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Comparison of Mid-Turbinate and Nasopharyngeal Specimens for Molecular Detection of SARS-CoV-2 Among Symptomatic Outpatients at a Pediatric Drive-Through Testing Site

Authors :
Joana Y Lively
Flor M. Munoz
Julie A. Boom
Pedro A. Piedra
Leila C. Sahni
Brian Rha
Vasanthi Avadhanula
Rebekah E John
Cameron A Brown
Karen E Feliz
Camerin S Ortiz
James J. Dunn
Source :
Journal of the Pediatric Infectious Diseases Society. 10(8)
Publication Year :
2021

Abstract

Background Nasopharyngeal (NP) specimen testing by reverse transcriptase polymerase chain reaction (RT-PCR) is the standard of care for detecting SARS-CoV-2. Data comparing the sensitivity and specificity of the NP specimen to the less invasive, mid-turbinate (MT) nasal specimen in children are limited. Methods Paired clinical NP and research MT specimens were collected from children Results Out of 907 children, 569 (62.7%) had parental consent and child assent when appropriate to participate and provided paired MT and NP specimens a median of 4 days after symptom onset (range 1-14 days). 16.5% (n = 94) of MT specimens were positive for SARS-CoV-2 compared with 20.0% (n = 114) of NP specimens. The sensitivity of research MT compared to clinical NP specimens was 82.5% (95% CI: 74.2%, 88.9%), specificity was 100.0% (95% CI: 99.2%, 100.0%), and overall agreement was 96.1% (κ = 0.87). The sensitivity of MT specimens decreased with time from 100% (95% CI: 59.0%, 100.0%) on day 1 of illness to 82.1% (95% CI: 73.8%, 88.7%) within 14 days of illness onset; sensitivity was generally >90% when specimens were collected within the first week of illness. Conclusion MT specimens, particularly those collected within the first week of illness, have moderately reduced sensitivity and equivalent specificity to less-tolerated NP specimens in pediatric outpatients. MT specimen use in children may represent a viable alternative to NP specimen collection.

Details

ISSN :
20487207
Volume :
10
Issue :
8
Database :
OpenAIRE
Journal :
Journal of the Pediatric Infectious Diseases Society
Accession number :
edsair.doi.dedup.....f0a8ba4706022cd66f210b6e4cf75e15