Sensitivity of the Molecular Test in Saliva for Detection of COVID-19 in Pediatric Patients With Concurrent Conditions

Frontiers in Pediatrics

article

Guzmán-Ortiz Ana Laura¹  Jaramillo-Esparza Carlos Mauricio²  Bonilla-Pellegrini Sergio René²  Reyna-Trinidad Irineo³  Márquez-González Horacio⁴  Medina-Contreras Oscar¹  Quezada Héctor¹  Nevárez-Ramírez Abraham Josué¹  López-Martínez Briceida⁵  Parra-Ortega Israel⁵  Angeles-Floriano Tania⁵  Martínez-Rodríguez Nancy¹  Jamaica-Balderas Lourdes¹  De la Rosa-Zamboni Daniela⁶  Ortega-Riosvelasco Fernando⁶ 

[1] Laboratorio de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez;Departamento de Infectología, Hospital Infantil de México Federico Gómez;Departamento de Enfermería, Hospital Infantil de México Federico Gómez;Departamento de Investigación Clínica, Hospital Infantil de México Federico Gómez;Laboratorio Clínico, Hospital Infantil de México Federico Gómez;Departamento de Epidemiología Hospitalaria, Hospital Infantil de México Federico Gómez

关键词: adolescents;    children;    COVID-19;    molecular diagnostics;    saliva;    SARS-CoV-2;   

DOI  :  10.3389/fped.2021.642781

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: The reference standard for the molecular diagnostic testing for COVID-19 is the use of nasopharyngeal or combined nasopharyngeal and oropharyngeal (NP/OP) swabs. Saliva has been proposed as a minimally invasive specimen whose collection reduces the risks for health care personnel. Objective: To assess the suitability of saliva for COVID-19 diagnosis as a replacement of the reference standard NP/OP swab in the setting of a tertiary care pediatric unit. Study design: A paired study based in the prospective cohort design in patients suspected of having COVID-19. Methods: RT-PCR was used to detect SARS-CoV-2 in paired samples of saliva and NP/OP swab collected from May through August 2020 from 156 pediatric participants, of whom 128 has at least one comorbidity and 91 showed clinical symptoms related to SARS-CoV-2 infection. Additionally, we studied a group of 326 members of the hospital staff, of whom 271 had symptoms related to SARS-CoV-2 infection. Results: In the group of pediatric participants the sensitivity of the diagnostic test in saliva was 82.3% (95% CI 56.6–96.2) and the specificity 95.6% (95% CI 90.8–98.4). The prevalence of COVID-19 was 10.9% (17/156). In 6 of the 23 participants who tested positive for SARS-CoV-2 in at least one specimen type, the virus was detected in saliva but not in NP/OP swab, while in 3 participants the NP/OP swab was positive and saliva negative. In the group of adults, the sensitivity of the test in saliva was 77.8% (95% CI 67.2–86.3) and prevalence 24.8% (81/326). Discordant results between the two types of specimens showed a significant association with low viral load in the pharynx of adults but not of pediatric participants. Interpretation: In the context of a pediatric tertiary care hospital, the sensibility of the test in saliva is not high enough to replace the use of NP/OP swab for COVID-19 diagnosis. Neither NP/OP swab nor saliva could detect all the participants infected with SARS-CoV-2.

【 授权许可】

CC BY