College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Clin Microbiol Infect. 2021 Sep;27(9):1330-1335. doi: 10.1016/j.cmi.2021.02.009. Epub 2021 Feb 19.
The high diagnostic accuracy indices for saliva severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase PCR (RT-PCR) reported in adults has not been demonstrated in children, and adequately powered studies focused on the paediatric population are lacking. This study was carried out to determine the diagnostic accuracy of saliva for SARS-CoV-2 RT-PCR in ambulatory children.
During 1 to 23 October 2020, we recruited a population-based sample of children presenting for coronavirus disease 2019 (COVID-19) screening in Dubai, United Arab Emirates. Each child provided paired nasopharyngeal (NP) swab and saliva for SARS-CoV-2 RT-PCR N, E and RdRp gene detection.
Paired NP swab and saliva samples were obtained from 476 children with mean ± standard deviation age of 10.8 ± 3.9 years, and 58.2% were male (277/476). Nine participants were sampled twice, so 485 pairs of NP swab/saliva were tested. Virus detection in at least one specimen type was reported in 17.9% (87/485), with similar detection in NP swab (16.7%, 81/485) and saliva (15.9%, 77/485). Sensitivity and specificity of saliva RT-PCR was 87.7% (95% confidence interval (CI) 78.5-93.9) and 98.5% (95% CI 96.8-99.5). The positive and negative predictive values were 92.2% (95% CI 84.2-96.3) and 97.6% (95% CI 95.7-98.6), with a kappa coefficient of 0.879 (95% CI 0.821-0.937). Concordance of findings between NP swab and saliva did not differ by age (p 0.67) or gender (p 0.29). Cycle threshold (Ct) values were significantly higher in NP swab/saliva pairs with discordant findings compared to those with both specimens positive.
In light of these findings, we recommend saliva as a diagnostic specimen for COVID-19 screening in children.
成人唾液严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)逆转录酶聚合酶链反应 (RT-PCR) 的高诊断准确性指标在儿童中尚未得到证实，并且缺乏针对儿科人群的充分有力的研究。本研究旨在确定唾液在门诊儿童中用于 SARS-CoV-2 RT-PCR 的诊断准确性。
在 2020 年 10 月 1 日至 23 日期间，我们招募了在阿拉伯联合酋长国迪拜进行 2019 年冠状病毒病 (COVID-19) 筛查的具有代表性的儿童人群。每个儿童均提供鼻咽 (NP) 拭子和唾液用于 SARS-CoV-2 RT-PCR N、E 和 RdRp 基因检测。
从 476 名平均年龄为 10.8 ± 3.9 岁的儿童中获得了配对的 NP 拭子和唾液样本，其中 58.2%为男性 (277/476)。9 名参与者被采样两次，因此共测试了 485 对 NP 拭子/唾液。在至少一种标本类型中报告了病毒检测结果，占 17.9% (87/485)，NP 拭子的检测结果相同 (16.7%，81/485)，唾液检测结果相同 (15.9%，77/485)。唾液 RT-PCR 的敏感性和特异性分别为 87.7% (95%置信区间 (CI) 78.5-93.9) 和 98.5% (95% CI 96.8-99.5)。阳性和阴性预测值分别为 92.2% (95% CI 84.2-96.3) 和 97.6% (95% CI 95.7-98.6)，kappa 系数为 0.879 (95% CI 0.821-0.937)。NP 拭子和唾液之间的发现一致性不因年龄 (p 0.67) 或性别 (p 0.29) 而异。与两种标本均为阳性相比，具有不一致发现的 NP 拭子/唾液对之间的循环阈值 (Ct) 值显著更高。
鉴于这些发现，我们建议将唾液作为儿童 COVID-19 筛查的诊断标本。
