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Gutiérrez-Gómez ML, Ruíz Z, Gamboa F, Roa NS, Cardozo C, Ariza B, Aristizábal A, Lugo A, Bolívar S, Henao D, García-Robayo DA. SARS-CoV-2 diagnosis in saliva samples: Usefulness and limitations. Diagn Microbiol Infect Dis 2024; 109:116320. [PMID: 38678688 DOI: 10.1016/j.diagmicrobio.2024.116320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 05/01/2024]
Abstract
Saliva samples are important for diagnosis, because they are noninvasive and easy to acquire. The objective of this cross-sectional study was to investigate the value saliva samples have in detecting SARS-CoV-2 in comparison to nasal swabs and a new system named CovidCheck. A standard methodology identified the virus in 185 nasopharyngeal swabs and saliva samples revealing a sensitivity, specificity and positive and negative predictive values of 82,100,100 and 94.67%, respectively for saliva samples. Viral presence in saliva samples with the standard methodology in comparison to the CovidCheck system was evaluated in 67 samples with sensitivity, specificity and positive and negative predictive values of 68, 81, 68 and 81%, respectively. In conclusion, our results highlight the usefulness saliva samples have in detecting respiratory viral infections. However, presence of viral inhibitors and viral load in saliva, and the patient's clinical status should be considered as they might affect amplifying systems results.
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Affiliation(s)
- María-Lucía Gutiérrez-Gómez
- Department of Morphological Sciences, School of Medicine, Pontificia Universidad Javeriana, Bogotá D.C, Colombia; Institute of Human Genetics, School of Medicine, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
| | - Zulema Ruíz
- Clinical Laboratory, San Ignacio University Hospital, Bogotá, D.C., Colombia
| | - Fredy Gamboa
- Center for Dental Research, School of Dentistry, Pontificia Universidad Javeriana, Bogotá D.C., Colombia; Department of Microbiology, School of Sciences, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Nelly S Roa
- Center for Dental Research, School of Dentistry, Pontificia Universidad Javeriana, Bogotá D.C., Colombia; Department of Buccal System, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia
| | - Claudia Cardozo
- Clinical Laboratory, San Ignacio University Hospital, Bogotá, D.C., Colombia
| | - Beatriz Ariza
- Clinical Laboratory, San Ignacio University Hospital, Bogotá, D.C., Colombia
| | - Andrés Aristizábal
- Department of Nutrition and Biochemistry, School of Sciences, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Andrés Lugo
- Department of Respiratory Care, respIRA group, San Ignacio University Hospital, Bogotá, D.C., Colombia
| | - Stevenson Bolívar
- Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, D. C., Colombia
| | - Daniel Henao
- Department of Dental System, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia
| | - Dabeiba-Adriana García-Robayo
- Center for Dental Research, School of Dentistry, Pontificia Universidad Javeriana, Bogotá D.C., Colombia; Department of Buccal System, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
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Kim MJ, Park PG, Hwang SJ, Bang SJ, Jung JH, Kown EB, Sul EK, Song KC, Choi JS, Han KR, Lee HY, Kim DH, Lee JM. Saliva-based Proteinase K method: A rapid and reliable diagnostic tool for the detection of SARS-COV-2 in children. J Med Virol 2024; 96:e29361. [PMID: 38178612 DOI: 10.1002/jmv.29361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
Early and accurate detection of viruses in children might help prevent transmission and severe diseases. In this study, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) detection in children was evaluated using saliva specimens with a Proteinase K (PTK)-based RNA preparation, as saliva collection is a simple and noninvasive procedure, even in young children, with fewer concerns about sample contamination. The saliva-based PTK and the conventional paired nasopharyngeal aspiration (NPA)-based detection methods were compared between COVID-19-positive and -negative children. In addition, the detection rate for SARS-COV-2 and the difference between admission and discharge by the saliva-based PTK method was tested in COVID-19 patients. The diagnostic accuracy of the saliva-based PTK method was 98.8% compared to NP swab-based reverse transcriptase polymerase chain reaction. Saliva samples showed high sensitivity (94.1%) and specificity (100%) when using the PTK method. Furthermore, the saliva-based PTK method significantly reduced the test processing time by 2 h. Notably, Ct values at discharge increased in saliva samples compared with those at admission, which might indicate patients' clinical conditions or virus activity. In conclusion, the saliva-based PTK implemented in this study streamlines RNA extraction, making the process faster, safer, and more cost-effective, demonstrating that this method is a rapid and reliable diagnostic tool for SARS-CoV-2 detection in children.
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Affiliation(s)
- Min Jung Kim
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
| | - Pil-Gu Park
- Department of Microbiology, Gachon University, Incheon, Korea
| | - Su Jin Hwang
- Department of Microbiology and Immunology, Institute for Immunology and Immunological Diseases, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Jun Bang
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Jae Hwa Jung
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Bin Kown
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
| | - Eun Kyung Sul
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
| | - Kyung Chul Song
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
| | - Joon-Sik Choi
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Korea
| | - Kyeo Re Han
- Department of Microbiology and Immunology, Institute for Immunology and Immunological Diseases, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Young Lee
- Department of Biomedical Laboratory Science, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea
| | - Dong Hyun Kim
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Jae Myun Lee
- Department of Microbiology and Immunology, Institute for Immunology and Immunological Diseases, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Bakshi SS, Mangayarkarasi V, Dash D, Das S, Ramesh S, Jayam C, Kalidoss VK. Comparative study on Saliva and Nasopharyngeal swabs and the outcome of RT-PCR test in patients with mild symptoms of SARS-CoV-2. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023; 74:315-319. [PMID: 36965822 DOI: 10.1016/j.otoeng.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/01/2022] [Accepted: 12/06/2022] [Indexed: 03/27/2023]
Abstract
AIM A simple and reliable method for diagnosing COVID 19 infections is the needed. The role of saliva in the transmission of the infection has already been established. METHOD Saliva and nasopharyngeal swabs from patients suspected to have COVID 19 infections were taken simultaneously, and the results of the RT-PCR were compared. RESULT Total 405 samples were collected, of which 250 males and 155 females. In the 391 samples included for analysis, 370 (94.63%) samples were found to have concordance results, and 21 (5.37%) samples had discordant results. CONCLUSION The use of saliva to diagnose COVID 19 infection is reliable, and its use can be recommended.
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Affiliation(s)
- Satvinder Singh Bakshi
- Department of ENT and Head & Neck Surgery, All India Institute of Medical Sciences Mangalagiri, Guntur, Andhra Pradesh, India.
| | - V Mangayarkarasi
- Department of Microbiology, AIIMS Mangalagiri, Guntur, Andhra Pradesh, India.
| | - Debabrata Dash
- Department of Microbiology, AIIMS Mangalagiri, Guntur, Andhra Pradesh, India.
| | - Soumyajit Das
- Department of ENT and Head & Neck Surgery, All India Institute of Medical Sciences Mangalagiri, Guntur, Andhra Pradesh, India.
| | - Seepana Ramesh
- Department of ENT and Head & Neck Surgery, All India Institute of Medical Sciences Mangalagiri, Guntur, Andhra Pradesh, India.
| | - Cheeranjeevi Jayam
- Department of Dentistry, AIIMS Mangalagiri, Guntur, Andhra Pradesh, India.
| | - Vinoth Kumar Kalidoss
- Department of Community and Family Medicine, AIIMS Mangalagiri, Guntur, Andhra Pradesh, India.
