Diagnosis of SARS-CoV-2 in children: accuracy of nasopharyngeal swab compared to nasopharyngeal aspirate

Pietro, Giada Maria Di; Capecchi, Ester; Luconi, Ester; Lunghi, G.; Bosis, Samantha; Bertolozzi, Giuseppe; Cantoni, Barbara; Marano, Giuseppe; Boracchi, Patrizia; Biganzoli, Elia; Castaldi, Silvana; Marchisio, Paola

doi:10.1007/s10096-020-04131-z

Cited by 6 publications

(10 citation statements)

References 35 publications

(35 reference statements)

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“…Twenty and a half percent of neonates had positive PCR test in our study which is lower than reported in another case study from Iran with 56% positive swab test [19], but higher than a Chinese study that reported 8.1% positive test in 1391 children younger than 16 years of age [22]. In a literature review, Trippella, et al showed 92% of tests in neonates were negative [8], however, among the negative neonates, some authors reported clinical symptoms [8,23].…”

Section: Discussioncontrasting

confidence: 82%

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Epidemiological Features of Neonates With COVID-19 Infection in Iran

Mohagheghi

Moshfegh

Zafaranloo

et al. 2021

Preprint

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Objective: Although, the COVID-19 Pandemic has drawn the attention of physicians and researchers from all corners of the globe since it has been out broken in different countries, we have also started to invest more about the epidemiological features of neonates that had been affected by COVID-19 in Iran till now.Method: This is a cross-sectional retrospective study including all neonates from a National Registry supported by Iranian Maternal and Neonatal Network (IMaN). Since February 2020 till February 2021, data of neonates under 28 days who were diagnosed with suspected or confirmed COVID-19 has been registered in this network were collected. General data including epidemiological, clinical outcomes and infection-related information were collected. Results: In our retrospective study, data of 4015 neonates admitted to hospital all over the country and reported in IMAN is included. Totally 3725 PCR tests were performed (92.8% of admitted neonates) and from these neonates 825 (20.5%) showed positive PCR test. There were no differences between gender, weight and gestational age in neonates with positive and negative PCR test. Neonatal clinical findings were dependent to the type of admission. Respiratory distress was the most common sign in neonates, who were admitted immediately after birth (63.9%), and who were transferred from another hospital (17%); however in those who were admitted after one to several days after discharge (19.1%), the most common sign were sepsis like syndrome (31.8%) and fever (27.4%). Almost 50% of admitted neonate`s mothers had positive PCR test (25% during pregnancy and 24.3% after delivery). The most important factor of neonatal death was need for respiratory support (aOR=18.17, 95% CI; 9.24– 35.69). Gestational age of <32 weeks (aOR=2.35, 95% CI; 1.35-4.10) and birth weight of <1500 grams (aOR= 3.47, 95% CI; 1.96-6.17) were the other two factors that correlated to death. Conclusion: This is the largest study of neonatal COVID-19 diseases in Iran published to date. The most common signs of COVID-19 diseases found in neonates are respiratory distress and sepsis-like syndrome.

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Section: Discussioncontrasting

confidence: 82%

“…In a literature review, Trippella, et al showed 92% of tests in neonates were negative [8], however, among the negative neonates, some authors reported clinical symptoms [8,23]. Multiple causes have been found for a negative swab test such as low virus titers, inappropriate swabbing sites, or variability on laboratory test performance [22].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Features of Neonates With COVID-19 Infection in Iran

Mohagheghi

Moshfegh

Zafaranloo

et al. 2021

Preprint

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Section: Discussionmentioning

confidence: 99%

“…For the direct identification of SARS-CoV-2, the PCR molecular testing should be performed on specimens taken from the upper (nasopharyngeal swab or aspirate and oropharyngeal swab) and the lower respiratory tract (BAL, tracheal aspirate and sputum) ( 18 , 19 ). Since higher viral loads are usually detected in the nose compared to the throat, the World Health Organization recommends to prioritize nasopharyngeal swab over oropharyngeal swab ( 19 , 20 ). All the described infants had a diagnosis of SARS-CoV-2 infection through a PCR molecular testing but only few authors reported the type of sample used for the test, in particular whether nasal or throat swabs ( 13 , 15 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

Intussusception in an Infant With SARS-CoV-2 Infection: A Case Report and a Review of the Literature

et al. 2021

Self Cite

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Coronavirus disease 2019 (COVID-19) is caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even if predominantly considered a respiratory pathogen, it could be associated with gastrointestinal involvement, generally in mild forms. Recent reports highlight the association between SARS-CoV-2 and intussusception in infants. A case of intussusception is hereby described in a previously healthy infant in whom the diagnosis of SARS-CoV-2 was made after the analysis of bronchoalveolar lavage and intraoperative specimens following surgical procedures. Accordingly, a review of infant cases with intussusception and SARS-CoV-2 infection is also reported.

