Evaluation of Influenza A Virus Nucleic Acid Point-of-Care Testing (POCT) Platforms and Their Clinical Impact on Oseltamivir Treatment Initiation Timing

Objective : To evaluate the diagnostic accuracy, clinical utility, and operational efficiency of nucleic acid Point-of-Care Testing (POCT) compared to Colloidal Gold Immunoassay (CGIA) and Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR) in the management of influenza. Method : A retrospective study was conducted on 247 patients with respiratory symptoms. The diagnostic performance (sensitivity, specificity, positive predictive value, and negative predictive value), treatment timelines (oseltamivir initiation/symptom resolution time), and cost-effectiveness of four detection methods (Ustar nucleic POCT, Cepheid Xpert nucleic POCT, CGIA for influenza A virus antigen, and RT-qPCR) were analyzed. Multivariate regression analysis was performed to identify predictive factors for timely treatment initiation (≤24 hours). Results : Compared to CGIA (sensitivity 68.0%, specificity 92.6%), the POCT methods demonstrated superior sensitivity (Ustar 92.0%, Cepheid 94.0%), specificity (Ustar 95.3%, Cepheid 96.7%), positive predictive value, and negative predictive value. Treatment initiation guided by POCT results was significantly faster (median 11-12 hours vs. CGIA 24 hours / RT-qPCR 28 hours, P=0.00), leading to markedly shorter symptom resolution times (fever: 24 hours vs. CGIA 36 hours / RT-qPCR 48 hours; cough: 48 hours vs. CGIA 72 hours / RT-qPCR 80 hours, P=0.00). The application of POCT (OR=3.85, P=0.00) and pediatric patient status (OR=2.13, P=0.03) were identified as significant independent predictors of timely treatment. POCT provided results within 30-32 min,representing an optimal balance between speed, accuracy. Conclusion : Nucleic acid POCT enables rapid and accurate diagnosis within 30 minutes, facilitates earlier antiviral treatment initiation, demonstrates significant benefits particularly in the pediatric population, and optimizes the overall influenza clinical management pathway.