Related Experiment Video
Updated: Aug 22, 2025
Large-Scale SARS-CoV-2 Testing Utilizing Saliva and Transposition Sample Pooling
Published on: June 23, 2022
Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study
Nadia Hua1, Martin Corsten1, Alexander Bello1
1Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man.
Background:
Accurate and timely testing for SARS-CoV-2 in the pediatric population is crucial to control the COVID-19 pandemic; saliva testing has been proposed as a less invasive alternative to nasopharyngeal swabs. We sought to compare the detection of SARS-CoV-2 using saliva versus nasopharyngeal swab in the pediatric population, and to determine the optimum time of testing for SARS-CoV-2 using saliva.
Methods:
We conducted a longitudinal diagnostic study in Ottawa, Canada, from Jan. 19 to Mar. 26, 2021. Children aged 3-17 years were eligible if they exhibited symptoms of COVID-19, had been identified as a high-risk or close contact to someone confirmed positive for SARS-CoV-2 or had travelled outside Canada in the previous 14 days. Participants provided both nasopharyngeal swab and saliva samples. Saliva was collected using a self-collection kit (DNA Genotek, OM-505) or a sponge-based kit (DNA Genotek, ORE-100) if they could not provide a saliva sample into a tube.
Results:
Among 1580 paired nasopharyngeal and saliva tests, 60 paired samples were positive for SARS-CoV-2. Forty-four (73.3%) were concordant-positive results and 16 (26.6%) were discordant, among which 8 were positive only on nasopharyngeal swab and 8 were positive only on saliva testing. The sensitivity of saliva was 84.6% (95% confidence interval 71.9%-93.1%).
Interpretation:
Salivary testing for SARS-CoV-2 in the pediatric population is less invasive and shows similar detection of SARS-CoV-2 to nasopharyngeal swabs. It may therefore provide a feasible alternative for diagnosis of SARS-CoV-2 infection in children.
