reduce susceptibility to NA inhibitors and BA, respectively, were screened using RT-PCR and genetic sequencing. Daily estimated viral reduction was evaluated using univariate and multivariate analyses for the factors such as age, treatment, vaccination status, or the emergence of PA or NA variants. The potential infectivity of the viral RNA shedding at the second visit samples was determined using the Receiver Operator Curve based on the positivity of virus isolation.

resultsAmong 518 patients, 465 (80.0%) and 116 (20.0%) were infected with influenza A (189 with BA, 58 with LA, 181 with OS, 37 with ZA) and influenza B (39 with BA, 10 with LA, 52 with OS, 15 with ZA). The emergence of 21 PA variants in influenza A was detected after BA treatment, but NA variants were not detected after NAIs treatment. Multiple linear regression analysis showed that the daily viral RNA shedding reduction in patients was slower in the two NAIs (OS and LA) than in BA, influenza B infection, aged 0-5 years, or the emergence of PA variants. The residual viral RNA shedding potentially infectious was detected in approximately 10-30% of the patients aged 6-18 years after five days of onset.

conclusionsViral clearance differed by age, type of influenza, choice of treatment, and susceptibility to BA. Additionally, the recommended homestay period in Japan seemed insufficient, but reduced viral spread to some extent since most school-age patients became non-infectious after 5 days of onset.

Indexed as

Influenza, HumanAdultAntiviral AgentsChildDibenzothiepinsEnzyme InhibitorsGuanidinesHumansJapanMorpholinesNeuraminidaseOseltamivirOutpatientsPyransPyridonesRNA, ViralAntiviral AgentsbaloxavirDibenzothiepinsEnzyme InhibitorsGuanidineslaninamivirMorpholinesNeuraminidaseOseltamivirPyransPyridonesRNA, ViralSialic AcidsTriazinesZanamivirBaloxavir marboxilDaily viral reductionInfluenza virusNeuraminidase inhibitorViral RNA shedding

Identifiers

PMID36991360
PMCPMC10054210
OpenAlexW4361291127

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.