Effective high-throughput RT-qPCR screening for SARS-CoV-2 infections in children
Felix Dewald, Isabelle Suárez, Ronja Johnen, Jan Großbach, Roberto Morán-Tovar, Gertrud Steger, Alexander Joachim, Gibran Horemheb-Rubio, Mira Fries, Florian Behr, Joao Kley, Andreas Lingnau, Alina Chloé Kretschmer, Carina Gude, Guadalupe del Carmen Baeza‐Flores, David del Valle Laveaga, Alberto Roblero-Hernández, Jesús Miguel Magaña‐Cerino, Adriana Torres Hernandez, Jesús Arturo Ruiz-Quiñones, Konstantin Schega, Viktoria Linne, Lena Junker, Marie Wunsch, Eva Heger, Elena Knops, Veronica Di Cristanziano, Meike Meyer, Christoph Hünseler, Lutz T. Weber, Jan-Christoffer Lüers, Gustav Quade, Hilmar Wisplinghoff, Carsten Tiemann, Rainer B. Zotz, Hassan Jomaa, Arthur B. Pranada, Ileana Herzum, Paul Cullen, Franz‐Josef Schmitz, Paul Philipsen, Georg Kirchner, Cornelius Knabbe, Martin Hellmich, Michael Buess, Anna Wolff, Annelene Kossow, Johannes Nießen, Sebastian Jeworutzki, Jörg-Peter Schräpler, Michael Lässig, Jörg Dötsch, Gerd Fätkenheuer, Rolf Kaiser, Andreas Beyer, Jan Rybniker, Florian Klein
Abstract
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 >10 6 copies/ml and >10 3 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.