Yves P. Fougère (Switzerland)

CHUV DFME
Dr Yves Fougere is actually Senior resident in Pediatric Infectious Diseases and Vaccinology Unit in Lausanne University Hospital. After completing his Swiss Pediatric Board exam in 2020 and obtaining a University Diploma (DU in Pediatric Infectious Diseases at the University of Paris Descartes France) in 2019 Dr. Yves Fougere completed almost a 3-year clinical experience in Pediatric Infectious Diseases at the Lausanne University Hospital.

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PERFORMANCE OF RT-PCR ON SALIVA SPECIMENS COMPARED TO NASOPHARYNGEAL SWABS FOR THE DETECTION OF SARS-COV-2 IN CHILDREN: A PROSPECTIVE COMPARATIVE CLINICAL TRIAL (ID 1142)

Session Name
2220 - ORAL PRESENTATIONS 06: COVID TRANSMISSION (ID 103)
Lecture Time
11:05 - 11:12
Room
Hall 03
Presenter

Abstract

Background

Saliva RT-PCR has already been reported as an attractive alternative for the detection of SARS-CoV-2 in adults. Pediatric evidence remains weak with discordant reported sensitivities.

Methods

Children and adolescents with symptoms suggestive of COVID-19 were prospectively enrolled in a comparative clinical trial of saliva and nasopharyngeal (NP) RT-PCR between November and December 2020 from two outpatient clinics. Detection rates and sensitivities of saliva and NP RT-PCR were compared. Participants with discordant NP and saliva RT-PCR results were also compared as well as viral load (VL) from paired NP-Saliva swabs.

Results

Out of 405 patients enrolled, 397 patients had two tests performed. Mean age was 12.7 years (range 1.2-18) and 192 (48.3%) were female. Detection rates were 22.9% (95% CI 18.8-27.1%) by saliva RT-PCR, 25.4% (21.2-29.7%) by NP RT-PCR, and 26.7% (22.4-31.1%) by any test. Sensitivity of saliva compared to NP RT-PCR was 85.2% (78.2-92.1%) and 94.5% (89.8-99.2%) for NP compared to saliva PCR. For a NP RT-PCR VL threshold of ≥103 and ≥104 copies/ml, sensitivity of saliva increases to 88.7% and 95.2% respectively. The 15 patients who had an isolated positive NP RT-PCR were significantly younger (p=0.034), had a lower VL (p<0.001), and were not able to drool saliva at the end of the sampling (p=0.002). VLs were significantly lower with saliva PCR than with NP RT-PCR (median 8.7 cp/ml x104; IQR 1.2x104-5.2x105; vs median 4.0x107cp/ml; IQR 8.6x105-1.x108; p<0.001, 95CI: -4.5x102 to - 7.7x101).

Conclusions

Saliva PCR shows diagnostic performances close to NP RT-PCR for SARS-CoV2 detection in most symptomatic outpatient children and adolescents.

Clinical Trial Registration

NCT04613310

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