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“…Es ist zu erwägen, erste Abstriche möglichst atraumatisch und weniger tief und intensiv vorzunehmen, bis man bei weiteren Abstrichen im Rahmen verfügter Serientestungen bei Schulkindern dann die Compliance für korrekte Abstriche erreicht. Einen Abstrich bei einer toleranten Person zu demonstrieren, dürfte Vertrauen wecken [7,23]. Unlängst wird von der Universität in Köln ein Abstrich bei Kindern mit einem Lutscher-ähnlichen Abstrichgerät untersucht ("Lolli-Test").…”

Section: Durchführung Der Abstricheunclassified

Der Nasen- oder Rachenabstrich in der COVID-19-Pandemie – Aspekte für den HNO-Arzt/die HNO-Ärztin – SARS-CoV-2, Coronavirus, Nasenabstrich, Rachenabstrich, Komplikationen

Deitmer

Dietz

Chaberny

et al. 2021

Laryngorhinootologie

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ZusammenfassungSeit Beginn der SARS-CoV-2-Pandemie werden zunehmend Abstriche oder andere Beprobungen aus dem oberen Aerodigestivtrakt genommen, da hier vor allen Dingen in frühen Erkrankungsstadien hohe Viruslasten bestehen. Als diagnostische Möglichkeiten sind Abstriche aus der vorderen Nase, dem Nasopharynx oder dem Oropharynx sowie die Gewinnung von Rachenspülwasser oder Speichel möglich. Als Labormethoden stehen in einigen Minuten ablesbare Antigentests oder langwierigere RT-PCR-Methoden zur Verfügung. Abstriche werden von ärztlichem Personal, medizinischem Fachpersonal, Laien und im Eigentest, jeweils nach Instruktionen, durchgeführt. Auf die Aussagekraft und die Sensitivität des gesamten diagnostischen Prozesses haben somit viele dieser Faktoren einen Einfluss. Die PCR-Labormethode ist sensitiver als die Antigenmethode; der Abstrich aus dem Nasopharynx wird als der valideste Abstrichort angesehen. Eine korrekte Durchführung eines Tests kann auch bei nicht professionellen Personen mit guten Instruktionen erreicht werden. Komplikationen werden bei solchen Abstrichen, gemessen an der anzunehmenden Anzahl durchgeführter Prozeduren, sehr selten berichtet. Kurzfristiges Nasenbluten bei traumatischen Abstrichen ist anzunehmen, ohne dass darüber Publikationen aufgefunden werden konnten. Abgebrochene Abstrichträger mussten HNO-ärztlich entfernt werden. Verletzungen der Schädelbasis mit Liquorrhö wurden bisher sehr vereinzelt berichtet, davon 2-mal bei Anomalien wie Meningozelen. Die Wahl eines geeigneten diagnostischen Mediums hängt von vielen Parametern, wie Verfügbarkeit, zeitlicher Ablauf bis zum Ergebnis, Abstrich durch kundiges Personal oder Eigentest und etlichen anderen praktischen Erwägungen, ab.

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Diagnosis of SARS-CoV-2 in children: accuracy of nasopharyngeal swab compared to nasopharyngeal aspirate

Cited by 6 publications

References 35 publications

Epidemiological Features of Neonates With COVID-19 Infection in Iran

Epidemiological Features of Neonates With COVID-19 Infection in Iran

Intussusception in an Infant With SARS-CoV-2 Infection: A Case Report and a Review of the Literature

Der Nasen- oder Rachenabstrich in der COVID-19-Pandemie – Aspekte für den HNO-Arzt/die HNO-Ärztin – SARS-CoV-2, Coronavirus, Nasenabstrich, Rachenabstrich, Komplikationen

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