Investigation of Viral Serology in Patients Admitted to the Emergency Department with Symptoms of Upper Respiratory Tract Infection Following the COVID-19 Pandemic

Objective: Respiratory tract infections (RTIs) are a significant public health problem, especially during winter, causing increased emergency department (ED) visits and antibiotic prescriptions. Rapid and accurate identification of causative pathogens is crucial for appropriate management and infection control.
Material and Methods: This prospective, observational, single-center study included 322 adult patients presenting with symptoms of upper respiratory tract infection to a university hospital ED between October 2023 and March 2024. Nasal and oropharyngeal swab samples were collected from all participants and analyzed using multiplex RT-qPCR for 21 respiratory pathogens, including SARS-CoV-2. Demographic data, clinical features, and physicians’ initial intentions regarding antibiotic or antiviral prescriptions were recorded.
Results: At least one respiratory pathogen was detected in 68.6% of patients, with Influenza A (17.1%), COVID-19 (11.2%), and Influenza B (6.8%) being the most common. Coinfection with two pathogens was found in 6.2% of cases, most frequently involving Influenza A and RSV. Before receiving PCR results, physicians reported that they would prescribe antibiotics to 32.9% of patients.
Conclusion: These findings highlight the importance of rapid diagnostic testing in reducing unnecessary antibiotic use and provide updated epidemiological data on adult RTIs in the post-COVID-19 era.

Keywords: Antibiotic stewardship, emergency department, multiplex PCR, upper respiratory tract infection, viral pathogens