Performance of RT-PCR on Saliva Specimens Compared With Nasopharyngeal Swabs for the Detection of SARS-CoV-2 in Children

Fougère, Yves; Schwob, Jean-Marc; Miauton, Alix; Hoegger, Francesca; Opota, Onya; Jaton, Katia; Brouillet, René; Greub, Gilbert; Genton, Blaise; Gehri, Mario; Taddeo, Ilaria; D’Acremont, Valérie; Asner, Sandra

doi:10.1097/inf.0000000000003198

Cited by 22 publications

(21 citation statements)

References 23 publications

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“…To our knowledge, this study is the largest paediatric study comparing OSS with the established gold standard. The results are in concordance with the few studies performed on children 5 7 9 10 24. A recent study performed in Dubai with 476 children demonstrated a sensitivity even higher (87.7%) than found here; however, the authors used a saliva sample rather than saliva swabs, and the children were older (mean 10.8 years old) 10.…”

Section: Discussionsupporting

confidence: 91%

Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population

et al. 2022

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ObjectivesTo 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.DesignCross-sectional multicentre diagnostic study.SettingStudy nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain.PatientsChildren 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 outcomePerformance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2.Results1174 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.ConclusionsRT-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.

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Section: Discussionsupporting

confidence: 91%

Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population

et al. 2022

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“…To allow for larger sample sizes without additional medical staff, in an accompanying sub-study, we evaluated the Salivette ® saliva collection system for children aged 3 to 11 [ 17 ]. Accordingly, saliva has been shown to be a well-established diagnostic specimen for detecting SARS-CoV-2 RNA [ 18 , 19 , 20 , 21 , 22 ], a child-friendly sampling alternative to swab-based methods [ 23 , 24 ] and one potentially suitable for the mass screening of children [ 25 ]. The findings in our evaluation of the Salivette ® system confirmed that assessment [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Saliva Mass Screening in Primary Schools: A 10-Week Sentinel Surveillance Study in Munich, Germany

Vogel¹,

Both

Nowak

et al. 2022

Diagnostics

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Representative, actively collected surveillance data on asymptomatic SARS-CoV-2 infections in primary schoolchildren remain scarce. We evaluated the feasibility of a saliva mass screening concept and assessed infectious activity in primary schools. During a 10-week period from 3 March to 21 May 2021, schoolchildren and staff from 17 primary schools in Munich participated in the sentinel surveillance, cohort study. Participants were tested using the Salivette® system, testing was supervised by trained school staff, and samples were processed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). We included 4433 participants: 3752 children (median age, 8 [range, 6–13] years; 1926 girls [51%]) and 681 staff members (median age, 41 [range, 14–71] years; 592 women [87%]). In total, 23,905 samples were processed (4640 from staff), with participants representing 8.3% of all primary schoolchildren in Munich. Only eight cases were detected: Five out of 3752 participating children (0.13%) and three out of 681 staff members (0.44%). There were no secondary cases. In conclusion, supervised Salivette® self-sampling was feasible, reliable, and safe and thus constituted an ideal method for SARS-CoV-2 mass screenings in primary schoolchildren. Our findings suggest that infectious activity among asymptomatic primary schoolchildren and staff was low. Primary schools appear to continue to play a minor role in the spread of SARS-CoV-2 despite high community incidence rates.

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“…Only very few reports have addressed saliva sampling in pediatric cohorts [16]. Of note, two studies comparing naso-/oropharyngeal swabs and saliva samples in symptomatic children found an overall saliva sensitivity of 85.2% (up to 95.2% in patients with high viral load (≥10 4 copies/mL) in nasopharyngal swabs) and 87.7%, respectively [17,18]. The Salivette ® system has been proposed as a device for collecting saliva for SARS-CoV-2 testing in adults [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Diagnostic Accuracy of Saliva-Based SARS-CoV-2 Screening in Educational Settings and Children Aged <12 Years

Hoch¹,

Vogel²,

Eberle³

et al. 2021

Diagnostics

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Children have been disproportionately affected during the COVID-19 pandemic. We aimed to assess a saliva-based algorithm for SARS-CoV-2 testing to be used in schools and childcare institutions under pandemic conditions. A weekly SARS-CoV-2 sentinel study in primary schools, kindergartens, and childcare facilities was conducted over a 12-week-period. In a sub-study covering 7 weeks, 1895 paired oropharyngeal and saliva samples were processed for SARS-CoV-2 rRT-PCR testing in both asymptomatic children (n = 1243) and staff (n = 652). Forty-nine additional concurrent swab and saliva samples were collected from SARS-CoV-2 infected patients (patient cohort). The Salivette® system was used for saliva collection and assessed for feasibility and diagnostic performance. For children, a mean of 1.18 mL saliva could be obtained. Based on results from both cohorts, the Salivette® testing algorithm demonstrated the specificity of 100% (95% CI 99.7–100) and sensitivity of 94.9% (95% CI 81.4–99.1) with oropharyngeal swabs as reference. Agreement between sampling systems was 100% for moderate to high viral load situations (defined as Ct-values <33 from oropharyngeal swabs). Comparative analysis of Ct-values derived from saliva vs. oropharyngeal swabs demonstrated a significant difference (mean 4.23; 95% CI 2.48–6.00). In conclusion, the Salivette® system proved to be an easy-to-use, safe and feasible saliva collection method and a more pleasant alternative to oropharyngeal swabs for SARS-CoV-2 testing in children aged 3 years and above.

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Performance of RT-PCR on Saliva Specimens Compared With Nasopharyngeal Swabs for the Detection of SARS-CoV-2 in Children

Cited by 22 publications

References 23 publications

Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population

Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population

SARS-CoV-2 Saliva Mass Screening in Primary Schools: A 10-Week Sentinel Surveillance Study in Munich, Germany

Feasibility and Diagnostic Accuracy of Saliva-Based SARS-CoV-2 Screening in Educational Settings and Children Aged <12 Years

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