COVID ReportsSARS-CoV-2 Viral Load Quantification, Clinical Findings and Outcomes in Children Seeking Emergency Department Care: Prospective Cohort StudyFreedman, Stephen B. MDCM, MSc*; Oberding, Lisa K. MSc†; Kim, Kelly BSc‡; Xie, Jianling MD, MPH‡; Berenger, Byron M. MD, MSc§,¶; Goulden, Ruza RN‡; Weisbeck, Sarah RN, MN‡; Pillai, Dylan R. MD, PhD¶ Author Information From the *Divisions of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta †Departments of Pathology and Laboratory Medicine and Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Alberta ‡Division of Pediatric Emergency Medicine, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta §Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta ¶Alberta Precision Laboratories, Diagnostic and Scientific Centre, Departments of Pathology & Laboratory Medicine and Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta. Accepted for publication March 10, 2022 This study was supported by grants from the Canadian Institutes of Health Research (Operating Grant: COVID-19 - Clinical management), Alberta Innovates, the Alberta Health Service – University of Calgary - Clinical Research Fund, the Alberta Children’s Hospital Research Institute, and the Canada Foundation for Innovation Exceptional Opportunities Fund – COVID-19. Dr. Stephen Freedman is supported by the Alberta Children’s Hospital Foundation Professorship in Child Health and Wellness. None of the funders played any role in the design or conduct of the study, collection, management, analysis, or interpretation of the data, or in the preparation, review, or approval of the manuscript and decision to submit the manuscript for publication. The authors have no conflicts of interest to disclose. S.F. wrote the original draft, which was reviewed and edited by L.O., K.K., J.X., B.B., R.G., S.W. and D.P. Conceptualization was performed by S.F. and D.P.; resources were obtained by S.F. and D.P.; investigations were carried out by S.F., L.O., K.K., R.G., S.W., and D.P.; formal analysis was performed by L.O. and J.X.; and S.F. and D.P. supervised the study. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.pidj.com) Address for correspondence: Stephen Freedman, MDCM, MSc, Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital Foundation Professor in Child Health and Wellness, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Alberta, Cananda. E-mail: [email protected] The Pediatric Infectious Disease Journal: July 2022 - Volume 41 - Issue 7 - p 566-569 doi: 10.1097/INF.0000000000003527 Buy SDC Metrics Abstract We compared the perfomance of SARS-CoV-2 reverse transcriptase real-time polymerase chain reaction (RT-PCR) to droplet digital PCR (ddPCR). 95% and 40% of positive and negative RT-PCR specimens, respectively, were positive on ddPCR yielding sensitivities of 84% (95% CI: 74, 91) and 97% (95% CI: 89, 99), for RT-PCR and ddPCR, respectively. We found that SARS-CoV-2 RT-PCR testing in children has a concerning false-negative rate at lower nucleocapsid gene copy numbers. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.