Systematic SARS-CoV-2 testing is a valuable tool for infection control and surveillance. However, broad application of high sensitive RT-qPCR testing in children is often hampered due to unpleasant sample collection, limited RT-qPCR capacities and high costs. Here, we developed a high-throughput approach (‘Lolli-Method’) for SARS-CoV-2 detection in children, combining non-invasive sample collection with an RT-qPCR-pool testing strategy. SARS-CoV-2 infections were diagnosed with sensitivities of 100% and 93.9% when viral loads were >10⁶ copies/ml and >10³ copies/ml in corresponding Naso-/Oropharyngeal-swabs, respectively. For effective application of the Lolli-Method in schools and daycare facilities, SEIR-modeling indicated a preferred frequency of two tests per week. The developed test strategy was implemented in 3,700 schools and 698 daycare facilities in Germany, screening over 800,000 individuals twice per week. In a period of 3 months, 6,364 pool-RT-qPCRs tested positive (0.64%), ranging from 0.05% to 2.61% per week. Notably, infections correlated with local SARS-CoV-2 incidences and with a school social deprivation index. Moreover, in comparison with the alpha variant, statistical modeling revealed a 36.8% increase for multiple (≥2 children) infections per class following infections with the delta variant. We conclude that the Lolli-Method is a powerful tool for SARS-CoV-2 surveillance and can support infection control in schools and daycare facilities.

系统性 SARS-CoV-2 检测是感染控制和监测的宝贵工具。然而，由于不愉快的样本采集、有限的 RT-qPCR 能力和高成本，高灵敏度 RT-qPCR 检测在儿童中的广泛应用经常受到阻碍。在这里，我们开发了一种用于儿童 SARS-CoV-2 检测的高通量方法（“Lolli 方法”），将非侵入性样本采集与 RT-qPCR 池检测策略相结合。^{当病毒载量 >10 6}拷贝/ml 和 >10 ³时，SARS-CoV-2 感染的敏感性分别为 100% 和 93.9%分别在相应的鼻/口咽拭子中拷贝/ml。为了在学校和日托机构中有效应用 Lolli 方法，SEIR 建模表明每周两次测试的首选频率。制定的测试策略在德国的 3,700 所学校和 698 个日托机构实施，每周对超过 800,000 人进行两次筛查。在 3 个月的时间里，6,364 个池 RT-qPCR 检测呈阳性 (0.64%)，范围从每周 0.05% 到 2.61%。值得注意的是，感染与当地的 SARS-CoV-2 发病率和学校社会剥夺指数相关。此外，与 alpha 变体相比，统计模型显示，在 delta 变体感染后，每个类别的多个（≥2 个儿童）感染增加了 36.8%。