key: cord-1024678-judakb15
authors: Chu, Stephen; Hale, Samuel
title: Letter in response to ‘Saliva is inferior to nose and throat swabs for SARS‐CoV‐2 detection in children’
date: 2021-09-21
journal: Acta Paediatr
DOI: 10.1111/apa.16110
sha: cba75e197b68f9eaf69287483e398784139bda51
doc_id: 1024678
cord_uid: judakb15

It is with interest that we read the article by von Linstow et al., which investigated the efficacy of saliva testing in comparison to nasal and oropharyngeal swabs (NOS) for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 The authors highlighted interesting ideas about why NOS may be preferable in paediatric patients; we wish to evaluate their findings and suggest further avenues for investigation.

It is with interest that we read the article by von Linstow The article did not break down the sample results by age, which is also something we believe should have been considered as a child aged 10 will react as differently to different sampling techniques as a child aged five or 16. With a median age of five, and a range of 6-17 years, it is hard to ascertain what age ranges positive samples were taken from and the variation between children of different ages, both in terms of efficacy, agreement between sampling techniques, preference of the children, and their ability to provide adequate samples. However, clarifying sub-groups of age ranges was shown in another study that saliva testing may be useful as an adjunct in children younger than 10, and stand-alone in older children. 3 This may be a more preferable approach to making a statement that saliva testing is inferior in children.

In our opinion, NOS is the standard for SARS-CoV-2 sampling, but it is also hasty to state that saliva is inferior without further investigations. The topic of paediatric COVID testing would benefit from studies with larger cohorts, more stringent and standardised sampling protocols and more in-depth demographic information to gauge the most appropriate methodology when testing children.

There are no conflicts of interest in connection with this paper.

Stephen Chu

Stephen Chu, GKT School of Medical Education, Hodgkin Building, Newcomen Street, London SE1 1UL, UK.

Email: stephen.chu@kcl.ac.uk

Stephen Chu https://orcid.org/0000-0002-6063-1379

Saliva is inferior to nose and throat swabs for SARS-CoV-2 detection in children

High efficacy of saliva in detecting SARS-CoV-2 by RT-PCR in adults and children

Adding saliva testing to oropharyngeal and deep nasal swab testing increases PCR detection of SARS-CoV-2 in primary care and children