ArticleEClinicalMedicine2021
Pooled RT-qPCR testing for SARS-CoV-2 surveillance in schools - a cluster randomised trial.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Effectiveness of SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths.The Cochrane database of systematic reviews · 2025Pooled it
- Diagnostic accuracy of rapid point-of-care tests for diagnosis of current SARS-CoV-2 infections in children: a systematic review and meta-analysis.BMJ evidence-based medicine · 2022Pooled it
- Impact of in-school antigen testing on the prevalence of asymptomatic SARS-CoV-2 carriers during the COVID-19 pandemic era.Frontiers in public health · 2026Article
- Children and adolescents' experiences of mandatory SARS-CoV-2 testing in schools: a cross-sectional survey.BMJ paediatrics open · 2024Article
- Development and validation of cost-effective SYBR Green-based RT-qPCR and its evaluation in a sample pooling strategy for detecting SARS-CoV-2 infection in the Indonesian setting.Scientific reports · 2024Article
- Influence parental- and child-related factors on the acceptance of SARS-CoV-2 test methods in schools and daycare facilities.Frontiers in public health · 2024Article
- Effectiveness of SARS-CoV-2 testing strategies: A scoping review.Cochrane evidence synthesis and methods · 2023Review
- Implementing the Lolli-Method and pooled RT-qPCR testing for SARS-CoV-2 surveillance in schools: a pilot project.Infection · 2023Article
- European Cohorts of patients and schools to Advance Response to Epidemics (EuCARE): a cluster randomised interventional and observational study protocol to investigate the relationship between schools and SARS-CoV-2 infection.BMC infectious diseases · 2023Article
- Age-specific contribution of contacts to transmission of SARS-CoV-2 in Germany.European journal of epidemiology · 2023Article
- Quantitative analysis of different respiratory specimens on two automated test systems for detection of SARS-CoV-2 RNA.Diagnostic microbiology and infectious disease · 2023Article
- Accelerating the Laboratory Testing Capacity through Saliva Pooling Prior to Direct RT-qPCR for SARS-CoV-2 Detection.Diagnostics (Basel, Switzerland) · 2022Article
- Acceptance of Different Self-sampling Methods for Semiweekly SARS-CoV-2 Testing in Asymptomatic Children and Childcare Workers at German Day Care Centers: A Nonrandomized Controlled Trial.JAMA network open · 2022Article
- Surveillance testing using salivary RT-PCR for SARS-CoV-2 in managed quarantine facilities in Australia: A laboratory validation and implementation study.The Lancet regional health. Western Pacific · 2022Article
- Results of the Cologne Corona surveillance (CoCoS) study - a prospective population-based cohort study: incidence data and potential underestimation of new SARS-CoV-2 adult infections by health authorities.BMC public health · 2022Article
- Effective high-throughput RT-qPCR screening for SARS-CoV-2 infections in children.Nature communications · 2022Article
- Article
- Comparative Evaluation of Six SARS-CoV-2 Real-Time RT-PCR Diagnostic Approaches Shows Substantial Genomic Variant-Dependent Intra- and Inter-Test Variability, Poor Interchangeability of Cycle Threshold and Complementary Turn-Around Times.Pathogens (Basel, Switzerland) · 2022Article
- Surveillance of Acute SARS-CoV-2 Infections in Elementary Schools and Daycare Facilities in Bavaria, Germany (09/2020-03/2021).Frontiers in pediatrics · 2022Article
- Where is the greatest risk of COVID-19 infection? Findings from Germany's largest public health department, Cologne.PloS one · 2022Article
Corrections and comments
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Authors and funding
29 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe extent to which children and adolescents contribute to SARS-CoV-2 transmission remains not fully understood. Novel high-capacity testing methods may provide real-time epidemiological data in educational settings helping to establish a rational approach to prevent and minimize SARS-CoV-2 transmission. We investigated whether pooling of samples for SARS-CoV-2 detection by RT-qPCR is a sensitive and feasible high-capacity diagnostic strategy for surveillance of SARS-CoV-2 infections in schools.
methodsIn this study, students and school staff of 14 educational facilities in Germany were tested sequentially between November 9 and December 23, 2020, two or three times per week for at least three consecutive weeks. Participants were randomized for evaluation of two different age adjusted swab sampling methods (oropharyngeal swabs or buccal swabs compared to saliva swabs using a 'lolli method'). Swabs were collected and pooled for SARS-CoV-2 RT-qPCR. Individuals of positive pooled tests were retested by RT-qPCR the same or the following day. Positive individuals were quarantined while the SARS-CoV-2 negative individuals remained in class with continued pooled RT-qPCR surveillance. The study is registered with the German Clinical Trials register (registration number: DRKS00023911).
findings5,537 individuals were eligible and 3970 participants were enroled and included in the analysis. In students, a total of 21,978 swabs were taken and combined in 2218 pooled RT-qPCR tests. We detected 41 positive pooled tests (1·8%) leading to 36 SARS-CoV-2 cases among students which could be identified by individual re-testing. The cumulative 3-week incidence for primary schools was 564/100,000 (6/1064, additionally 1 infection detected in week 4) and 1249/100,000 (29/2322) for secondary schools. In secondary schools, there was no difference in the number of SARS-CoV-2 positive students identified from pooled oropharyngeal swabs compared to those identified from pooled saliva samples (lolli method) (14 vs. 15 cases; 1·3% vs. 1·3%; OR 1.1; 95%-CI 0·5-2·5). A single secondary school accounted for 17 of 36 cases (47%) indicating a high burden of asymptomatic prevalent SARS-CoV-2 cases in the respective school and community.
interpretationIn educational settings, SARS-CoV-2 screening by RT-qPCR-based pooled testing with easily obtainable saliva samples is a feasible method to detect incident cases and observe transmission dynamics.
fundingFederal Ministry of education and research (BMBF; Project B-FAST in "NaFoUniMedCovid19"; registration number: 01KX2021).
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