Common Coronavirus Disease 2019 Upper Respiratory Tract Sampling Techniques in Children

Reza Shervin Badv; Maryam  Sotoudeh Anvari; Farhoud Toutounchian; Moones Toosang; Maryam Monajemzadeh; MohammadTaghi  Haghi Ashtiani; Setareh Mamishi; Keyvan Mirnia; Rohola  Shirzadi; Abbas Mohammadi

doi:10.18502/jimc.v6i1.11839

Reza Shervin Badv Pediatrics Centre of Excellence, Department of Pediatric Neurology, Children’s Medical Centre, Tehran University of Medical Sciences, Tehran, Iran
Maryam Sotoudeh Anvari Molecular Pathology and Cytogenetics Division, Pathology Department, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Farhoud Toutounchian Pediatrics Centre of Excellence, Department of Forensic Medicine and Clinical Toxicology, Children’s Medical Centre, Tehran University of Medical Sciences, Tehran, Iran
Moones Toosang Department of Pathology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Maryam Monajemzadeh Department of Pathology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
MohammadTaghi Haghi Ashtiani Department of Pathology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Setareh Mamishi Pediatric Gastroenterology and Hepatology Research Center, Children’s Medical Center, Children Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran
Keyvan Mirnia Pediatrics Centre of Excellence, Department of Neonatology, Children’s Medical Centre, Tehran University of Medical Sciences, Tehran, Iran
Rohola Shirzadi Pediatric Respiratory and Sleep Medicine Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Abbas Mohammadi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v6i1.11839

Keywords: Bronchoalveolar lavage, Children, COVID-19

Abstract

Background: During COVID-19 pandemic, most studies have focused on sampling technique in adults. Considering the need to be aware of the effectiveness and evaluation of sampling methods in children, we have motivated a search for introducing and performing sampling techniques, especially upper respiratory tract sampling in children. We systematically reviewed the literature to understand the performance of different sampling methods in children in COVID-19.

Methods: We systematically reviewed PubMed, Google Scholar, medRxiv, and bioRxiv (last retrieval August 1st, 2021) for comparative studies of deferent sampling techniques by using the search keywords including: children, pediatric sampling, nasopharyngeal, COVID-19, oropharyngeal, swabs, SARS, CoV2. 8 relevant manuscripts were sourced from a total of 4852 search results.

Results: Nasopharyngeal (NP) swabs testing significantly had higher positivity rate over oropharyngeal swab in detecting SARS-CoV-2. Nasal swab has a low sensitivity in detecting SARSCoV-2 in children when referred to the nasopharyngeal aspiration (NPA), whereas its specificity is high. Therefore, NPA can be as the gold standard for detection of SARS-CoV-2.

Conclusion: Saliva is not a useful for diagnosing COVID-19 in children. Negative nasopharyngeal and oropharyngeal swabs do not rule out COVID-19 and in patients with strong clinical suspicion, and Bronchoalveolar lavage (BAL) can be helpful.