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Liu Y, Kumblathan T, Tao J, Xu J, Feng W, Xiao H, Hu J, Huang CV, Wu Y, Zhang H, Li XF, Le XC. Recent advances in RNA sample preparation techniques for the detection of SARS-CoV-2 in saliva and gargle. Trends Analyt Chem 2023; 165:117107. [PMID: 37317683 PMCID: PMC10204347 DOI: 10.1016/j.trac.2023.117107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023]
Abstract
Molecular detection of SARS-CoV-2 in gargle and saliva complements the standard analysis of nasopharyngeal swabs (NPS) specimens. Although gargle and saliva specimens can be readily obtained non-invasively, appropriate collection and processing of gargle and saliva specimens are critical to the accuracy and sensitivity of the overall analytical method. This review highlights challenges and recent advances in the treatment of gargle and saliva samples for subsequent analysis using reverse transcription polymerase chain reaction (RT-PCR) and isothermal amplification techniques. Important considerations include appropriate collection of gargle and saliva samples, on-site inactivation of viruses in the sample, preservation of viral RNA, extraction and concentration of viral RNA, removal of substances that inhibit nucleic acid amplification reactions, and the compatibility of sample treatment protocols with the subsequent nucleic acid amplification and detection techniques. The principles and approaches discussed in this review are applicable to molecular detection of other microbial pathogens.
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Affiliation(s)
- Yanming Liu
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Teresa Kumblathan
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Jeffrey Tao
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Jingyang Xu
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Wei Feng
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Huyan Xiao
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Jianyu Hu
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Camille V Huang
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Yiping Wu
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Hongquan Zhang
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - Xing-Fang Li
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
| | - X Chris Le
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada
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Buonsenso D, Valentini P, Mariani F, Di Noi S, Mazza S, Palucci I, Sanguinetti M, Sali M. Comparison between Nasopharyngeal and Saliva Samples for the Detection of Respiratory Viruses in Children with Acute Lower Respiratory Tract Infections: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050899. [PMID: 37238447 DOI: 10.3390/children10050899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
PURPOSE During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated. METHODS Children younger than 18 years of age admitted with respiratory signs and symptoms underwent both nasopharyngeal and SS procedures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SS were calculated, considering the nasopharyngeal swab result as the gold standard. RESULTS A total of 83 patients (44 females, 53%) underwent both nasopharyngeal and SS procedures. Overall, the sensitivity of SS was 49.4%. Sensitivity according to different respiratory viruses ranged from 0% to 71.43%, while the specificity ranged from 96% to 100%. Negative predictive value ranged from 68.06% to 98.8%, while positive predictive value ranged from 0 to 100%. SS sensitivity in patients younger than 12 months of age was 39.47%, while in patients older than or equal to 12 months of age it was 57.78%. Patients with negative SS had a significantly lower median age (8.5 months (15.25) vs. 23 months (34), p = 0.001) and a significantly lower quantity of median saliva collected for salivary analysis (0 μL (213) vs. 300 μL (100), p < 0.001). CONCLUSIONS SS has a relatively low sensitivity in detecting common respiratory viruses in children with LRTI, with a lower probability in younger children (and in particular those younger than 6 months of age) or those from whom we have collected lesser amounts of saliva. New strategies to improve saliva collection are needed for testing on a larger study population.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Silvia Di Noi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Sofia Mazza
- Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ivana Palucci
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
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6
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Moraleda C, Domínguez-Rodríguez S, Mesa JM, García-Sánchez P, de la Serna M, Alonso-Cadenas JA, Bermejo A, Sabrido G, Martínez-Campos L, González-Posada AF, Illán-Ramos M, Cobos-Carrascosa E, Ballesteros Á, Galán JC, Llorente F, Aguilera-Alonso D, Jiménez AB, Catalán P, Dahdouh E, Navarro I, Fernández-Garoz B, Mendoza P, Pérez-Jorge C, Cabezas-Fernández T, Blázquez-Gamero D, Rivas G, Gonzalez-Donapetry P, Sáez E, Fernández-Pinero J, Lucas-Fernández J, Pérez-Ramírez E, Merino P, Miragaya S, Lorente J, Iglesias I, Tagarro A. Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population. Arch Dis Child 2022; 107:1051-1058. [PMID: 35688603 PMCID: PMC9240444 DOI: 10.1136/archdischild-2021-323712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/12/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. DESIGN Cross-sectional multicentre diagnostic study. SETTING Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain. PATIENTS Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected. MAIN OUTCOME Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2. RESULTS 1174 children were included, aged 3.8 years (IQR 1.7-9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR. CONCLUSIONS RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested.
