Very High Negative Concordance Rate of RT-PCR for SARS-CoV-2 in Nasopharyngeal Swab and Tracheo-Bronchial Aspirate in Children

Reliable testing methods for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children are essential to allow normal activities. Diagnosis of SARS-CoV-2 infection is currently based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR) performed on nasopharyngeal (NP)...

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Published in:Frontiers in pediatrics Vol. 10; p. 866111
Main Authors: Camporesi, Anna, De Silvestri, Annalisa, Diotto, Veronica, Ferrario, Stefania, Eccher, Laura, De Ferrari, Alessandra, Messina, Francesco, Pelizzo, Gloria, Mileto, Davide, Calcaterra, Valeria, Buonsenso, Danilo
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media S.A 25.05.2022
Subjects:
children
naso-pharyngeal swab
Pediatrics
RT-PCR-Real-Time PCR
SARS-CoV-2
tracheo-bronchial aspirate
RT-PCR-Real-Time PCR
SARS-CoV-2
children
naso-pharyngeal swab
tracheo-bronchial aspirate
ISSN:2296-2360, 2296-2360
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Summary:Reliable testing methods for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children are essential to allow normal activities. Diagnosis of SARS-CoV-2 infection is currently based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR) performed on nasopharyngeal (NP) swabs; concerns have been raised regarding NP swab accuracy in children to detect the virus because of potential lack of cooperation of the patients or due to general uncertainties about concordance between high and low respiratory tract specimens in children. The aim of the study (IRB approval: ST/2020/405) is to prospectively compare RT-PCR results on NP and tracheo-bronchial aspirate (TA) in children admitted to the hospital for surgery or admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary children hospital in Milano, Italy, during a peak of COVID-19 infections in the city. A total of 385 patients were enrolled in the study: 364 from surgical theater and 21 from PICU. Two patients (0.5%) tested positive on TA and were negative on NP; both cases occurred in November 2020, during a peak of infection in the city. Specificity of NP swab was.995 (95% CI: 0.980–0.999). Two patients with positive NP swabs tested negative on TA.
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This article was submitted to Children and Health, a section of the journal Frontiers in Pediatrics
Edited by: Giacomo Spinato, University Hospital of Padua, Italy
Reviewed by: Cristoforo Fabbris, University of Padua, Italy; Nathan Zelyas, University of Alberta, Canada
ISSN:2296-2360
2296-2360
DOI:10.3389/fped.2022.866111