尽管SARS-CoV-2检测的范围在扩大，但现有的检测方法尚未获得紧急使用授权，用于自行收集14岁以下儿童前鼻孔(鼻)拭子的检测，因为儿科自拭子对SARS-CoV-2检测敏感性的影响尚不清楚。该研究旨在比较学龄儿童自采鼻拭子检测SARS-CoV-2的能力和医务人员采集的能力。

研究纳入197例患者，数据结果显示与医务人员采集的拭子相比，自我采集的拭子阳性率和阴性阳性率分别为97.8% (95% CI, 94.7%-100.0%)和98.1% (95% CI, 95.6%-100.0%)，组间SARS-CoV-2 Ct值无显著差异(平均[SD] Ct，自我拭子:26.7 [5.4]vs医务人员拭子:26.3 [6.0];P =0.65)。

4 ~ 14岁的儿童和青少年在听到和看到简单的指导材料后，自行采集后，会得到与医护人员采集的拭子检测SARS-CoV-2接近的鼻拭子。

Abstract

Importance: Despite the expansion of SARS-CoV-2 testing, available tests have not received Emergency Use Authorization for performance with self-collected anterior nares (nasal) swabs from children younger than 14 years because the effect of pediatric self-swabbing on SARS-CoV-2 test sensitivity is unknown.

Objective: To characterize the ability of school-aged children to self-collect nasal swabs for SARS-CoV-2 testing compared with collection by health care workers.

Design, setting, and participants: Cross-sectional study of 197 symptomatic children and adolescents aged 4 to 14 years old. Individuals were recruited based on results of testing in the Children's Healthcare of Atlanta system from July to August 2021.

Exposures: Children and adolescents were given instructional material consisting of a short instructional video and a handout with written and visual steps for self-swab collection. Participants first provided a self-collected nasal swab. Health care workers then collected a second specimen.

Main outcomes and measures: The primary outcome was SARS-CoV-2 detection and relative quantitation by cycle threshold (Ct) in self- vs health care worker-collected nasal swabs when tested with a real-time reverse transcriptase-polymerase chain reaction test with Emergency Use Authorization.

Results: Among the study participants, 108 of 194 (55.7%) were male and the median age was 9 years (IQR, 6-11). Of the 196 participants, 87 (44.4%) tested positive for SARS-CoV-2 and 105 (53.6%) tested negative by both self- and health care worker-collected swabs. Two children tested positive by self- or health care worker-collected swab alone; 1 child had an invalid health care worker swab. Compared with health care worker-collected swabs, self-collected swabs had 97.8% (95% CI, 94.7%-100.0%) and 98.1% (95% CI, 95.6%-100.0%) positive and negative percent agreement, respectively, and SARS-CoV-2 Ct values did not differ significantly between groups (mean [SD] Ct, self-swab: 26.7 [5.4] vs health care worker swab: 26.3 [6.0]; P = .65).

Conclusions and relevance: After hearing and seeing simple instructional materials, children and adolescents aged 4 to 14 years self-collected nasal swabs that closely agreed on SARS-CoV-2 detection with swabs collected by health care workers.

文章连接：

https://jamanetwork.com/journals/jama/fullarticle/2795837

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