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Oral cavity samples as a non-invasive method for respiratory virus detection in Pediatric patients: A comparative
Laura Riascos Orjuela1, Eliana Patricia Calvo1, Carolina Coronel-Ruiz1
1Laboratorio de Virología, Vicerrectoría de Investigaciones, Universidad el Bosque, 110121 Bogotá, Colombia.
Insights
Oral cavity swabs offer a non-invasive method for detecting common respiratory viruses like influenza A and RSV in children. This approach shows good agreement with traditional methods, making it a viable alternative for pediatric respiratory virus diagnosis.
Area of Science:
- Pediatric infectious diseases
- Virology
- Diagnostic methods
Background:
- Respiratory viruses cause significant childhood morbidity and mortality globally.
- Traditional diagnostic sampling methods (nasopharyngeal swabs/aspirates) are invasive and poorly tolerated by children.
- Non-invasive alternatives like oral cavity samples are being explored for ease of collection and cost-effectiveness.
Purpose of the Study:
- To assess the utility of oral cavity (OC) samples for detecting respiratory viruses in pediatric patients.
- To compare the diagnostic performance of OC samples against standard nasopharyngeal aspirates (NPA).
Main Methods:
- A paired comparative study was conducted on 133 pediatric patients with acute respiratory disease symptoms.
- Both nasopharyngeal aspirate (NPA) and oral cavity (OC) samples were collected from each patient.
- Samples were analyzed using multiplex RT-qPCR for five common respiratory viruses, with concordance assessed by Cohen's kappa coefficient.
Main Results:
- Oral cavity samples demonstrated significant concordance with NPA for detecting Influenza A (κ=0.755) and Respiratory Syncytial Virus (RSV) (κ=0.693).
- Weak agreement was observed for Adenovirus (AdV) (κ=0.404).
- Reliable agreement for Influenza B and SARS-CoV-2 could not be determined due to insufficient positive sample numbers.
Conclusions:
- Oral cavity sampling is a feasible and non-invasive method for detecting certain respiratory viruses in children.
- The performance of oral cavity sampling varies depending on the specific virus.
- These findings support the use of oral swabs as a practical alternative for pediatric respiratory virus diagnostics.
Introduction:
Respiratory viruses are the leading cause of acute respiratory infections (ARIs) worldwide. Despite preventive measures, these infections remain a major cause of morbidity and mortality in children. In Colombia, the most common viral agents include respiratory syncytial virus (RSV), influenza (flu), rhinovirus (RV), adenovirus (AdV) and SARS-CoV-2. Although timely detection is crucial for effective treatment and monitoring, standard diagnostic sampling such as nasopharyngeal swabs (NPS) and aspirates (NPA), are invasive, uncomfortable and often poorly tolerated, particularly in pediatric populations. This has led to a growing interest in non-invasive alternatives, such as oral swabs and saliva samples, which are easier to collect and more cost-effective.
Objective:
To evaluate the usefulness of oral cavity (OC) samples as a non-invasive method for the detection of respiratory viruses.
Methods:
We conducted a paired, comparative study including 133 pediatric patients presenting with signs or symptoms of acute respiratory disease. For each patient, both NPA and OC samples were collected and analyzed using a multiplex RT-qPCR assay targeting five respiratory viruses. Concordance between sampling methods was assessed using Cohen's kappa coefficient.
Results:
The OC samples showed significant concordance with the NPA for the detection of FluA (κ = 0.755) and RSV (κ = 0.693), and weak agreement with AdV (κ = 0.404). No reliable agreement could be determined for FluB and SARS-CoV-2 due to the low number of positive samples.
Conclusion:
These findings support oral cavity sampling as a feasible non-invasive method for detecting selected respiratory viruses in children, while highlighting virus-dependent differences in performance.
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