{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:34:32Z","timestamp":1787016872960,"version":"build-2736575974"},"reference-count":45,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Canadian Government | Health Canada","award":["Safe Restart Agreement Contribution Program"],"award-info":[{"award-number":["Safe Restart Agreement Contribution Program"]}]},{"DOI":"10.13039\/501100003206","name":"Alberta Children's Hospital Foundation","doi-asserted-by":"crossref","award":["Professorship in Child Health and Wellness"],"award-info":[{"award-number":["Professorship in Child Health and Wellness"]}],"id":[{"id":"10.13039\/501100003206","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,12,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      To optimize the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children, specimen collection and testing method are crucial considerations. Ideally, specimen collection is easy and causes minimal discomfort, and the laboratory approach is simple, accurate, and rapid. In this prospective cohort study we evaluated the accuracy of a point-of care nucleic acid device using caregiver\/patient self-collected buccal swabs. Participants were recruited in 14 Canadian tertiary care pediatric emergency departments. Children &lt;18 years of age deemed to require SARS-CoV-2 testing were eligible. Caregivers or the patient-collected buccal swabs which were tested on the ABBOTT ID NOW. The reference standard was nasopharyngeal swab specimens collected by a healthcare provider tested via laboratory reverse transcription PCR (RT-PCR). We enrolled 2,640 study participants and 14.4% (381\/2,640) were SARS-CoV-2 RT-PCR-positive. Eight percent (223\/2,640) and 85.0% (2,244\/2,640) were concordant test-positive and concordant test-negative, respectively. Sensitivity and specificity of the investigational approach were 58.5% [95% confidence interval (CI): 53.4, 63.5] and 99.3% (95% CI: 98.9, 99.6), respectively. Cycle threshold values were lower among concordant [median 17 (15, 21)] relative to discordant [median 30 (22, 35)] swabs (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Sensitivity was greatest among children &lt;4 years of age, when caregivers performed the swabs, among unvaccinated children, and those with shorter symptom duration. Across multiple pain measures, less pain was associated with buccal swab testing. Although accuracy of the buccal swab point-of-care SARS-CoV-2 test was good and negative agreement was excellent, sensitivity was only 58.5%. Concordance was greater among those with higher viral loads, and the approach involving buccal swabs was less painful.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>To optimize the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children, specimen collection and testing method are crucial considerations. Ideally, specimen collection is easy and causes minimal discomfort, and laboratory approach is simple, accurate, and rapid. We evaluated the accuracy and pain associated with buccal swab specimen collection by caregivers or children themselves who were tested using a point-of-care isothermal nucleic acid amplification SARS-CoV-2 test. This novel approach was compared to nasopharyngeal swab specimens tested using laboratory-based PCR tests. While negative agreement was excellent, positive percent agreement was less than 60%. Concordance was greater among those with higher viral loads, and thus, sensitivity is excellent when transmissibility is more likely to occur. Importantly, the approach involving buccal swabs was significantly less painful, and thus, children and their caregivers are more likely to agree to testing using such an approach.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>CLINICAL TRIALS<\/jats:title>\n                      <jats:p>\n                        Registered at ClinicalTrials.gov (\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT05040763?cond=NCT05040763&amp;rank=1\" xlink:type=\"simple\">NCT05040763<\/jats:ext-link>\n                        ).\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01884-24","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T09:02:14Z","timestamp":1730192534000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Accuracy of point-of-care SARS-CoV-2 detection using buccal swabs in pediatric emergency departments"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-6192","authenticated-orcid":true,"given":"Stephen B.","family":"Freedman","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Calgary","place":["Calgary, Canada"]},{"name":"Department of Emergency Medicine, University of Calgary","place":["Calgary, Canada"]},{"name":"Sections of Pediatric Emergency Medicine and Gastroenterology, University of Calgary","place":["Calgary, Canada"]},{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, 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Pediatric Emergency Medicine, Department of Pediatrics, University of Alberta","place":["Edmonton, Canada"]},{"name":"Department of Pediatrics, Women\u2019s and Children\u2019s Health Research Institute, University of Alberta","place":["Edmonton, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1265-3482","authenticated-orcid":false,"given":"Maala","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Ottawa, Children\u2019s Hospital of Eastern Ontario","place":["Ottawa, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Berthelot","sequence":"additional","affiliation":[{"name":"D\u00e9partement de m\u00e9decine de famille et de m\u00e9decine d\u2019urgence, CHU de Qu\u00e9bec-Universit\u00e9 Laval","place":["Qu\u00e9bec City, 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