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Affiliation(s)
- Cinta Moraleda
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre. Pediatric Research and Clinical Trials Unit (UPIC). RITIP (Translational Research Network in Pediatric Infectious Diseases), Madrid, Spain
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Sara Domínguez-Rodríguez
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Juan Miguel Mesa
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
| | - Paula García-Sánchez
- Emergency Pediatric Department. Instituto Investigación Hospital La Paz (IDIPaz), Hospital Universitario La Paz, Madrid, Spain
| | - María de la Serna
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
| | - José Antonio Alonso-Cadenas
- Emergency Pediatric Department. Instituto Investigación La Princesa, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Amanda Bermejo
- Pediatric Department, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | - Gema Sabrido
- Pediatric Department, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Leticia Martínez-Campos
- Pediatric Infectious Diseases, Materno Infantil. Hospital Universitario Torrecárdenas, Almeria, Spain
| | | | - Marta Illán-Ramos
- Pediatrics Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Elena Cobos-Carrascosa
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Álvaro Ballesteros
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Juan Carlos Galán
- Microbiology Department, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Francisco Llorente
- Centro de Investigacion en Sanidad Animal INIA-CSIC, Valdeolmos, Madrid, Spain
| | - David Aguilera-Alonso
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario Gregorio Marañón. Unidad de Investigación Maternoinfantil Fundación Familia Alonso (UDIMIFFA), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM). CIBER en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Ana Belén Jiménez
- Pediatrics Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiologia Clinica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Elias Dahdouh
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz. IdiPAZ, Madrid, Spain
| | - Ignacio Navarro
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
| | | | - Pablo Mendoza
- Microbiology Department, Hospital Universitario de Móstoles, Mostoles, Madrid, Spain
| | - Concepción Pérez-Jorge
- Microbiology Department, Hospital Universitario Rey Juan Carlos, Mostoles, Madrid, Spain
| | | | - Daniel Blázquez-Gamero
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario 12 de Octubre. Pediatric Research and Clinical Trials Unit (UPIC). RITIP (Translational Research Network in Pediatric Infectious Diseases), Madrid, Spain
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
- Universidad Complutense, Madrid, Spain
| | - Gonzalo Rivas
- Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Elena Sáez
- Microbiology Department, UR Salud. Hospital Universitario Infanta Sofía. Paediatrics Research Group, San Sebastian de los Reyes, Madrid, Spain
| | | | - Jesús Lucas-Fernández
- Microbiology Department, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisa Pérez-Ramírez
- Centro de Investigacion en Sanidad Animal INIA-CSIC, Valdeolmos, Madrid, Spain
| | - Paloma Merino
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Sandra Miragaya
- Clinic Analysis Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Jorge Lorente
- Emergency Pediatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Irene Iglesias
- Centro de Investigacion en Sanidad Animal INIA-CSIC, Valdeolmos, Madrid, Spain
| | - Alfredo Tagarro
- Instituto de Investigación 12 de Octubre (imas12), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
- Paediatrics Department. Pediatrics Research Group, Hospital Universitario Infanta Sofia, San Sebastian de los Reyes, Madrid, Spain
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7
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Barrera-Avalos C, Mena J, Luraschi R, Rojas P, Mateluna-Flores C, Vallejos-Vidal E, Imarai M, Sandino AM, Valdés D, Vera R, Hernández I, Reyes-López FE, Acuña-Castillo C. Sensitivity analysis of rapid antigen tests for the Omicron SARS-CoV-2 variant detection from nasopharyngeal swab samples collected in Santiago of Chile. Front Public Health 2022; 10:976875. [PMID: 36339133 PMCID: PMC9631301 DOI: 10.3389/fpubh.2022.976875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
The COVID-19 pandemic continues to be a concern and keeps global health authorities on alert. The RT-PCR technique has been the gold-standard assay for detecting the SARS-CoV-2 virus. However, rapid antigen tests (RATs) have been widely used to increase the number of tests faster and more efficiently in the population. Nevertheless, the appearance of new viral variants, with genomic mutations associated with greater contagiousness and immune evasion, highlights the need to evaluate the sensitivity of these RATs. This report evaluates the sensitivity of SD Biosensor-Roche, Panbio™, and Clinitest® RATs widely used in Santiago de Chile in the detection of the Omicron variant from Nasopharyngeal samples (NPSs), the most predominant SARS-CoV-2 variant in Chile and the world. SD Biosensor-Roche shows a detection sensitivity of 95.7% in the viral amplification range of 20 ≤ Cq < 25, while Panbio™ and Clinitest® show 100% and 91.3%, respectively. In the viral amplification ranges of 25 ≤ Cq < 30, the detection sensitivity decreased to 28% for SD Biosensor-Roche, 32% for Panbio™, and 72% for Clinitest®. This study indicates that the tested RATs have high sensitivity in detecting the Omicron variant of concern (VOC) at high viral loads. By contrast, its sensitivity decreases at low viral loads. Therefore, it is suggested to limit the use of RATs as an active search method, considering that infections in patients are increasingly associated with lower viral loads of SARS-CoV-2. These antecedents could prevent contagion outbreaks and reduce the underestimation of the current Omicron variant circulation at the local level.
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Affiliation(s)
- Carlos Barrera-Avalos
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Javier Mena
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Roberto Luraschi
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Patricio Rojas
- Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Carlos Mateluna-Flores
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Eva Vallejos-Vidal
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Mónica Imarai
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Ana María Sandino
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Daniel Valdés
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Rodrigo Vera
- Hospital de Urgencia Asistencia Pública (HUAP), Santiago, Chile
| | - Iván Hernández
- Hospital de Urgencia Asistencia Pública (HUAP), Santiago, Chile
| | - Felipe E. Reyes-López
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile,*Correspondence: Felipe E. Reyes-López
| | - Claudio Acuña-Castillo
- Centro de Biotecnología Acuícola, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile,Claudio Acuña-Castillo
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8
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Hua N, Corsten M, Bello A, Bhatt M, Milwid R, Champredon D, Turgeon P, Zemek R, Dawson L, Mitsakakis N, Webster R, Caulley L, Angel JB, Bastien N, Poliquin G, Johnson-Obaseki S. Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study. CMAJ Open 2022; 10:E981-E987. [PMID: 36347561 PMCID: PMC9648623 DOI: 10.9778/cmajo.20210279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate and timely testing for SARS-CoV-2 in the pediatric population is crucial to control the COVID-19 pandemic; saliva testing has been proposed as a less invasive alternative to nasopharyngeal swabs. We sought to compare the detection of SARS-CoV-2 using saliva versus nasopharyngeal swab in the pediatric population, and to determine the optimum time of testing for SARS-CoV-2 using saliva. METHODS We conducted a longitudinal diagnostic study in Ottawa, Canada, from Jan. 19 to Mar. 26, 2021. Children aged 3-17 years were eligible if they exhibited symptoms of COVID-19, had been identified as a high-risk or close contact to someone confirmed positive for SARS-CoV-2 or had travelled outside Canada in the previous 14 days. Participants provided both nasopharyngeal swab and saliva samples. Saliva was collected using a self-collection kit (DNA Genotek, OM-505) or a sponge-based kit (DNA Genotek, ORE-100) if they could not provide a saliva sample into a tube. RESULTS Among 1580 paired nasopharyngeal and saliva tests, 60 paired samples were positive for SARS-CoV-2. Forty-four (73.3%) were concordant-positive results and 16 (26.6%) were discordant, among which 8 were positive only on nasopharyngeal swab and 8 were positive only on saliva testing. The sensitivity of saliva was 84.6% (95% confidence interval 71.9%-93.1%). INTERPRETATION Salivary testing for SARS-CoV-2 in the pediatric population is less invasive and shows similar detection of SARS-CoV-2 to nasopharyngeal swabs. It may therefore provide a feasible alternative for diagnosis of SARS-CoV-2 infection in children.
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Affiliation(s)
- Nadia Hua
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Martin Corsten
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Alexander Bello
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Maala Bhatt
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Rachael Milwid
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - David Champredon
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Patricia Turgeon
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Roger Zemek
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Lauren Dawson
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Nicholas Mitsakakis
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Richard Webster
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Lisa Caulley
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Jonathan B Angel
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Nathalie Bastien
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Guillaume Poliquin
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man
| | - Stephanie Johnson-Obaseki
- Department of Otolaryngology - Head and Neck Surgery (Hua, Caulley, Johnson-Obaseki), University of Ottawa, Ottawa, Ont.; Division of Otolaryngology - Head and Neck Surgery (Corsten), Dalhousie University, Halifax, NS; National Microbiology Laboratory (Bello, Bastien, Poliquin), Public Health Agency of Canada, Winnipeg, Man.; Department of Pediatrics and Emergency Medicine (Bhatt, Zemek), Children's Hospital of Eastern Ontario; Division of Pediatric Emergency Research (Bhatt, Zemek, Dawson, Mitsakakis, Webster), Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont.; National Microbiology Laboratory (Milwid, Turgeon), Public Health Agency of Canada, Saint-Hyacinthe, Que.; National Microbiology Laboratory (Champredon), Public Health Agency of Canada, Guelph, Ont.; Division of Infectious Diseases (Angel), University of Ottawa, Ottawa, Ont.; Chronic Disease Program (Angel), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Pediatrics and Child Health (Poliquin), University of Manitoba, Winnipeg, Man.
