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 meta-analysis

ABSTRACT

OBJECTIVES@#COVID-19, SARS-COV-2, Nasopharyngeal RT-PCR, Saliva RT-PCR, Children, 0- 18 years old.@*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%). @*CONCLUSION@#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 sample size, and to include both symptomatic and asymptomatic pediatric age group participants. A future prospective research study comparing the two diagnostic modalities is likewise recommended.