Performance of RT-PCR on Saliva Specimens Compared With Nasopharyngeal Swabs for the Detection of SARS-CoV-2 in Children: A Prospective Comparative Clinical Trial.

Details

Serval ID
serval:BIB_420EB68B8459
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Performance of RT-PCR on Saliva Specimens Compared With Nasopharyngeal Swabs for the Detection of SARS-CoV-2 in Children: A Prospective Comparative Clinical Trial.
Journal
The Pediatric infectious disease journal
Author(s)
Fougère Y., Schwob J.M., Miauton A., Hoegger F., Opota O., Jaton K., Brouillet R., Greub G., Genton B., Gehri M., Taddeo I., D'Acremont V., Asner S.A.
ISSN
1532-0987 (Electronic)
ISSN-L
0891-3668
Publication state
Published
Issued date
01/08/2021
Peer-reviewed
Oui
Volume
40
Number
8
Pages
e300-e304
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
Saliva reverse transcriptase-Polymerase chain reaction (RT-PCR) is an attractive alternative for the detection of severe acute respiratory syndrome coronavirus 2 in adults with less known in children.
Children with coronavirus disease 2019 symptoms were prospectively enrolled in a 1-month comparative clinical trial of saliva and nasopharyngeal (NP) RT-PCR. Detection rates and sensitivities of saliva and NP RT-PCR were compared as well as discordant NP and saliva RT-PCR findings including viral loads (VLs).
Of 405 patients enrolled, 397 patients had 2 tests performed. Mean age was 12.7 years (range, 1.2-17.9). Sensitivity of saliva was 85.2% (95% confidence interval: 78.2%-92.1%) when using NP as the standard; sensitivity of NP was 94.5% (89.8%-99.2%) when saliva was considered as the standard. For a NP RT-PCR VL threshold of ≥103 and ≥104 copies/mL, sensitivity of saliva increases to 88.7% and 95.2%, respectively. Sensitivity of saliva and NP swabs was, respectively, 89.5% and 95.3% in patient with symptoms less than 4 days (P = 0.249) and 70.0% and 95.0% in those with symptoms ≥4-7 days (P = 0.096). The 15 patients who had an isolated positive NP RT-PCR were younger (P = 0.034), had lower NP VL (median 5.6 × 103 vs. 3.9 × 107, P < 0.001), and could not drool saliva at the end of the sampling (P = 0.002). VLs were lower with saliva than with NP RT-PCR (median 8.7 cp/mL × 104; interquartile range 1.2 × 104-5.2 × 105; vs. median 4.0 × 107 cp/mL; interquartile range, 8.6 × 105-1 × 108; P < 0.001).
While RT-PCR testing on saliva performed more poorly in younger children and likely after longer duration of symptoms, saliva remains an attractive alternative to NP swabs in children.
Keywords
COVID-19/diagnosis, COVID-19/virology, COVID-19 Testing, Child, Child, Preschool, Diagnostic Tests, Routine, Female, Humans, Infant, Infant, Newborn, Male, Nasopharynx/virology, Prospective Studies, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2/genetics, SARS-CoV-2/isolation & purification, Saliva/virology, Sensitivity and Specificity, Specimen Handling, Viral Load
Pubmed
Web of science
Open Access
Yes
Create date
19/07/2021 9:57
Last modification date
05/08/2021 6:37
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