SARS-CoV-2 diagnosis is a cornerstone for the management of coronavirus disease 2019 (COVID-19). Numerous studies have assessed saliva performance over nasopharyngeal sampling (NPS), but data in young children are still rare. We explored saliva performance for SARS-CoV-2 detection by RT-PCR according to the time interval from initial symptoms or patient serological status. We collected 509 NPS and saliva paired samples at initial diagnosis from 166 children under 12 years of age (including 57 children under 6), 106 between 12 and 17, and 237 adults. In children under 12, overall detection rate for SARS-CoV-2 was comparable in saliva and NPS, with an overall agreement of 89.8%. Saliva sensitivity was significantly lower than that of NPS (77.1% compared to 95.8%) in pre-school and school-age children but regained 96% when considering seronegative children only. This pattern was also observed to a lesser degree in adolescents but not in adults. Sensitivity of saliva was independent of symptoms, in contrary to NPS, whose sensitivity decreased significantly in asymptomatic subjects. Performance of saliva is excellent in children under 12 at early stages of infection. This reinforces saliva as a collection method for early and unbiased SARS-CoV-2 detection and a less invasive alternative for young children.

中文翻译：

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用于学龄前和学龄儿童 SARS-CoV-2 分子检测的唾液

SARS-CoV-2 诊断是 2019 年冠状病毒病 (COVID-19) 管理的基石。许多研究评估了鼻咽采样 (NPS) 的唾液性能，但幼儿的数据仍然很少。我们根据初始症状或患者血清学状态的时间间隔，探索了通过 RT-PCR 检测 SARS-CoV-2 的唾液性能。我们从 166 名 12 岁以下的儿童（包括 57 名 6 岁以下的儿童）、106 名 12 至 17 岁的儿童和 237 名成人的初步诊断中收集了 509 份 NPS 和唾液配对样本。在 12 岁以下儿童中，唾液和 NPS 中 SARS-CoV-2 的总体检出率相当，总体一致性为 89.8%。唾液敏感性显着低于 NPS（77.1% 与 95. 8%）在学龄前和学龄儿童中，但仅考虑血清反应阴性儿童时恢复了 96%。这种模式在青少年中也观察到较小程度，但在成人中没有。唾液的敏感性与症状无关，与 NPS 相反，其敏感性在无症状受试者中显着降低。在感染的早期阶段，12 岁以下儿童的唾液性能非常好。这加强了唾液作为早期和公正检测 SARS-CoV-2 的收集方法和对幼儿的侵入性较小的替代方法。在感染的早期阶段，12 岁以下儿童的唾液性能非常好。这加强了唾液作为早期和公正检测 SARS-CoV-2 的收集方法和对幼儿的侵入性较小的替代方法。在感染的早期阶段，12 岁以下儿童的唾液性能非常好。这加强了唾液作为早期和公正检测 SARS-CoV-2 的收集方法和对幼儿的侵入性较小的替代方法。