tetano
Editor, Senior Moderator
J Paediatr Child Health
. 2021 Feb 19.
doi: 10.1111/jpc.15405. Online ahead of print.
Comparison of nasopharyngeal samples for SARS-CoV-2 detection in a paediatric cohort
Jorge Rodrigues[SUP] 1 [/SUP], Catarina Gouveia[SUP] 1 2 [/SUP], Madalena Almeida Santos[SUP] 3 [/SUP], Olga Costa[SUP] 3 [/SUP], Rita C?rte-Real[SUP] 3 [/SUP], Maria Jo?o Brito[SUP] 1 [/SUP]
Affiliations
Abstract
Aim: The diagnosis of coronavirus disease 2019 (COVID-19) depends on accurate and rapid testing. Choosing an appropriate sample may impact diagnosis. Naso-oropharyngeal swabs (NOS) are most frequently used, despite several limitations. Since studies suggest nasopharyngeal aspirate (NPA) as a superior alternative in children, we hypothesised collecting both nasopharyngeal swab and aspirate would improve our diagnostic accuracy.
Methods: Observational, longitudinal, prospective study from 7 March to 7 May in a tertiary paediatric hospital in Lisbon. The objective was to compare the rate of detection of SARS-CoV-2 between NOS and NPA samples collected simultaneously.
Results: A total of 438 samples collected from 85 patients with confirmed COVID-19. There were 47.7% overall positive specimens - 32% (70/219) positive NOS and 63.5% (139/219) positive NPA. The tests were 67.6% concordant (k = 0.45). 50.3% had positive NPA with negative NOS, while 1.3% had positive NOS with negative NPA. NPA proved to be more sensitive (98.6% with 95% confidence interval 91.2-99.9% vs. 49.6% with 95% confidence interval 41.1-58.2%, P < 0.001). Additionally, the difference between NPA and NOS positive samples was statistically significant across all population groups (age, health condition, clinical presentation, contact with COVID-19 patients or need for hospitalisation), meaning NPA is more sensitive overall.
Conclusions: Nasopharyngeal aspirates had greater sensitivity than naso-oropharyngeal swabs in detecting SARS-CoV-2. Our results suggest paediatric patients would benefit from collecting nasopharyngeal aspirates in hospital settings, whenever feasible, to improve diagnosis of COVID-19.
Keywords: COVID-19; SARS-CoV-2; diagnosis; molecular biology; polymerase chain reaction.
. 2021 Feb 19.
doi: 10.1111/jpc.15405. Online ahead of print.
Comparison of nasopharyngeal samples for SARS-CoV-2 detection in a paediatric cohort
Jorge Rodrigues[SUP] 1 [/SUP], Catarina Gouveia[SUP] 1 2 [/SUP], Madalena Almeida Santos[SUP] 3 [/SUP], Olga Costa[SUP] 3 [/SUP], Rita C?rte-Real[SUP] 3 [/SUP], Maria Jo?o Brito[SUP] 1 [/SUP]
Affiliations
- PMID: 33605504
- DOI: 10.1111/jpc.15405
Abstract
Aim: The diagnosis of coronavirus disease 2019 (COVID-19) depends on accurate and rapid testing. Choosing an appropriate sample may impact diagnosis. Naso-oropharyngeal swabs (NOS) are most frequently used, despite several limitations. Since studies suggest nasopharyngeal aspirate (NPA) as a superior alternative in children, we hypothesised collecting both nasopharyngeal swab and aspirate would improve our diagnostic accuracy.
Methods: Observational, longitudinal, prospective study from 7 March to 7 May in a tertiary paediatric hospital in Lisbon. The objective was to compare the rate of detection of SARS-CoV-2 between NOS and NPA samples collected simultaneously.
Results: A total of 438 samples collected from 85 patients with confirmed COVID-19. There were 47.7% overall positive specimens - 32% (70/219) positive NOS and 63.5% (139/219) positive NPA. The tests were 67.6% concordant (k = 0.45). 50.3% had positive NPA with negative NOS, while 1.3% had positive NOS with negative NPA. NPA proved to be more sensitive (98.6% with 95% confidence interval 91.2-99.9% vs. 49.6% with 95% confidence interval 41.1-58.2%, P < 0.001). Additionally, the difference between NPA and NOS positive samples was statistically significant across all population groups (age, health condition, clinical presentation, contact with COVID-19 patients or need for hospitalisation), meaning NPA is more sensitive overall.
Conclusions: Nasopharyngeal aspirates had greater sensitivity than naso-oropharyngeal swabs in detecting SARS-CoV-2. Our results suggest paediatric patients would benefit from collecting nasopharyngeal aspirates in hospital settings, whenever feasible, to improve diagnosis of COVID-19.
Keywords: COVID-19; SARS-CoV-2; diagnosis; molecular biology; polymerase chain reaction.