Diagnostic accuracy of Saliva Reverse Transcription Polymerase Chain Reaction (RT-PCR) compared to Nasopharyngeal Swab Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the detection of SARS-COV-2 in pediatric patients ages 0-18 years old: A met
Jazztine V Del Rosario | Maria Eva I Jopson
Discipline: medicine by specialism
Abstract:
OBJECTIVES: To determine the diagnostic accuracy of Saliva RT-PCR in the detection of
SARS-COV-2 in pediatric patients ages 0-18 years old, compared to the nasopharyngeal RTPCR
swab.
METHODOLOGY: A metanalysis was done to synthesize the diagnostic accuracy of saliva
RT-PCR compared to the nasopharyngeal RT-PCR in the detection of SARS-COV 2 in
pediatric patients ages 0-18 years old. Five studies published from January to September 2021
were analyzed using the "midas" command of STATA14. MIDAS command is a comprehensive
program of statistical and graphical routines for undertaking meta-analysis of diagnostic test
performance in Stata. The index and reference tests (gold standard) are dichotomous. Primary
data synthesis is performed within the bivariate mixed-effects regression framework focused on
making inferences about average sensitivity and specificity.
RESULTS: The World Health Organization’s acceptable sensitivity and specificity for products
used in COVID-19 diagnostics is ≥ 80% and ≥ 97% respectively. The results of this metanalysis
showed the pooled sensitivity of Saliva RT-PCR as compared to the Nasopharyngeal RT-PCR
is at 87% (81-92% at 95% CI) and the pooled specificity is at 97% (95% CI: 96-98%).
CONCLUSIONS: This metanalysis demonstrates that saliva can be used as an alternative
specimen for SARS-COV-2 diagnostic testing in children. Aside from the acceptable pooled
specificity and sensitivity, the use of saliva offers several advantages. However, the authors
recommend to include more studies for future metanalysis research, to further increase samplesize, and to include both symptomatic and asymptomatic pediatric age group participants. A
future prospective research study comparing the two diagnostic modalities is likewise
recommended
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