OBJECTIVES: To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. DESIGN: Cross-sectional multicentre diagnostic study. SETTING: Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain. PATIENTS: Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected. MAIN OUTCOME: Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2. RESULTS: 1174 children were included, aged 3.8 years (IQR 1.7-9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR. CONCLUSIONS: RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested.
COVID-19 , Child , Humans , COVID-19/diagnosis , SARS-CoV-2/genetics , COVID-19 Testing , Saliva , Reverse Transcription , Prospective Studies , Cross-Sectional Studies , Sensitivity and Specificity , Polymerase Chain Reaction
Introducción: A 30 de abril de 2020, se habían notificado 203.715 infecciones SARS-CoV-2 en España, 54.486 en Madrid, y el 21,4% eran trabajadores de la salud. El objetivo del estudio es determinar la prevalencia serológica de infección SARS-CoV-2 en trabajadores de un hospital monográfico pediátrico. Método: Del 13 al 30 de abril, 1.523 trabajadores fueron convocados a realizar un test serológico (All Test®) frente a SARS-CoV-2 y respondieron un cuestionario con información demográfica, clínico-epidemiológica y de exposición a COVID-19. Resultados: Mil doscientos noventa y dos (84,8%) fueron estudiados. La prevalencia serológica (IgM y/o IgG+) a SARS-CoV-2 fue del 17,2% (222/1.292) y del 15,5% (201/1.292) considerando IgG positiva. La edad media fue 44±13 años, el 73% eran mujeres. El 33,8% (75/222) fueron asintomáticos. Tenían rRT-PCR positiva previa 81. El 14% (32/222) contacto familiar. Conclusión: La prevalencia serológica SARS-CoV-2 en los trabajadores de un hospital pediátrico fue mayor que en la población general. Muchos pasaron una infección inadvertida.(AU)
Introduction: As of 30 April 2020, 203.715 SARS-CoV-2 infections had been reported in Spain, 54.486 in Madrid, 21.4% were health care workers. Our objective is to determine seroprevalence of COVID-19 among workers in a monographic pediatric hospital. Methods: Between April13th and 30th, 1.523 health workers were recruited to be tested for SARS-CoV-2 serology screening (All Test®) and they answered a questionnaire with demographic, epidemiological and clinical information and previous exposure to COVID-19. Findings: One thousand two hundred ninety two (84.8%) were tested. Positive serology (IgM and/or IgG) to SARS-CoV-2 was found in 17.2% (222/1.292), in 15.5% (201/1.292) if only IgG was considered. Median age was 44±13 years, 73% were female. The 33.8% (75/222) were asymptomatic. Eighty one had a previous positive rRT-PCR. The 14% (32/222) referred a family contact. Conclusion: Serology prevalence for SARS-CoV-2 in workers of a pediatric hospital was higher than in general population. Many of them had an unnoticed infection.(AU)
Humans , Male , Female , Young Adult , Adult , Severe acute respiratory syndrome-related coronavirus , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Hospitals, Pediatric , Spain , Immunoglobulin G , Seroepidemiologic Studies , Chromatography , Health Personnel , Epidemiology, Descriptive , Cross-Sectional Studies , Microbiology , Communicable Diseases , Surveys and Questionnaires
INTRODUCTION: As of 30 April 2020, 203.715 SARS-CoV-2 infections had been reported in Spain, 54.486 in Madrid, 21.4% were health care workers. Our objective is to determine seroprevalence of COVID-19 among workers in a monographic pediatric hospital. METHODS: Between April13th and 30th, 1.523 health workers were recruited to be tested for SARS-CoV-2 serology screening (All Test®) and they answered a questionnaire with demographic, epidemiological and clinical information and previous exposure to COVID-19. FINDINGS: One thousand two hundred ninety two (84.8%) were tested. Positive serology (IgM and/or IgG) to SARS-CoV-2 was found in 17.2% (222/1.292), in 15.5% (201/1.292) if only IgG was considered. Median age was 44±13 years, 73% were female. The 33.8% (75/222) were asymptomatic. Eighty one had a previous positive rRT-PCR. The 14% (32/222) referred a family contact. CONCLUSION: Serology prevalence for SARS-CoV-2 in workers of a pediatric hospital was higher than in general population. Many of them had an unnoticed infection.
COVID-19 , SARS-CoV-2 , Adult , COVID-19/diagnosis , COVID-19/epidemiology , Child , Female , Health Personnel , Hospitals, Pediatric , Humans , Immunoglobulin G , Male , Middle Aged , Seroepidemiologic Studies , Spain/epidemiology
Epileptic encephalopathy related to CACNA1E has been described as a severe neurodevelopmental disorder presenting with early-onset refractory seizures, hypotonia, macrocephaly, hyperkinetic movements, and contractures and is associated with an autosomal dominant inheritance pattern. Most pathogenic variants described to date are missense variants with a gain of function effect, and the role of haploinsufficiency has yet to be clarified. We describe 2 cases of CACNA1E encephalopathy. Notable findings include congenital contractures and movement disorders predating onset of epilepsy, particularly dystonia. We further compared the key phenotypic features depending on variant location. In conclusion, the appearance of congenital contractures, areflexia, and movement disorders before the onset of epilepsy may provide key guidance in the diagnosis of epileptic CACNA1E encephalopathy. A genotype-phenotype correlation was found between the presence of movement disorders and severe intellectual disability and the location of the variant in the CACNA1E gene.
INTRODUCTION: As of 30 April 2020, 203.715 SARS-CoV-2 infections had been reported in Spain, 54.486 in Madrid, 21.4% were health care workers. Our objective is to determine seroprevalence of COVID-19 among workers in a monographic pediatric hospital. METHODS: Between April13th and 30th, 1.523 health workers were recruited to be tested for SARS-CoV-2 serology screening (All Test®) and they answered a questionnaire with demographic, epidemiological and clinical information and previous exposure to COVID-19. FINDINGS: One thousand two hundred ninety two (84.8%) were tested. Positive serology (IgM and/or IgG) to SARS-CoV-2 was found in 17.2% (222/1.292), in 15.5% (201/1.292) if only IgG was considered. Median age was 44±13 years, 73% were female. The 33.8% (75/222) were asymptomatic. Eighty one had a previous positive rRT-PCR. The 14% (32/222) referred a family contact. CONCLUSION: Serology prevalence for SARS-CoV-2 in workers of a pediatric hospital was higher than in general population. Many of them had an unnoticed infection.
