# Practical Challenges in the Diagnosis of SARS-CoV-2 Infection in Children

## TL;DR

This study examines the challenges in diagnosing SARS-CoV-2 in children, focusing on sample collection techniques and the accuracy of rapid antigen tests compared to RT-PCR.

## Contribution

The study provides insights into the practical challenges of nasopharyngeal sample collection and evaluates the performance of rapid antigen tests in pediatric populations.

## Key findings

- Healthcare workers achieved an average compliance score of 7.60 in sample collection procedures.
- Rapid antigen tests showed 50% sensitivity and 97.5% specificity when compared to RT-PCR in children.
- Many patients reported discomfort such as pain, coughing, or sneezing during sample collection.

## Abstract

Background/Objectives: The COVID-19 pandemic, caused by SARS-CoV-2, required the rapid development of diagnostic tests. SARS-CoV-2, part of the betacoronavirus genus, shares characteristics with SARS-CoV-1, including its ability to survive on surfaces, facilitating the spread of the infection. This study analyzes the technique of nasopharyngeal secretion collection for SARS-CoV-2 diagnosis and compares the accuracy of rapid antigen and molecular tests. Methods: This study had two components: study A assessed the healthcare personnel training in collecting nasopharyngeal secretions and the discomfort associated with applying a questionnaire. Study B compared rapid antigen test accuracy with RT-PCR among children, through a retrospective analysis. The data were statistically analyzed to assess compliance with the testing protocols. Results: In study A, 88 healthcare workers achieved an average compliance score of 7.60 out of 10 regarding the collection procedure. Over 70% of participants correctly followed the fundamental steps of the procedure. Many patients who underwent sample collection reported pain and symptoms such as coughing or sneezing. In study B, 198 pediatric patients were tested using rapid antigen tests, collected simultaneously with RT-PCR. The rapid tests showed a 50% sensitivity and 97.5% specificity. Conclusions: This study indicates that nasopharyngeal specimen collection techniques are based on international recommendations, but improvements could be made to reduce discomfort. Rapid antigen tests are helpful for screening due to their high specificity and negative predictive value. Continuous healthcare personnel training and the monitoring of diagnostic techniques remain essential in managing SARS-CoV-2 and other viral infections.