1. Comparison of Mid-turbinate Nasal Swabs, Saliva, and Nasopharyngeal Swabs for SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction Testing in Pediatric Outpatients
- Author
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Vos, Miriam B., Gonzalez, Mark D., Stone, Cheryl, Cleeton, Rebecca, Figueroa, Janet, Jerris, Robert, Park, Sunita I., Heilman, Stacy, Nayee, Risha, Chahroudi, Ann, Schoof, Nils, Mavigner, Maud, Morris, Claudia R., Leong, Traci, Grindle, Amanda, Westbrook, Adrianna, Lam, Wilbur, and Rogers, Beverly B.
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Pediatrics -- Services ,Genetic transcription -- Analysis ,Polymerase chain reaction -- Testing ,Health - Abstract
* Context.--Diagnostic testing for 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 3 sample types for SARS-CoV-2 polymerase chain reaction (PCR) testing in children, collected and tested at a single facility. Design.--We prospectively recruited 142 symptomatic and asymptomatic children/young adults into a sample comparison study performed in a single health care system. Each child provided self-collected saliva, and a trained health care provider collected a mid-turbinate nasal swab and nasopharyngeal (NP) swab. Specimens were assayed within 24 hours of collection by using reverse transcription-polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 on a single testing platform. Results.--Concurrently collected saliva and mid-turbinate swabs had greater than 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 from saliva samples. Conclusions.--These findings suggest that all 3 sample types from children are useful for SARS-CoV-2 diagnostic testing by RT-PCR, and that concordance is greatest when the child has had symptoms of COVID-19 within the past 10 days. This study provides scientific justification for using sample types other than the NP swab for SARS-CoV-2 testing in pediatric populations. (Arch Pathol Lab Med. 2022;146:1056-1061; doi: 10.5858/arpa.2021-0625-SA), A pandemic provides a unique setting upon which the basic tenets of laboratory medicine are challenged. Specimen collection for SARS-CoV-2 is one such example, for which validation studies, which are [...]
- Published
- 2022
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