Moraleda, CintaDomínguez-Rodríguez, SaraMesa, Juan MiguelGarcía-Sánchez, Paulade la Serna, MaríaAlonso-Cadenas, José AntonioBermejo, AmandaSabrido, GemaMartínez-Campos, LeticiaGonzález-Posada, Aránzazu FlaviaIllán-Ramos, MartaCobos-Carrascosa, ElenaBallesteros, ÁlvaroGalán, Juan CarlosLlorente, FranciscoAguilera-Alonso, DavidJiménez, Ana BelénCatalán, PilarDahdouh, EliasNavarro, IgnacioFernández-Garoz, BárbaraMendoza, PabloPérez-Jorge, ConcepciónCabezas-Fernández, TeresaBlázquez-Gamero, DanielRivas, GonzaloGonzalez-Donapetry, PatriciaSáez, ElenaFernández-Pinero, JovitaLucas-Fernández, JesúsPérez-Ramírez, ElisaMerino, PalomaMiragaya, SandraLorente, JorgeIglesias, IreneTagarro, AlfredoEPICO working group2023-05-032023-05-032022-06-10http://hdl.handle.net/10668/20131To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. Cross-sectional multicentre diagnostic study. Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain. Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected. Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2. 1174 children were included, aged 3.8 years (IQR 1.7-9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR. RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested.enCovid-19Infectious Disease MedicineMicrobiologyMolecular BiologyVirologyChildHumansCOVID-19SARS-CoV-2COVID-19 TestingSalivaReverse TranscriptionProspective StudiesCross-Sectional StudiesSensitivity and SpecificityPolymerase Chain Reactionresearch article35688603open access10.1136/archdischild-2021-3237121468-2044PMC9240444https://adc.bmj.com/content/archdischild/early/2022/06/09/archdischild-2021-323712.full.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9240444/pdf