tetano
Editor, Senior Moderator
Arch Pathol Lab Med
. 2022 May 16.
doi: 10.5858/arpa.2021-0625-SA. Online ahead of print.
Comparison of Mid-turbinate Nasal Swabs, Saliva and Nasopharyngeal Swabs for SARSCoV-2 Reverse Transcription Polymerase Chain Reaction Testing in Pediatric Outpatients
Miriam B Vos[SUP] 1 [/SUP], Mark D Gonzalez[SUP] 2 [/SUP], Cheryl Stone[SUP] 3 [/SUP], Rebecca Cleeton[SUP] 1 [/SUP], Janet Figueroa[SUP] 4 [/SUP], Robert Jerris[SUP] 2 [/SUP], Sunita I Park[SUP] 2 [/SUP], Stacy Heilman[SUP] 1 [/SUP], Risha Nayee[SUP] 1 4 [/SUP], Ann Chahroudi[SUP] 1 [/SUP], Nils Schoof[SUP] 4 [/SUP], Maud Mavigner[SUP] 4 [/SUP], Claudia R Morris[SUP] 1 [/SUP], Traci Leong[SUP] 5 [/SUP], Amanda Grindle[SUP] 6 [/SUP], Adrianna Westbrook[SUP] 4 [/SUP], Wilbur Lam[SUP] 1 7 [/SUP], Beverly B Rogers[SUP] 2 [/SUP]
Affiliations
Abstract
Context.–: Diagnostic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in symptomatic and asymptomatic children remains integral to care, particularly for supporting return to and attendance in schools. The concordance of SARS-CoV-2 detection in children using various specimen types has not been widely studied.
Objective.–: To compare three sample types for SARS-CoV-2 PCR testing in children collected and tested at a single facility.
Design.–: We prospectively recruited 142 symptomatic and asymptomatic children into a sample comparison study performed in a single healthcare system. Each child provided self-collected saliva, and a trained healthcare provider collected a mid-turbinate nasal swab and nasopharyngeal (NP) swab. Specimens were assayed within 24 hours of collection using reverse transcriptase-polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 on a single testing platform.
Results.–: Concurrently collected saliva and mid-turbinate swabs had >95% positive agreement with NP swabs when obtained within 10 days of symptom onset. Positive agreement of saliva and mid-turbinate samples collected from children with symptom onset >10 days prior, or without symptoms, was 82% compared to NP swab samples. Cycle threshold (Ct) values for mid-turbinate nasal samples more closely correlated with Ct values from NP samples than saliva sample Ct values.
Conclusions.–: These findings suggest that all three sample types from children are useful for SARS-CoV-2 diagnostic testing by RT-PCR, and that concordance is greatest when the child has symptoms of coronavirus disease 2019 (COVID-19) within the past 10 days. This study provides scientific justification for utilizing sample types other than the NP swab for SARS-CoV-2 testing in pediatric populations.
. 2022 May 16.
doi: 10.5858/arpa.2021-0625-SA. Online ahead of print.
Comparison of Mid-turbinate Nasal Swabs, Saliva and Nasopharyngeal Swabs for SARSCoV-2 Reverse Transcription Polymerase Chain Reaction Testing in Pediatric Outpatients
Miriam B Vos[SUP] 1 [/SUP], Mark D Gonzalez[SUP] 2 [/SUP], Cheryl Stone[SUP] 3 [/SUP], Rebecca Cleeton[SUP] 1 [/SUP], Janet Figueroa[SUP] 4 [/SUP], Robert Jerris[SUP] 2 [/SUP], Sunita I Park[SUP] 2 [/SUP], Stacy Heilman[SUP] 1 [/SUP], Risha Nayee[SUP] 1 4 [/SUP], Ann Chahroudi[SUP] 1 [/SUP], Nils Schoof[SUP] 4 [/SUP], Maud Mavigner[SUP] 4 [/SUP], Claudia R Morris[SUP] 1 [/SUP], Traci Leong[SUP] 5 [/SUP], Amanda Grindle[SUP] 6 [/SUP], Adrianna Westbrook[SUP] 4 [/SUP], Wilbur Lam[SUP] 1 7 [/SUP], Beverly B Rogers[SUP] 2 [/SUP]
Affiliations
- PMID: 35576234
- DOI: 10.5858/arpa.2021-0625-SA
Abstract
Context.–: Diagnostic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in symptomatic and asymptomatic children remains integral to care, particularly for supporting return to and attendance in schools. The concordance of SARS-CoV-2 detection in children using various specimen types has not been widely studied.
Objective.–: To compare three sample types for SARS-CoV-2 PCR testing in children collected and tested at a single facility.
Design.–: We prospectively recruited 142 symptomatic and asymptomatic children into a sample comparison study performed in a single healthcare system. Each child provided self-collected saliva, and a trained healthcare provider collected a mid-turbinate nasal swab and nasopharyngeal (NP) swab. Specimens were assayed within 24 hours of collection using reverse transcriptase-polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 on a single testing platform.
Results.–: Concurrently collected saliva and mid-turbinate swabs had >95% positive agreement with NP swabs when obtained within 10 days of symptom onset. Positive agreement of saliva and mid-turbinate samples collected from children with symptom onset >10 days prior, or without symptoms, was 82% compared to NP swab samples. Cycle threshold (Ct) values for mid-turbinate nasal samples more closely correlated with Ct values from NP samples than saliva sample Ct values.
Conclusions.–: These findings suggest that all three sample types from children are useful for SARS-CoV-2 diagnostic testing by RT-PCR, and that concordance is greatest when the child has symptoms of coronavirus disease 2019 (COVID-19) within the past 10 days. This study provides scientific justification for utilizing sample types other than the NP swab for SARS-CoV-2 testing in pediatric populations.