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Diagnosis of SARS-CoV-2 in children: accuracy of nasopharyngeal swab compared to nasopharyngeal aspirate
European Journal of Clinical Microbiology & Infectious Diseases ( IF 4.5 ) Pub Date : 2021-01-07 , DOI: 10.1007/s10096-020-04131-z
Giada Maria Di Pietro 1 , Ester Capecchi 1 , Ester Luconi 2 , Giovanna Lunghi 1, 2 , Samantha Bosis 2 , Giuseppe Bertolozzi 2 , Barbara Cantoni 2 , Giuseppe Marano 3 , Patrizia Boracchi 3 , Elia Biganzoli 1, 3 , Silvana Castaldi 1, 2 , Paola Marchisio 1, 2 ,
Affiliation  

The tests currently used for the identification of SARS-CoV-2 include specimens taken from the upper and lower respiratory tract. Although recommendations from the World Health Organization prioritise the usage of a nasopharyngeal swab (NS), nasopharyngeal aspirates (NPA) are thought to be superior in identifying SARS-CoV-2 in children. To our knowledge, however, no paediatric study has been published on the subject. The aim of this study is to evaluate the diagnostic performances of NS referred to NPA for SARS-CoV-2 in children. We calculated the sensitivity and specificity of the NS referred to the NPA of the whole sample and considered both age and collection period as covariates in different analyses. We collected 300 paired samples. The NS had a specificity of 97.7% and a sensitivity of 58.1%. We found similar results for the group of subjects ≥ 6 years old, while for subjects < 6 years old, the sensitivity was 66.7% and the specificity 97.8%. Considering period as a covariate, the sensitivity and specificity for patients hospitalised in March (31 patients, 52 records) were 70.0% and 97.6%, while for patients involved in the follow-up (16 patients, 57 records), they were 57.2% and 89.7%. The NS has a low sensitivity in detecting SARS-CoV-2 in children when referred to the NPA, whereas its specificity is high. Our results suggest that in children under 6 years of age, NSs should be preferred whenever possible. Though statistically not significant, the sensitivity of the NS rises when performed before the NPA.



中文翻译:

儿童 SARS-CoV-2 的诊断:鼻咽拭子与鼻咽抽吸物相比的准确性

目前用于识别 SARS-CoV-2 的测试包括从上呼吸道和下呼吸道采集的样本。尽管世界卫生组织的建议优先使用鼻咽拭子 (NS),但鼻咽抽吸物 (NPA) 被认为在识别儿童 SARS-CoV-2 方面具有优势。然而,据我们所知,尚未发表关于该主题的儿科研究。本研究的目的是评估 NS 参考 NPA 对儿童 SARS-CoV-2 的诊断性能。我们计算了 NS 的敏感性和特异性,参考了整个样本的 NPA,并将年龄和收集期视为不同分析中的协变量。我们收集了 300 个配对样本。NS 的特异性为 97.7%,敏感性为 58.1%。我们发现 ≥ 6 岁受试者组的结果相似,而对于 < 6 岁受试者,敏感性为 66.7%,特异性为 97.8%。以期为协变量,3月份住院患者(31例,52条记录)的敏感性和特异性分别为70.0%和97.6%,而参与随访的患者(16例,57条记录)的敏感性和特异性分别为57.2%和 89.7%。当提到 NPA 时,NS 在检测儿童 SARS-CoV-2 方面的敏感性较低,而其特异性却很高。我们的研究结果表明,对于 6 岁以下的儿童,应尽可能首选 NS。虽然统计上不显着,但在 NPA 之前执行 NS 的敏感性会上升。以期为协变量,3月份住院患者(31例,52条记录)的敏感性和特异性分别为70.0%和97.6%,而参与随访的患者(16例,57条记录)的敏感性和特异性分别为57.2%和 89.7%。当提到 NPA 时,NS 在检测儿童 SARS-CoV-2 方面的敏感性较低,而其特异性却很高。我们的研究结果表明,对于 6 岁以下的儿童,应尽可能首选 NS。虽然统计上不显着,但在 NPA 之前执行 NS 的敏感性会上升。以期为协变量,3月份住院患者(31例,52条记录)的敏感性和特异性分别为70.0%和97.6%,而参与随访的患者(16例,57条记录)的敏感性和特异性分别为57.2%和 89.7%。当提到 NPA 时,NS 在检测儿童 SARS-CoV-2 方面的敏感性较低,而其特异性却很高。我们的研究结果表明,对于 6 岁以下的儿童,应尽可能首选 NS。虽然统计上不显着,但在 NPA 之前执行 NS 的敏感性会上升。当提到 NPA 时,NS 在检测儿童 SARS-CoV-2 方面的敏感性较低,而其特异性却很高。我们的研究结果表明,对于 6 岁以下的儿童,应尽可能首选 NS。虽然统计上不显着,但在 NPA 之前执行 NS 的敏感性会上升。当提到 NPA 时,NS 在检测儿童 SARS-CoV-2 方面的敏感性较低,而其特异性却很高。我们的研究结果表明,对于 6 岁以下的儿童,应尽可能首选 NS。虽然统计上不显着,但在 NPA 之前执行 NS 的敏感性会上升。

更新日期:2021-01-07
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