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Dewald F, Suárez I, Johnen R, Grossbach J, Moran-Tovar R, Steger G, Joachim A, Rubio GH, Fries M, Behr F, Kley J, Lingnau A, Kretschmer A, Gude C, Baeza-Flores G, Del Valle DL, Roblero-Hernandez A, Magana-Cerino J, Hernandez AT, Ruiz-Quinones J, Schega K, Linne V, Junker L, Wunsch M, Heger E, Knops E, Di Cristanziano V, Meyer M, Hünseler C, Weber LT, Lüers JC, Quade G, Wisplinghoff H, Tiemann C, Zotz R, Jomaa H, Pranada A, Herzum I, Cullen P, Schmitz FJ, Philipsen P, Kirchner G, Knabbe C, Hellmich M, Buess M, Wolff A, Kossow A, Niessen J, Jeworutzki S, Schräpler JP, Lässig M, Dötsch J, Fätkenheuer G, Kaiser R, Beyer A, Rybniker J, Klein F. Effective high-throughput RT-qPCR screening for SARS-CoV-2 infections in children. Nat Commun 2022; 13:3640. [PMID: 35752615 PMCID: PMC9233713 DOI: 10.1038/s41467-022-30664-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/11/2022] [Indexed: 12/15/2022] Open
Abstract
Systematic SARS-CoV-2 testing is a valuable tool for infection control and surveillance. However, broad application of high sensitive RT-qPCR testing in children is often hampered due to unpleasant sample collection, limited RT-qPCR capacities and high costs. Here, we developed a high-throughput approach (‘Lolli-Method’) for SARS-CoV-2 detection in children, combining non-invasive sample collection with an RT-qPCR-pool testing strategy. SARS-CoV-2 infections were diagnosed with sensitivities of 100% and 93.9% when viral loads were >106 copies/ml and >103 copies/ml in corresponding Naso-/Oropharyngeal-swabs, respectively. For effective application of the Lolli-Method in schools and daycare facilities, SEIR-modeling indicated a preferred frequency of two tests per week. The developed test strategy was implemented in 3,700 schools and 698 daycare facilities in Germany, screening over 800,000 individuals twice per week. In a period of 3 months, 6,364 pool-RT-qPCRs tested positive (0.64%), ranging from 0.05% to 2.61% per week. Notably, infections correlated with local SARS-CoV-2 incidences and with a school social deprivation index. Moreover, in comparison with the alpha variant, statistical modeling revealed a 36.8% increase for multiple (≥2 children) infections per class following infections with the delta variant. We conclude that the Lolli-Method is a powerful tool for SARS-CoV-2 surveillance and can support infection control in schools and daycare facilities. Dewald et al. combine a non-invasive sampling approach (Lolli-Test) with an RT qPCR-pool testing strategy to screen for SARS-CoV-2 infections in children and use the method for surveillance and infection control in > 4000 school and daycare settings.
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Affiliation(s)
- Felix Dewald
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Isabelle Suárez
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,German Center for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Ronja Johnen
- CECAD Research center, University of Cologne, Cologne, Germany
| | - Jan Grossbach
- CECAD Research center, University of Cologne, Cologne, Germany.,CECAD Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, University of Cologne, Cologne, Germany
| | | | - Gertrud Steger
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Alexander Joachim
- Department of Pediatrics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gibran Horemheb Rubio
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
| | - Mira Fries
- Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,Health department of Cologne, Cologne, Germany
| | - Florian Behr
- Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,Health department of Cologne, Cologne, Germany
| | - Joao Kley
- Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Andreas Lingnau
- Ministry of Schools and Education of North Rhine-Westphalia, Düsseldorf, Germany
| | - Alina Kretschmer
- Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Carina Gude
- CECAD Research center, University of Cologne, Cologne, Germany
| | - Guadelupe Baeza-Flores
- Centro de Investigación en Enfermedades Tropicales y Emergentes, Hospital Regional de Alta Especialidad, Dr. Juan Graham Casasús, Villahermosa, Mexico
| | - David Laveaga Del Valle
- Centro de Investigación en Enfermedades Tropicales y Emergentes, Hospital Regional de Alta Especialidad, Dr. Juan Graham Casasús, Villahermosa, Mexico
| | - Alberto Roblero-Hernandez
- Centro de Investigación en Enfermedades Tropicales y Emergentes, Hospital Regional de Alta Especialidad, Dr. Juan Graham Casasús, Villahermosa, Mexico
| | - Jesus Magana-Cerino
- Centro de Investigación en Enfermedades Tropicales y Emergentes, Hospital Regional de Alta Especialidad, Dr. Juan Graham Casasús, Villahermosa, Mexico
| | | | - Jesus Ruiz-Quinones
- Centro de Investigación en Enfermedades Tropicales y Emergentes, Hospital Regional de Alta Especialidad, Dr. Juan Graham Casasús, Villahermosa, Mexico
| | | | - Viktoria Linne
- Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lena Junker
- Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Marie Wunsch
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Heger
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elena Knops
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veronica Di Cristanziano
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Meike Meyer
- Department of Pediatrics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christoph Hünseler
- Department of Pediatrics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lutz T Weber
- Department of Pediatrics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan-Christoffer Lüers
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Gustav Quade
- MVZ Labor Dr. Quade & Kollegen GmbH, Cologne, Germany
| | | | | | - Rainer Zotz
- Institute for Laboratory Medicine ZotzKlimas, Düsseldorf, Germany.,Department of Haemostasis, Haemotherapy and Transfusion Medicine, Heinrich Heine University Medical Centre, Düsseldorf, Germany
| | | | - Arthur Pranada
- Medizinisches Versorgungszentrum Dr. Eberhard & Partner, Dortmund, Germany
| | - Ileana Herzum
- Medizinische Laboratorien Düsseldorf, Düsseldorf, Germany
| | | | | | - Paul Philipsen
- Labor Mönchengladbach MVZ Dr. Stein und Kollegen, Mönchengladbach, Germany
| | - Georg Kirchner
- Eurofins Laborbetriebsgesellschaft Gelsenkirchen GmbH & Eurofins MVZ Medizinisches Labor Gelsenkirchen GmbH, Gelsenkirchen, Germany
| | - Cornelius Knabbe
- Heart- and Diabetes Center NRW, Medical Faculty, Ruhr-University Bochum, Institute for Laboratory and Transfusion Medicine, Bad Oeynhausen, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Anna Wolff
- Health department of Cologne, Cologne, Germany
| | - Annelene Kossow
- Health department of Cologne, Cologne, Germany.,Institute for Hygiene, University Hospital Münster, Münster, Germany
| | | | | | - Jörg-Peter Schräpler
- Faculty of Social Science, Ruhr-University Bochum, Bochum, Germany.,German Socio Economic Panel Study (SOEP), Berlin, Germany
| | - Michael Lässig
- Institute for Biological Physics, University of Cologne, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatrics, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gerd Fätkenheuer
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Rolf Kaiser
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,German Center for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Andreas Beyer
- CECAD Research center, University of Cologne, Cologne, Germany.,CECAD Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, University of Cologne, Cologne, Germany.,Institute for Genetics, Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | - Jan Rybniker
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,Department I of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.,German Center for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Florian Klein
- Institute of Virology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany. .,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany. .,German Center for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.
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