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9
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Vos MB, Gonzalez MD, Stone C, Cleeton R, Figueroa J, Jerris R, Park SI, Heilman S, Nayee R, Chahroudi A, Schoof N, Mavigner M, Morris CR, Leong T, Grindle A, Westbrook A, Lam W, Rogers BB. Comparison of Mid-turbinate Nasal Swabs, Saliva, and Nasopharyngeal Swabs for SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction Testing in Pediatric Outpatients. Arch Pathol Lab Med 2022; 146:1056-1061. [PMID: 35576234 DOI: 10.5858/arpa.2021-0625-sa] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Diagnostic testing for SARS-CoV-2 in symptomatic and asymptomatic children remains integral to care, particularly for supporting return to and attendance in schools. The concordance of SARS-CoV-2 detection in children, using various specimen types, has not been widely studied. OBJECTIVE.— To compare 3 sample types for SARS-CoV-2 polymerase chain reaction (PCR) testing in children, collected and tested at a single facility. DESIGN.— We prospectively recruited 142 symptomatic and asymptomatic children/young adults into a sample comparison study performed in a single health care system. Each child provided self-collected saliva, and a trained health care provider collected a mid-turbinate nasal swab and nasopharyngeal (NP) swab. Specimens were assayed within 24 hours of collection by using reverse transcription-polymerase chain reaction (RT-PCR) to detect SARS-CoV-2 on a single testing platform. RESULTS.— Concurrently collected saliva and mid-turbinate swabs had greater than 95% positive agreement with NP swabs when obtained within 10 days of symptom onset. Positive agreement of saliva and mid-turbinate samples collected from children with symptom onset >10 days prior, or without symptoms, was 82% compared to NP swab samples. Cycle threshold (Ct) values for mid-turbinate nasal samples more closely correlated with Ct values from NP samples than from saliva samples. CONCLUSIONS.— These findings suggest that all 3 sample types from children are useful for SARS-CoV-2 diagnostic testing by RT-PCR, and that concordance is greatest when the child has had symptoms of COVID-19 within the past 10 days. This study provides scientific justification for using sample types other than the NP swab for SARS-CoV-2 testing in pediatric populations.
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Affiliation(s)
- Miriam B Vos
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Mark D Gonzalez
- From the Department of Pathology (Gonzalez, Jerris, Park, Rogers), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Cheryl Stone
- From the Department of Research Administration (Stone), Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Rebecca Cleeton
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Janet Figueroa
- From the Department of Pediatrics (Figueroa, Nayee, Schoof, Mavigner, Westbrook), Emory University School of Medicine, Atlanta, Georgia
| | - Robert Jerris
- From the Department of Pathology (Gonzalez, Jerris, Park, Rogers), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Sunita I Park
- From the Department of Pathology (Gonzalez, Jerris, Park, Rogers), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Stacy Heilman
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Risha Nayee
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
- From the Department of Pediatrics (Figueroa, Nayee, Schoof, Mavigner, Westbrook), Emory University School of Medicine, Atlanta, Georgia
| | - Ann Chahroudi
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Nils Schoof
- From the Department of Pediatrics (Figueroa, Nayee, Schoof, Mavigner, Westbrook), Emory University School of Medicine, Atlanta, Georgia
| | - Maud Mavigner
- From the Department of Pediatrics (Figueroa, Nayee, Schoof, Mavigner, Westbrook), Emory University School of Medicine, Atlanta, Georgia
| | - Claudia R Morris
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
| | - Traci Leong
- From the Department of Biostatistics and Bioinformatics, Emory Rollins School of Public Health, Atlanta, Georgia (Leong)
| | - Amanda Grindle
- From the Special Care Unit (Grindle), Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Adrianna Westbrook
- From the Department of Pediatrics (Figueroa, Nayee, Schoof, Mavigner, Westbrook), Emory University School of Medicine, Atlanta, Georgia
| | - Wilbur Lam
- From the Department of Pediatrics (Vos, Cleeton, Heilman, Nayee, Chahroudi, Morris, Lam), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
- From the Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta (Lam)
| | - Beverly B Rogers
- From the Department of Pathology (Gonzalez, Jerris, Park, Rogers), Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia
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Kukull B, Shakir SM, Hanson KE. Performance of Non-Nasopharyngeal Sample Types for Molecular Detection of SARS-CoV-2. Clin Lab Med 2022; 42:249-259. [PMID: 35636825 PMCID: PMC8860668 DOI: 10.1016/j.cll.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Linstow M, Kruse A, Kirkby N, Marie Søes L, Nygaard U, Poulsen A. Saliva is inferior to nose and throat swabs for SARS-CoV-2 detection in children. Acta Paediatr 2021; 110:3325-3326. [PMID: 34324722 PMCID: PMC8444819 DOI: 10.1111/apa.16049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Marie‐Louise Linstow
- Department of Paediatrics and Adolescent Medicine The Juliane Marie CentreCopenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Alexandra Kruse
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Hvidovre Hvidovre Denmark
| | - Nikolai Kirkby
- Department of Clinical Microbiology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Lillian Marie Søes
- Department of Clinical Microbiology Copenhagen University Hospital Hvidovre Hvidovre Denmark
| | - Ulrikka Nygaard
- Department of Paediatrics and Adolescent Medicine The Juliane Marie CentreCopenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine The Juliane Marie CentreCopenhagen University Hospital Rigshospitalet Copenhagen Denmark
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Savela ES, Winnett A, Romano AE, Porter MK, Shelby N, Akana R, Ji J, Cooper MM, Schlenker NW, Reyes JA, Carter AM, Barlow JT, Tognazzini C, Feaster M, Goh YY, Ismagilov RF. Quantitative SARS-CoV-2 viral-load curves in paired saliva and nasal swabs inform appropriate respiratory sampling site and analytical test sensitivity required for earliest viral detection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.02.21254771. [PMID: 33851180 PMCID: PMC8043477 DOI: 10.1101/2021.04.02.21254771] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Early detection of SARS-CoV-2 infection is critical to reduce asymptomatic and pre-symptomatic transmission, curb the spread of variants by travelers, and maximize treatment efficacy. Low-sensitivity nasal-swab testing (antigen and some nucleic-acid-amplification tests) is commonly used for surveillance and symptomatic testing, but the ability of low-sensitivity nasal-swab tests to detect the earliest stages of infection has not been established. In this case-ascertained study, initially-SARS-CoV-2-negative household contacts of individuals diagnosed with COVID-19 prospectively self-collected paired anterior-nares nasal-swab and saliva samples twice daily for viral-load quantification by high-sensitivity RT-qPCR and digital-RT-PCR assays. We captured viral-load profiles from the incidence of infection for seven individuals and compared diagnostic sensitivities between respiratory sites. Among unvaccinated persons, high-sensitivity saliva testing detected infection up to 4.5 days before viral loads in nasal swabs reached the limit of detection of low-sensitivity nasal-swab tests. For most participants, nasal swabs reached higher peak viral loads than saliva, but were undetectable or at lower loads during the first few days of infection. High-sensitivity saliva testing was most reliable for earliest detection. Our study illustrates the value of acquiring early (within hours after a negative high-sensitivity test) viral-load profiles to guide the appropriate analytical sensitivity and respiratory site for detecting earliest infections. Such data are challenging to acquire but critical to design optimal testing strategies in the current pandemic and will be required for responding to future viral pandemics. As new variants and viruses emerge, up-to-date data on viral kinetics are necessary to adjust testing strategies for reliable early detection of infections.
