Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population. Issue 11 (10th June 2022)

• Record Type: Journal Article
• Authors: Moraleda, Cinta; Domínguez-Rodríguez, Sara; Mesa, Juan Miguel; García-Sánchez, Paula; de la Serna, María; Alonso-Cadenas, José Antonio; Bermejo, Amanda; Sabrido, Gema; Martínez-Campos, Leticia; González-Posada, Aránzazu Flavia; Illán-Ramos, Marta; Cobos-Carrascosa, Elena; Ballesteros, Álvaro; Galán, Juan Carlos; Llorente, Francisco; Aguilera-Alonso, David; Jiménez, Ana Belén; Catalán, Pilar; Dahdouh, Elias; Navarro, Ignacio; Fernández-Garoz, Bárbara; Mendoza, Pablo; Pérez-Jorge, Concepción; Cabezas-Fernández, Teresa; Blázquez-Gamero, Daniel; Rivas, Gonzalo; Gonzalez-Donapetry, Patricia; Sáez, Elena; Fernández-Pinero, Jovita; Lucas-Fernández, Jesús; Pérez-Ramírez, Elisa; Merino, Paloma; Miragaya, Sandra; Lorente, Jorge; Iglesias, Irene; Tagarro, Alfredo;
• Is Part Of: Archives of disease in childhood. Volume 107:Issue 11(2022)
• Page Start: 1051
• Page End: 1058
• Publication Date: 2022-06-10
• Subjects: Covid-19 -- Microbiology -- Molecular Biology -- Virology -- Infectious Disease Medicine; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2021-323712
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objectives: To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. Design: Cross-sectional multicentre diagnostic study. Setting: Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain. Patients: Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected. Main outcome: Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2. Results: 1174 children were included, aged 3.8 years (IQR 1.7–9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR. Conclusions: RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested. Abstract : The results from this multi-centre prospective diagnostic test accuracy study suggest that molecular testing of oral saliva samples for SARS-CoV-2 in children is an accurate and less invasive alternative to molecular testing of nasopharyngeal/oropharyngeal swabs.