Evidence map›Paper›PMID 40952744›Full record

ArticleJAMA network open2025

Clinical Testing for COVID-19, Influenza, and RSV in Hospitalized Youths, 2016-2024.

Ariana P Toepfer, Rachel E Rutkowski, Leila C Sahni, Geoffrey A Weinberg, Marian G Michaels, Rangaraj Selvarangan, Mary Allen Staat, Natasha Halasa, Janet A Englund, Julie A Boom and 11 more

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

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

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. 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

21 authors.

Ariana P ToepferNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Rachel E RutkowskiNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Leila C SahniTexas Children's Hospital, Houston.
Geoffrey A WeinbergDepartment of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Marian G MichaelsDepartment of Pediatrics University of Pittsburgh School of Medicine (UPMC), UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Rangaraj SelvaranganChildren's Mercy, Kansas City, Missouri.
Mary Allen StaatDepartment of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Natasha HalasaVanderbilt University Medical Center, Nashville, Tennessee.
Janet A EnglundSeattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle.
Julie A BoomTexas Children's Hospital, Houston.
Peter G SzilagyiDepartment of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Jennifer E SchusterChildren's Mercy, Kansas City, Missouri.
Elizabeth P SchlaudeckerDepartment of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Laura S StewartVanderbilt University Medical Center, Nashville, Tennessee.
Eileen J KleinSeattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle.
Samantha M OlsonNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Sascha EllingtonNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Meredith L McMorrowNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Heidi L MolineNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Fatimah S DawoodNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
New Vaccine Surveillance Network Collaborators

Funding

NCIRD CDC HHS U01 IP001049NCIRD CDC HHS U01 IP001158
6 · The paper itself

Abstract

Importance: Studies of COVID-19, influenza, and respiratory syncytial virus (RSV) disease clinical epidemiology, disease burden, and vaccine effectiveness often rely on clinical testing to identify cases, particularly with increasing use of electronic health record data. However, few data are available describing clinical testing practices to inform interpretation of these studies. Objective: To characterize clinical testing frequency for SARS-CoV-2, influenza, and RSV among children and adolescents hospitalized with acute respiratory illness during the 2016 to 2024 respiratory illness seasons by age, intensive care unit admission, and time period (2016-2020 and each season in 2020-2024); estimate the case fraction missed by clinical testing alone; and identify patient characteristics associated with clinical testing. Design, Setting, and Participants: This cross-sectional study analyzed data collected through prospective surveillance with systematic molecular testing (surveillance testing) for SARS-CoV-2, influenza viruses, and RSV among children and adolescents younger than 18 years hospitalized with acute respiratory illness at 6 US medical centers during the winter respiratory illness seasons of 2016 to 2024. In-hospital clinical molecular testing data were abstracted from the medical record. Main Outcomes and Measures: The proportion of children and adolescents with clinical molecular testing for SARS-CoV-2, influenza viruses, and RSV. Results: During 2016 to 2024, a total of 26 073 hospitalized youths were enrolled (14 459 aged <2 years [55.5%]; 14 833 male [56.9%]), including 12 090 youths during 2016 to 2020 combined. Overall, 10 450 youths (40.1%) had an underlying medical condition. The proportion of youths with clinical testing decreased for SARS-CoV-2 from 3965 of 4388 youths (90.4%) during 2020 to 2021 to 2802 of 3685 youths (76.0%) during 2023 to 2024 (P < .001). In contrast, clinical testing increased from the 2016 to 2020 seasons to the 2023 to 2024 season for influenza viruses (5384 of 12 090 youths [44.5%] to 2740 of 3685 youths [74.4%]; P < .001) and RSV (5072 youths [42.0%] to 2638 youths [71.6%]; P < .001). During the 2023 to 2024 season, the proportion of youths identified as positive for each virus by surveillance testing alone (ie, without clinical testing) was 23 of 112 youths (20.5%) for SARS-CoV-2, 78 of 286 youths (27.3%) for influenza, and 290 of 979 youths (29.6%) for RSV; youths were more likely to receive clinical testing if they were admitted to the intensive care unit (eg, SARS-CoV-2: adjusted odds ratio [aOR], 2.62; 95% CI, 2.06-3.33) or had underlying conditions (eg, any vs no underlying condition for SARS-CoV-2: aOR, 1.56; 95% CI, 1.33-1.84). Conclusions and Relevance: In this study, SARS-CoV-2 clinical testing decreased between 2020 to 2021 and 2023 to 2024 seasons, whereas influenza and RSV testing increased significantly between 2016 to 2020 and 2023 to 2024 seasons; approximately three-quarters of children and adolescents were tested for the 3 viruses in 2023 to 2024.

Indexed as

COVID-19COVID-19 TestingInfluenza, HumanRespiratory Syncytial Virus InfectionsAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleHospitalizationHumansInfantInfant, NewbornMaleProspective StudiesSARS-CoV-2

Identifiers

PMID40952744
PMCPMC12439058

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.