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Affiliation(s)
- Emily S. Savela
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Alexander Winnett
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Anna E. Romano
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Michael K. Porter
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Natasha Shelby
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Reid Akana
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Jenny Ji
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Matthew M. Cooper
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Noah W. Schlenker
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Jessica A. Reyes
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Alyssa M. Carter
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Jacob T. Barlow
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
| | - Colten Tognazzini
- City of Pasadena Public Health Department, 1845 N. Fair Oaks Ave., Pasadena, CA, USA 91103
| | - Matthew Feaster
- City of Pasadena Public Health Department, 1845 N. Fair Oaks Ave., Pasadena, CA, USA 91103
| | - Ying-Ying Goh
- City of Pasadena Public Health Department, 1845 N. Fair Oaks Ave., Pasadena, CA, USA 91103
| | - Rustem F. Ismagilov
- California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, USA 91125
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13
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Miranda-Ortiz H, Fernández-Figueroa EA, Ruíz-García EB, Muñoz-Rivas A, Méndez-Pérez A, Méndez-Galván J, Astudillo-de la Vega H, Gabiño-López B, Nava-Monroy R, López-Flores a la Torre A, López-Vergara Anaya T, Vilar-Compte D, Coquis-Navarrete U, Valdés-Reyes M, Sánchez-Montes S, Becker I. Development of an alternative saliva test for diagnosis of SARS-CoV-2 using TRIzol: Adapting to countries with lower incomes looking for a large-scale detection program. PLoS One 2021; 16:e0255807. [PMID: 34407100 PMCID: PMC8372963 DOI: 10.1371/journal.pone.0255807] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/24/2021] [Indexed: 11/19/2022] Open
Abstract
The use of saliva for the diagnosis of SARS-CoV-2 has shown to be a good alternative to nasopharyngeal swabs (NPS), since it permits self-collection, avoids the exposure of healthy persons to infected patients, reduces waiting times, eliminates the need of personal protective equipment and is non-invasive. Yet current saliva testing is still expensive due to the need of specialized tubes containing buffers to stabilize the RNA of SARS-CoV-2 and inactivate the virus. These tubes are expensive and not always accessible in sufficient quantities. We now developed an alternative saliva testing method, using TRIzol for extraction, viral inactivation, and storage of SARS-CoV-2 RNA, combined with RT-qPCR, which was comparable in its performance to NPS. Paired saliva samples and NPS were taken from 15 asymptomatic healthcare workers and one patient with SARS-CoV-2. Further 13 patients with SARS-CoV-2 were only saliva-tested. All the tests were performed according to CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel. Saliva (4 mL) was taken in sterile 50 mL tubes, 1.5 mL TRIzol were added and mixed. Our results show that 5 μL of saliva RNA extracted with TRIzol allow for an adequate detection of the virus in patients positive for SARS-CoV-2 and was equally sensitive to NPS in TRIzol. We conclude that saliva testing using TRIzol is a recommendable method for diagnosis of SARS-CoV-2 since it has several advantages over currently used saliva tests: it can be done with normal sterile tubes, does not need cold-chain handling, is stable at room temperature, is non-invasive and less costly, making it more accessible for low-income countries. Cheaper saliva testing using TRIzol is especially relevant for low-income countries to optimize diagnosis and help define quarantine durations for families, healthcare workers, schools, and other public workplaces, thus decreasing infections and mortality caused by SARS-CoV-2.
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Affiliation(s)
| | - Edith A. Fernández-Figueroa
- Computational and Integrative Genomics, National Institute of Genomic Medicine, Mexico City, Mexico
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- * E-mail: (EAFF); (IB)
| | - Erika B. Ruíz-García
- Department of Gastrointestinal Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
- Translational Medicine Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Anallely Muñoz-Rivas
- Genomic Diagnostic Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | | | - Jorge Méndez-Galván
- Dirección de Investigación, Hospital Infantil de México “Federico Gómez”, Mexico City, Mexico
| | - Horacio Astudillo-de la Vega
- Translational Research Laboratory in Cancer & Cellular Therapy, Hospital de Oncologia, Siglo XXI, IMSS, Mexico City, Mexico
| | - Belem Gabiño-López
- Laboratory of Histology and Confocal Microscopy, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Ricardo Nava-Monroy
- Laboratory of Histology and Confocal Microscopy, National Institute of Genomic Medicine, Mexico City, Mexico
| | | | | | - Diana Vilar-Compte
- Department of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Uriel Coquis-Navarrete
- Translational Medicine Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Melissa Valdés-Reyes
- Translational Medicine Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Sokani Sánchez-Montes
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Veracruz, Mexico
| | - Ingeborg Becker
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- * E-mail: (EAFF); (IB)
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14
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Chong CY, Tan NWH, Yung CF, Nadua K, Kam KQ, Li J, Thoon KC. Pediatric Kawasaki Disease Trends Prior to and During COVID-19 Outbreak in Singapore. J Pediatric Infect Dis Soc 2021:piab047. [PMID: 34383064 DOI: 10.1093/jpids/piab047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/04/2021] [Indexed: 11/13/2022]
Abstract
Kawasaki disease (KD, typical/atypical/partial) admissions (n = 644) were surveyed from 2017 to 2020 and compared to urinary tract infection (UTI) admissions and COVID-19 in 2020. KD admissions decreased by 27% and median KD age decreased in 2020, whereas UTI admissions remained steady. KD admissions showed a seasonality with a peak in April and nadir in February-March. All KD/KD-related pediatric intensive care unit cases tested negative for COVID-19, and no multisystem inflammatory syndrome in children was found.
