Comparison of saliva with oral and nasopharyngeal swabs for SARS-CoV-2 detection on various commercial and laboratory developed assays

Link to article at PubMed

J Med Virol. 2021 Apr 14. doi: 10.1002/jmv.27026. Online ahead of print.


BACKGROUND: The accurate laboratory detection of the SARS-CoV-2 is a crucial element in the fight against COVID-19. RT-PCR testing on combined oral and nasopharyngeal swab (ONPS) suffers from several limitations, including the need for qualified personnel, the discomfort caused by invasive nasopharyngeal sample collection and the possibility of swab and transport media shortage. Testing on saliva would represent an advancement.

OBJECTIVE: To compare the concordance between saliva samples and ONPS for the detection of SARS-CoV-2 on various commercial and laboratory-developed tests (LDT).

STUDY DESIGN: Individuals were recruited from eight institutions in of Quebec, Canada, if they had SARS-CoV-2 RNA detected on a recently collected ONPS, and accepted to provide another ONPS, paired with saliva. Assays available in the different laboratories (Abbott RealTime SARS-CoV-2, Cobas® SARS-CoV-2, SimplexaTM COVID-19 Direct, Allplex™ 2019-nCoV, RIDA®GENE SARS-CoV-2 and an LDT preceded by three different extraction methods) were used to determine the concordance between saliva and ONPS results.

RESULTS: Overall, 320 tests were run from a total of 125 saliva and ONPS sample pairs. All assays yielded similar sensitivity when saliva was compared to ONPS, with the exception of one LDT (67% vs 93%). The mean difference in cycle threshold (delta CT) was generally (but not significantly) in favor of the ONPS for all NAATs. The maximum mean delta CT was 2.0, while individual delta CT varied importantly from -17.5 to 12.4.

CONCLUSION: Saliva seems to be associated with sensitivity similar to ONPS for the detection of SARS-CoV-2 by various assays. This article is protected by copyright. All rights reserved.

PMID:33851739 | DOI:10.1002/jmv.27026

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