Performance of saliva specimens for the molecular detection of SARS-CoV-2 in the community setting: does sample collection method matter?
| Autor: | Mar Carvajal, Marta Fernández-González, Montserrat Ruiz-García, Claudio Cuartero, Manuel Sánchez, José A. García, Mar Masiá, Ana Infante, Nieves Gonzalo-Jiménez, Alba de la Rica, Carlos de Gregorio, Vanesa Agulló, Félix Gutiérrez |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Microbiology (medical) Saliva medicine.medical_specialty viruses Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gastroenterology Asymptomatic Specimen Handling Nasopharynx Virology Internal medicine diagnostics Humans Medicine Prospective Studies Prospective cohort study saliva SARS-CoV-2 business.industry virus diseases COVID-19 Confidence interval PCR Ambulatory Community setting Female Sample collection medicine.symptom business Kappa |
| Zdroj: | Journal of Clinical Microbiology |
| DOI: | 10.1101/2020.12.01.20241349 |
| Popis: | Data on the performance of saliva specimens for diagnosing coronavirus disease 2019 (COVID-19) in ambulatory patients are scarce and inconsistent. We assessed saliva-based specimens for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase PCR (RT-PCR) in the community setting and compared three different collection methods. Data on the performance of saliva specimens for diagnosing coronavirus disease 2019 (COVID-19) in ambulatory patients are scarce and inconsistent. We assessed saliva-based specimens for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase PCR (RT-PCR) in the community setting and compared three different collection methods. This prospective study was conducted in three primary care centers. RT-PCR was performed on paired nasopharyngeal swabs (NPS) and saliva samples collected from outpatients with a broad clinical spectrum of illness. To assess differences in collection methods, saliva specimens were obtained in a different way in each of the participating centers: supervised collection (SVC), oropharyngeal washing (OPW), and self-collection (SC). Pairs of NPS and saliva samples from 577 patients (median age, 39 years; 44% men; 42% asymptomatic) were collected and tested, and 120 (20.8%) gave positive results. The overall agreement with NPS results and kappa coefficients (κ) for saliva samples obtained by SVC, OPW, and SC were 95% (κ = 0.85), 93.4% (κ = 0.76), and 93.3% (κ = 0.76), respectively. The sensitivities (95% confidence intervals [95% CI]) of the saliva specimens ranged from 86% (72.6% to 93.7%) for SVC to 66.7% (50.4% to 80%) for SC samples. Sensitivity was higher for samples with lower cycle threshold (CT) values. The best RT-PCR performance was observed for SVC, with sensitivities (95% CI) of 100% (85.9% to 100%) in symptomatic individuals and 88.9% (50.7% to 99.4%) in asymptomatic individuals at CT values of ≤30. We conclude that saliva is an acceptable specimen for the detection of SARS-CoV-2 in the community setting. Specimens collected under supervision perform comparably to NPS and can effectively identify individuals at higher risk of transmission under real-life conditions. |
| Databáze: | OpenAIRE |
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