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Affiliation(s)
- Chia Yin Chong
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
| | - Natalie Woon Hui Tan
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
| | - Chee Fu Yung
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
| | - Karen Nadua
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
| | - Kai Qian Kam
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
| | - Jiahui Li
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
| | - Koh Cheng Thoon
- Infectious Diseases, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
- National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Nanyang Technological University, Singapore
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15
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Oliver J, Tosif S, Lee LY, Costa AM, Bartel C, Last K, Clifford V, Daley A, Allard N, Orr C, Nind A, Alexander K, Meagher N, Sait M, Ballard SA, Williams E, Bond K, Williamson DA, Crawford NW, Gibney KB. Adding saliva testing to oropharyngeal and deep nasal swab testing increases PCR detection of SARS-CoV-2 in primary care and children. Med J Aust 2021; 215:273-278. [PMID: 34287935 PMCID: PMC8447377 DOI: 10.5694/mja2.51188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To compare the concordance and acceptability of saliva testing with standard‐of‐care oropharyngeal and bilateral deep nasal swab testing for severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) in children and in general practice. Design Prospective multicentre diagnostic validation study. Setting Royal Children’s Hospital, and two general practices (cohealth, West Melbourne; Cirqit Health, Altona North) in Melbourne, July–October 2020. Participants 1050 people who provided paired saliva and oropharyngeal‐nasal swabs for SARS‐CoV‐2 testing. Main outcome measures Numbers of cases in which SARS‐CoV‐2 was detected in either specimen type by real‐time polymerase chain reaction; concordance of results for paired specimens; positive percent agreement (PPA) for virus detection, by specimen type. Results SARS‐CoV‐2 was detected in 54 of 1050 people with assessable specimens (5%), including 19 cases (35%) in which both specimens were positive. The overall PPA was 72% (95% CI, 58–84%) for saliva and 63% (95% CI, 49–76%) for oropharyngeal‐nasal swabs. For the 35 positive specimens from people aged 10 years or more, PPA was 86% (95% CI, 70–95%) for saliva and 63% (95% CI, 45–79%) for oropharyngeal‐nasal swabs. Adding saliva testing to standard‐of‐care oropharyngeal‐nasal swab testing increased overall case detection by 59% (95% CI, 29–95%). Providing saliva was preferred to an oropharyngeal‐nasal swab by most participants (75%), including 141 of 153 children under 10 years of age (92%). Conclusion In children over 10 years of age and adults, saliva testing alone may be suitable for SARS‐CoV‐2 detection, while for children under 10, saliva testing may be suitable as an adjunct to oropharyngeal‐nasal swab testing for increasing case detection.
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Affiliation(s)
- Jane Oliver
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC
| | | | | | | | | | | | - Vanessa Clifford
- The Royal Children's Hospital, Melbourne, VIC.,Melbourne Medical School, University of Melbourne, Melbourne, VIC
| | - Andrew Daley
- The Royal Children's Hospital, Melbourne, VIC.,The Royal Women's Hospital, Melbourne, VIC
| | - Nicole Allard
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC.,cohealth, Melbourne, VIC
| | | | | | - Karyn Alexander
- Melbourne Medical School, University of Melbourne, Melbourne, VIC.,Cirqit Health, Melbourne, VIC
| | | | - Michelle Sait
- Public Health Laboratory, University of Melbourne, Melbourne, VIC
| | - Susan A Ballard
- Public Health Laboratory, University of Melbourne, Melbourne, VIC
| | | | - Katherine Bond
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health, Melbourne, VIC
| | - Deborah A Williamson
- Public Health Laboratory, University of Melbourne, Melbourne, VIC.,Melbourne Health, Melbourne, VIC
| | - Nigel W Crawford
- Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC), Murdoch Children's Research Institute, Melbourne, VIC
| | - Katherine B Gibney
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC.,Royal Melbourne Hospital, Melbourne, VIC
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16
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Lee RA, Herigon JC, Benedetti A, Pollock NR, Denkinger CM. Performance of Saliva, Oropharyngeal Swabs, and Nasal Swabs for SARS-CoV-2 Molecular Detection: a Systematic Review and Meta-analysis. J Clin Microbiol 2021; 59:JCM.02881-20. [PMID: 33504593 DOI: 10.1101/2020.11.12.20230748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Abstract
Nasopharyngeal (NP) swabs are considered the highest-yield sample for diagnostic testing for respiratory viruses, including SARS-CoV-2. The need to increase capacity for SARS-CoV-2 testing in a variety of settings, combined with shortages of sample collection supplies, have motivated a search for alternative sample types with high sensitivity. We systematically reviewed the literature to understand the performance of alternative sample types compared to NP swabs. We systematically searched PubMed, Google Scholar, medRxiv, and bioRxiv (last retrieval 1 October 2020) for comparative studies of alternative specimen types (saliva, oropharyngeal [OP], and nasal [NS] swabs) versus NP swabs for SARS-CoV-2 diagnosis using nucleic acid amplification testing (NAAT). A logistic-normal random-effects meta-analysis was performed to calculate % positive alternative-specimen, % positive NP, and % dual positives overall and in subgroups. The QUADAS 2 tool was used to assess bias. From 1,253 unique citations, we identified 25 saliva, 11 NS, 6 OP, and 4 OP/NS studies meeting inclusion criteria. Three specimen types captured lower % positives (NS [82%, 95% CI: 73 to 90%], OP [84%, 95% CI: 57 to 100%], and saliva [88%, 95% CI: 81 to 93%]) than NP swabs, while combined OP/NS matched NP performance (97%, 95% CI: 90 to 100%). Absence of RNA extraction (saliva) and utilization of a more sensitive NAAT (NS) substantially decreased alternative-specimen yield of positive samples. NP swabs remain the gold standard for diagnosis of SARS-CoV-2, although alternative specimens are promising. Much remains unknown about the impact of variations in specimen collection, processing protocols, and population (pediatric versus adult, late versus early in disease course), such that head-to head studies of sampling strategies are urgently needed.
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Affiliation(s)
- Rose A Lee
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Joshua C Herigon
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Andrea Benedetti
- Department of Medicine and of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Nira R Pollock
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Claudia M Denkinger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
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17
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Lee RA, Herigon JC, Benedetti A, Pollock NR, Denkinger CM. Performance of Saliva, Oropharyngeal Swabs, and Nasal Swabs for SARS-CoV-2 Molecular Detection: a Systematic Review and Meta-analysis. J Clin Microbiol 2021; 59:e02881-20. [PMID: 33504593 PMCID: PMC8091856 DOI: 10.1128/jcm.02881-20] [Citation(s) in RCA: 181] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Nasopharyngeal (NP) swabs are considered the highest-yield sample for diagnostic testing for respiratory viruses, including SARS-CoV-2. The need to increase capacity for SARS-CoV-2 testing in a variety of settings, combined with shortages of sample collection supplies, have motivated a search for alternative sample types with high sensitivity. We systematically reviewed the literature to understand the performance of alternative sample types compared to NP swabs. We systematically searched PubMed, Google Scholar, medRxiv, and bioRxiv (last retrieval 1 October 2020) for comparative studies of alternative specimen types (saliva, oropharyngeal [OP], and nasal [NS] swabs) versus NP swabs for SARS-CoV-2 diagnosis using nucleic acid amplification testing (NAAT). A logistic-normal random-effects meta-analysis was performed to calculate % positive alternative-specimen, % positive NP, and % dual positives overall and in subgroups. The QUADAS 2 tool was used to assess bias. From 1,253 unique citations, we identified 25 saliva, 11 NS, 6 OP, and 4 OP/NS studies meeting inclusion criteria. Three specimen types captured lower % positives (NS [82%, 95% CI: 73 to 90%], OP [84%, 95% CI: 57 to 100%], and saliva [88%, 95% CI: 81 to 93%]) than NP swabs, while combined OP/NS matched NP performance (97%, 95% CI: 90 to 100%). Absence of RNA extraction (saliva) and utilization of a more sensitive NAAT (NS) substantially decreased alternative-specimen yield of positive samples. NP swabs remain the gold standard for diagnosis of SARS-CoV-2, although alternative specimens are promising. Much remains unknown about the impact of variations in specimen collection, processing protocols, and population (pediatric versus adult, late versus early in disease course), such that head-to head studies of sampling strategies are urgently needed.
