{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:42:00Z","timestamp":1760233320563,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The choice of the best SARS-CoV-2 detection approach is crucial to predict which children with SARS-CoV-2 are at high risk of spreading the virus in order to manage public health measures and policies. In this prospective observational study of 35 children admitted to the Pediatric Emergency Departments of two tertiary hospitals in Northern Italy who tested positive for SARS-CoV-2 by standard RT-PCR in nasopharyngeal swab (NPS), we evaluated their presenting symptoms according to their salivary viral load (SVL) determined by droplet digital PCR (ddPCR). Despite an overall low concordance between SARS-CoV-2 detected by salivary ddPCR and NPS RT-PCR (54.3%), when only patients with nasopharyngeal symptoms were analyzed, the sensitivity of ddPCR in saliva specimens increased to 71.4%, and over half of these patients had high SVL (&gt;105 copies\/mL), which was significantly more frequent than in children without nasopharyngeal symptoms (57.1% vs. 14.3%, OR = 8, CI 95% 1.28\u201350.03, p = 0.03). All asymptomatic children had low SVL values. Our findings support the hypothesis that children with nasopharyngeal symptoms are at higher risk of spreading SARS-CoV-2 due to their high SVL and, conversely, asymptomatic children are unlikely to spread the virus due to their low SVL, regardless of their NPS positivity.<\/jats:p>","DOI":"10.3390\/v15010081","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T08:42:22Z","timestamp":1672216942000},"page":"81","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["#Stayathome If You Have a Cold: High SARS-CoV-2 Salivary Viral Loads in Pediatric Patients with Nasopharyngeal Symptoms"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6676-5773","authenticated-orcid":false,"given":"Alice","family":"Monzani","sequence":"first","affiliation":[{"name":"Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9973-2620","authenticated-orcid":false,"given":"Cinzia","family":"Borgogna","sequence":"additional","affiliation":[{"name":"Virology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4929-3759","authenticated-orcid":false,"given":"Daniela","family":"Ferrante","sequence":"additional","affiliation":[{"name":"Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Ciacchini","sequence":"additional","affiliation":[{"name":"Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Felici","sequence":"additional","affiliation":[{"name":"Pediatric and Pediatric Emergency Unit, The Children Hospital, AO SS. Antonio e Biagio e Cesare Arrigo, 15100 Alessandria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5187-0140","authenticated-orcid":false,"given":"Marisa","family":"Gariglio","sequence":"additional","affiliation":[{"name":"Virology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4173-146X","authenticated-orcid":false,"given":"Ivana","family":"Rabbone","sequence":"additional","affiliation":[{"name":"Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e300","DOI":"10.1097\/INF.0000000000003198","article-title":"Performance of RT-PCR on Saliva Specimens Compared With Nasopharyngeal Swabs for the Detection of SARS-CoV-2 in Children: A Prospective Comparative Clinical Trial","volume":"40","author":"Schwob","year":"2021","journal-title":"Pediatr. 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Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/22221751.2021.1878937","article-title":"Saliva viral load better correlates with clinical and immunological profiles in children with coronavirus disease 2019","volume":"10","author":"Chua","year":"2021","journal-title":"Emerg. Microbes Infect."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.3201\/eid2608.201246","article-title":"US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2","volume":"26","author":"Lu","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1056\/NEJMc2016359","article-title":"Saliva or Nasopharyngeal Swab Specimens for Detection of SARS-CoV-2","volume":"383","author":"Wyllie","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e352","DOI":"10.1093\/cid\/ciaa1156","article-title":"Comparing Nasopharyngeal Swab and Early Morning Saliva for the Identification of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)","volume":"72","author":"Rao","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1017\/S095026882100008X","article-title":"SARS-CoV-2 viral RNA load dynamics in the nasopharynx of infected children","volume":"149","author":"Kam","year":"2021","journal-title":"Epidemiol. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.jinf.2022.02.025","article-title":"SARS-CoV-2 Omicron infection is associated with high nasopharyngeal viral load","volume":"84","author":"Salvagno","year":"2022","journal-title":"J. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e126","DOI":"10.1016\/j.jinf.2022.02.015","article-title":"High amounts of SARS-CoV-2 in aerosols exhaled by patients with Omicron variant infection","volume":"84","author":"Zheng","year":"2022","journal-title":"J. Infect."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Granerud, B.K., Ueland, T., Lind, A., S\u00f8raas, A., Fevang, B., Steffensen, A.K., Al-Baldawi, H., Lund-Johansen, F., Aukrust, P., and Halvorsen, B. (2022). Omicron Variant Generates a Higher and More Sustained Viral Load in Nasopharynx and Saliva Than the Delta Variant of SARS-CoV-2. 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