Open Access Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study
- DOI
- Language of the publication
- English
- Date
- 2022-11-08
- Type
- Article
- Author(s)
- Hua, Nadia
- Corsten, Martin
- Bello, Alexander
- Bhatt, Maala
- Milwid, Rachael
- Champredon, David
- Turgeon, Patricia
- Zemek, Roger
- Dawson, Laurent
- Mitsakakis, Nicholas
- Webster, Richard
- Caulley, Lisa
- Angel, Jonathan B.
- Bastien, Nathalie
- Poliquin, Guillaume
- Johnson-Obaseki, Stephanie
- Publisher
- CMA Impact Inc.
Abstract
BACKGROUND: Accurate and timely testing for SARS-CoV-2 in the pediatric population is crucial to control the COVID-19 pandemic; saliva testing has been proposed as a less invasive alternative to nasopharyngeal swabs. We sought to compare the detection of SARS-CoV-2 using saliva versus nasopharyngeal swab in the pediatric population, and to determine the optimum time of testing for SARS-CoV-2 using saliva. METHODS: We conducted a longitudinal diagnostic study in Ottawa, Canada, from Jan. 19 to Mar. 26, 2021. Children aged 3–17 years were eligible if they exhibited symptoms of COVID-19, had been identified as a high-risk or close contact to someone confirmed positive for SARS-CoV-2 or had travelled outside Canada in the previous 14 days. Participants provided both nasopharyngeal swab and saliva samples. Saliva was collected using a self-collection kit (DNA Genotek, OM-505) or a sponge-based kit (DNA Genotek, ORE-100) if they could not provide a saliva sample into a tube. RESULTS: Among 1580 paired nasopharyngeal and saliva tests, 60 paired samples were positive for SARS-CoV-2. Forty-four (73.3%) were concordant-positive results and 16 (26.6%) were discordant, among which 8 were positive only on nasopharyngeal swab and 8 were positive only on saliva testing. The sensitivity of saliva was 84.6% (95% confidence interval 71.9%–93.1%). INTERPRETATION: Salivary testing for SARS-CoV-2 in the pediatric population is less invasive and shows similar detection of SARS-CoV-2 to nasopharyngeal swabs. It may therefore provide a feasible alternative for diagnosis of SARS-CoV-2 infection in children.
Plain language summary
Accurate and timely testing for SARS-CoV-2 in the pediatric population is crucial to control the COVID-19 pandemic; saliva testing has been proposed as a less invasive alternative to nasopharyngeal swabs. We sought to compare the detection of SARS-CoV-2 using saliva versus nasopharyngeal swab in the pediatric population, and to determine the optimum time of testing for SARS-CoV-2 using saliva. Among 1580 paired nasopharyngeal and saliva tests, 60 paired samples were positive for SARS-CoV-2. Forty-four (73.3%) were concordant-positive results and 16 (26.6%) were discordant, among which 8 were positive only on nasopharyngeal swab and 8 were positive only on saliva testing. The sensitivity of saliva was 84.6% (95% confidence interval 71.9%–93.1%). Salivary testing for SARS-CoV-2 in the pediatric population is less invasive and shows similar detection of SARS-CoV-2 to nasopharyngeal swabs. It may therefore provide a feasible alternative for diagnosis of SARS-CoV-2 infection in children.
Subject
- Health
Keywords
- COVID-19 Testing,
- COVID-19* / diagnosis,
- COVID-19* / epidemiology,
- Child,
- Humans,
- Pandemics,
- SARS-CoV-2*,
- Saliva
Rights
Peer review
Yes
Open access level
Gold
Article
- Journal title
- CMAJ Open
- Journal volume
- 10
- Journal issue
- 4
- Article number
- E981-E987
Citation(s)
Hua N, Corsten M, Bello A, et al. Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study. CMAJ open. 2022;10(4):E981-E987. doi:https://doi.org/10.9778/cmajo.20210279