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Affiliation(s)
- Rose A Lee
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Joshua C Herigon
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Andrea Benedetti
- Department of Medicine and of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Nira R Pollock
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Claudia M Denkinger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
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18
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Chua GT, Wong JSC, To KKW, Lam ICS, Yau FYS, Chan WH, Ho PPK, Duque JSR, Yip CCY, Ng ACK, Wong WHS, Kwong JHY, Leung KFS, Wan PT, Lam K, Wong ICK, Kwok J, Ho MHK, Chan GCF, Lau YL, Ip P, Kwan MYW. Saliva viral load better correlates with clinical and immunological profiles in children with coronavirus disease 2019. Emerg Microbes Infect 2021; 10:235-241. [PMID: 33467982 PMCID: PMC7899683 DOI: 10.1080/22221751.2021.1878937] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Pediatric COVID-19 studies exploring the relationships between NPS and saliva viral loads, clinical and immunological profiles are lacking. Methods Demographics, immunological profiles, nasopharyngeal swab (NPS), and saliva samples collected on admission, and hospital length of stay (LOS) were assessed in children below 18 years with COVID-19. Findings 91 patients were included between March and August 20 20. NPS and saliva viral loads were correlated (r = 0.315, p = 0.01). Symptomatic patients had significantly higher NPS and saliva viral loads than asymptomatic patients. Serial NPS and saliva viral load measurements showed that the log10 NPS (r = −0.532, p < 0.001) and saliva (r = −0.417, p < 0.001) viral loads for all patients were inversely correlated with the days from symptom onset with statistical significance. Patients with cough, sputum, and headache had significantly higher saliva, but not NPS, viral loads. Higher saliva, but not NPS, viral loads were associated with total lymphopenia, CD3 and CD4 lymphopenia (all p < 0.05), and were inversely correlated with total lymphocyte (r = −0.43), CD3 (r = −0.55), CD4 (r = −0.60), CD8 (r = −0.41), B (r = −0.482), and NK (r = −0.416) lymphocyte counts (all p < 0.05). Interpretation Saliva viral loads on admission in children correlated better with clinical and immunological profiles than NPS.
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Affiliation(s)
- Gilbert T Chua
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Joshua S C Wong
- Paediatric Infectious Disease Unit, Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
| | - Kelvin K W To
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Ivan C S Lam
- Paediatric Infectious Disease Unit, Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
| | - Felix Y S Yau
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
| | - Wai Hung Chan
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
| | - Polly P K Ho
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
| | - Jaime S R Duque
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Cyril C Y Yip
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Anthony C K Ng
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Joyce H Y Kwong
- Haematology laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
| | - Kate F S Leung
- Haematology laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
| | - P T Wan
- Haematology laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
| | - Kelly Lam
- Haematology laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, People's Republic of China.,Research Department of Practice and Policy, UCL School of Pharmacy, University College, London, United Kingdom
| | - Janette Kwok
- Divison of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, HKSAR, People's Republic of China
| | - Marco H K Ho
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Godfrey C F Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yu Lung Lau
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Mike Y W Kwan
- Paediatric Infectious Disease Unit, Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, People's Republic of China
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19
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Saliva for molecular detection of SARS-CoV-2 in school-age children. Clin Microbiol Infect 2021; 27:1330-1335. [PMID: 33618013 PMCID: PMC7894096 DOI: 10.1016/j.cmi.2021.02.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 01/05/2023]
Abstract
Objectives The high diagnostic accuracy indices for saliva severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase PCR (RT-PCR) reported in adults has not been demonstrated in children, and adequately powered studies focused on the paediatric population are lacking. This study was carried out to determine the diagnostic accuracy of saliva for SARS-CoV-2 RT-PCR in ambulatory children. Methods During 1 to 23 October 2020, we recruited a population-based sample of children presenting for coronavirus disease 2019 (COVID-19) screening in Dubai, United Arab Emirates. Each child provided paired nasopharyngeal (NP) swab and saliva for SARS-CoV-2 RT-PCR N, E and RdRp gene detection. Results Paired NP swab and saliva samples were obtained from 476 children with mean ± standard deviation age of 10.8 ± 3.9 years, and 58.2% were male (277/476). Nine participants were sampled twice, so 485 pairs of NP swab/saliva were tested. Virus detection in at least one specimen type was reported in 17.9% (87/485), with similar detection in NP swab (16.7%, 81/485) and saliva (15.9%, 77/485). Sensitivity and specificity of saliva RT-PCR was 87.7% (95% confidence interval (CI) 78.5–93.9) and 98.5% (95% CI 96.8–99.5). The positive and negative predictive values were 92.2% (95% CI 84.2–96.3) and 97.6% (95% CI 95.7–98.6), with a kappa coefficient of 0.879 (95% CI 0.821–0.937). Concordance of findings between NP swab and saliva did not differ by age (p 0.67) or gender (p 0.29). Cycle threshold (Ct) values were significantly higher in NP swab/saliva pairs with discordant findings compared to those with both specimens positive. Conclusions In light of these findings, we recommend saliva as a diagnostic specimen for COVID-19 screening in children.
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20
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Saliva Is a Promising Alternative Specimen for the Detection of SARS-CoV-2 in Children and Adults. J Clin Microbiol 2021; 59:JCM.02686-20. [PMID: 33239380 PMCID: PMC8111155 DOI: 10.1128/jcm.02686-20] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023] Open
Abstract
Testing efforts for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been burdened by the scarcity of testing materials and personal protective equipment for health care workers. The simple and painless process of saliva collection allows for widespread testing, but enthusiasm is hampered by variable performance compared to that of nasopharyngeal swab (NPS) samples. Testing efforts for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been burdened by the scarcity of testing materials and personal protective equipment for health care workers. The simple and painless process of saliva collection allows for widespread testing, but enthusiasm is hampered by variable performance compared to that of nasopharyngeal swab (NPS) samples. We prospectively collected paired NPS and saliva samples from a total of 300 unique adult and pediatric patients. SARS-CoV-2 RNA was detected in 32.2% (97/300) of the individuals using the TaqPath COVID-19 Combo kit (Thermo Fisher). Performance of saliva and NPS was compared against the total number of positives regardless of specimen type. The overall concordances for saliva and NPS were 91.0% (273/300) and 94.7% (284/300), respectively. The values for positive percent agreement (PPA) for saliva and NPS were 81.4% (79/97) and 89.7% (87/97), respectively. Saliva yielded detection of 10 positive cases that were negative by NPS. For symptomatic and asymptomatic pediatric patients not previously diagnosed with COVID-19, the performances of saliva and NPS were comparable (PPA, 82.4% versus 85.3%). The overall values for PPA for adults were 83.3% and 90.7% for saliva and NPS, respectively, with saliva yielding detection of 4 fewer cases than NPS. However, saliva performance for symptomatic adults was identical to NPS performance (PPA of 93.8%). With lower cost and self-collection capabilities, saliva can be an appropriate sample choice alternative to NPS for detection of SARS-CoV-2 in children and adults.
