Effective high-throughput RT-qPCR screening for SARS-CoV-2 infections in children

Area of Science:

• Virology
• Public Health
• Epidemiology

Background:

• Systematic SARS-CoV-2 testing is crucial for infection control and surveillance.
• High-sensitivity RT-qPCR in children faces challenges like unpleasant sample collection, limited capacity, and high costs.

Purpose of the Study:

• To develop a high-throughput, non-invasive SARS-CoV-2 detection method for children.
• To evaluate the effectiveness of this method in schools and daycare facilities.

Main Methods:

• Developed the 'Lolli-Method' combining non-invasive sample collection with RT-qPCR pool testing.
• Utilized SEIR-modeling to determine optimal testing frequency (twice weekly).
• Implemented the strategy in 3,700 schools and 698 daycare facilities in Germany, screening over 800,000 individuals.

Main Results:

• Achieved high sensitivity for SARS-CoV-2 detection (>10^6 copies/ml: 100%; >10^3 copies/ml: 93.9%).
• Screened over 800,000 individuals, with 6,364 positive pool-RT-qPCR tests (0.64%) over 3 months.
• Observed correlations between infections, local incidence, social deprivation, and a 36.8% increase in class infections with the Delta variant compared to Alpha.

Conclusions:

• The Lolli-Method is an effective tool for SARS-CoV-2 surveillance in children.
• This strategy supports infection control in educational settings like schools and daycare facilities.