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21
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Ku CW, Shivani D, Kwan JQT, Loy SL, Erwin C, Ko KKK, Ng XW, Oon L, Thoon KC, Kalimuddin S, Chan JKY. Validation of self-collected buccal swab and saliva as a diagnostic tool for COVID-19. Int J Infect Dis 2021; 104:255-261. [PMID: 33401035 PMCID: PMC7833930 DOI: 10.1016/j.ijid.2020.12.080] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Effective management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires large-scale testing to identify and isolate infectious carriers. Self-administered buccal swab and saliva collection are convenient, painless, and safe alternatives to the current healthcare worker (HCW)-collected nasopharyngeal swab (NPS). METHODS A cross-sectional single-centre study was conducted on 42 participants who had tested positive for SARS-CoV-2 via an NPS within the past 7 days. Real-time polymerase chain reaction (RT-PCR) was performed and cycle threshold (Ct) values were obtained for each test. The positive percent agreement (PPA), negative percent agreement (NPA), and overall agreement (OA) were calculated for the saliva samples and buccal swabs, and compared with NPS. RESULTS Among the 42 participants, 73.8% (31/42) tested positive by any one of the three tests. With reference to NPS, the saliva test had PPA 66.7%, NPA 91.7%, and OA 69.0%; the buccal swab had PPA 56.7%, NPA 100%, and OA 73.8%. CONCLUSION Self-collected saliva tests and buccal swabs showed only moderate agreement with HCW-collected NPS. Primary screening for SARS-CoV-2 may be performed with a saliva test or buccal swab, with a negative test warranting a confirmatory NPS to avoid false-negatives, minimize discomfort, and reduce the risk of spread to the community and HCWs.
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Affiliation(s)
- Chee Wai Ku
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore; Academic Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore
| | - Durai Shivani
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Jacqueline Q T Kwan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - See Ling Loy
- Academic Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, 229899, Singapore
| | - Christina Erwin
- Academic Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore
| | - Karrie K K Ko
- Academic Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Microbiology, Singapore General Hospital, Singapore; Department of Molecular Pathology, Singapore General Hospital, Singapore
| | - Xiang Wen Ng
- Department of Reproductive Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, 229899, Singapore
| | - Lynette Oon
- Department of Molecular Pathology, Singapore General Hospital, Singapore
| | - Koh Cheng Thoon
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Shirin Kalimuddin
- Department of Infectious Diseases, Singapore General Hospital, Block 4 Level 1, Singapore General Hospital, Outram Rd, 169608, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.
| | - Jerry K Y Chan
- Academic Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, 229899, Singapore.
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22
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Medeiros da Silva RC, Nogueira Marinho LC, de Araújo Silva DN, Costa de Lima K, Pirih FQ, Luz de Aquino Martins AR. Saliva as a possible tool for the SARS-CoV-2 detection: A review. Travel Med Infect Dis 2020; 38:101920. [PMID: 33220456 PMCID: PMC7674016 DOI: 10.1016/j.tmaid.2020.101920] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Salivary tests for the new coronavirus (SARS-CoV-2) diagnosis have been suggested as alternative methods for the nasopharyngeal and oropharyngeal tests. METHOD Two reviewers independently performed a search in the following electronic databases: PubMed, Medline, Cochrane Library, Web of Science, Embase and Scopus to identify cross-sectional and cohort studies that used saliva samples for SARS-CoV-2 detection. The search strategy was: ("saliva") and ("SARS-CoV-2" or "coronavirus" or "COVID-1"). RESULTS A total of 363 studies were identified and 39 were selected for review. Salivary samples for SARS-CoV-2 detection was as consistent and sensitive as the nasopharyngeal swabs in most studies, having been effective in detecting asymptomatic infections previously tested negative in nasopharyngeal samples. Viral nucleic acids found in saliva obtained from the duct of the salivary gland may indicate infection in that gland. Live viruses could be detected in saliva by viral culture. CONCLUSIONS Salivary samples show great potential in SARS-CoV-2 detection and may be recommended as a simple and non-invasive alternative.
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Affiliation(s)
| | | | | | - Kenio Costa de Lima
- Dentistry Department, Rio Grande Do Norte Federal University, Natal, RN, Brazil.
| | - Flavia Queiroz Pirih
- Dentistry Department, Rio Grande Do Norte Federal University, Natal, RN, Brazil.
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23
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Yee R, Truong T, Pannaraj PS, Eubanks N, Gai E, Jumarang J, Turner L, Peralta A, Lee Y, Dien Bard J. Saliva is a promising alternative specimen for the detection of SARS-CoV-2 in children and adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 33140064 PMCID: PMC7605576 DOI: 10.1101/2020.10.25.20219055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Testing efforts for SARS-CoV-2 have been burdened by the scarcity of testing materials and personal protective equipment for healthcare workers. The simple and painless process of saliva collection allows for widespread testing, but enthusiasm is hampered by variable performance compared to nasopharyngeal swab (NPS) samples. We prospectively collected paired NPS and saliva samples from a total of 300 unique adult and pediatric patients. SARS-CoV-2 RNA was detected in 32.2% (97/300) of the individuals using the TaqPath COVID-19 Combo Kit (Thermo Fisher). Performance of saliva and NPS were compared against the total number of positives regardless of specimen type. The overall concordance for saliva and NPS was 91.0% (273/300) and 94.7% (284/300), respectively. The positive percent agreement (PPA) for saliva and NPS was 81.4% (79/97) and 89.7% (87/97), respectively. Saliva detected 10 positive cases that were negative by NPS. In symptomatic and asymptomatic pediatric patients not previously diagnosed with COVID-19, the performances of saliva and NPS were comparable (PPA: 82.4% vs 85.3%). The overall PPA for adults were 83.3% and 90.7% for saliva and NPS, respectively, with saliva detecting 4 cases less than NPS. However, saliva performance in symptomatic adults was identical to NPS (PPA of 93.8%). With lower cost and self-collection capabilities, saliva can be an appropriate alternative sample choice to NPS for detection of SARS-CoV-2 in children and adults. Saliva is an acceptable alternative specimen compared to nasopharyngeal swabs for detection of SARS-CoV-2. Specifically, saliva demonstrated comparable performance to nasopharyngeal swabs in symptomatic and asymptomatic pediatric patients and in symptomatic adults.
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Affiliation(s)
- Rebecca Yee
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Thao Truong
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Pia S Pannaraj
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA.,Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Natalie Eubanks
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Emily Gai
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Jaycee Jumarang
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA
| | - Lauren Turner
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA
| | - Ariana Peralta
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA
| | - Yesun Lee
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA
| | - Jennifer Dien Bard
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA.,Keck School of Medicine, University of Southern California, Los Angeles, CA
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