Routine saliva testing for the identification of silent COVID-19 infections in healthcare workers
Objective: Current COVID-19 guidelines recommend symptom-based screening and regular nasopharyngeal (NP) testing for healthcare personnel in high-risk settings. We sought to estimate case detection percentages with various routine NP and saliva testing frequencies.
Design: Simulation modelling study.
Methods: We constructed a sensitivity function based on the average infectiousness profile of symptomatic COVID-19 cases to determine the probability of being identified at the time of testing. This function was fitted to reported data on the percent positivity of symptomatic COVID-19 patients using NP testing. We then simulated a routine testing program with different NP and saliva testing frequencies to determine case detection percentages during the infectious period, as well as the pre-symptomatic stage.
Results: Routine bi-weekly NP testing, once every two weeks, identified an average of 90.7% (SD: 0.18) of cases during the infectious period and 19.7% (SD: 0.98) during the pre-symptomatic stage. With a weekly NP testing frequency, the corresponding case detection percentages were 95.9% (SD: 0.18) and 32.9% (SD: 1.23), respectively. A 5-day saliva testing schedule had a similar case detection percentage as weekly NP testing during the infectious period, but identified about 10% more cases (mean: 42.5%; SD: 1.10) during the pre-symptomatic stage.
Conclusion: Our findings highlight the utility of routine non-invasive saliva testing for frontline healthcare workers to protect vulnerable patient populations. A 5-day saliva testing schedule should be considered to help identify silent infections and prevent outbreaks in nursing homes and healthcare facilities.
| Errataetall: |
UpdateIn: Infect Control Hosp Epidemiol. 2021 Oct;42(10):1189-1193. - PMID 33427141 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2020 |
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| Enthalten in: |
medRxiv : the preprint server for health sciences - (2020) vom: 30. Nov. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhang, Kevin [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 03.04.2024 published: Electronic UpdateIn: Infect Control Hosp Epidemiol. 2021 Oct;42(10):1189-1193. - PMID 33427141 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1101/2020.11.27.20240044 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318355264 |
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| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a UpdateIn: Infect Control Hosp Epidemiol. 2021 Oct;42(10):1189-1193. - PMID 33427141 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Objective: Current COVID-19 guidelines recommend symptom-based screening and regular nasopharyngeal (NP) testing for healthcare personnel in high-risk settings. We sought to estimate case detection percentages with various routine NP and saliva testing frequencies | ||
| 520 | |a Design: Simulation modelling study | ||
| 520 | |a Methods: We constructed a sensitivity function based on the average infectiousness profile of symptomatic COVID-19 cases to determine the probability of being identified at the time of testing. This function was fitted to reported data on the percent positivity of symptomatic COVID-19 patients using NP testing. We then simulated a routine testing program with different NP and saliva testing frequencies to determine case detection percentages during the infectious period, as well as the pre-symptomatic stage | ||
| 520 | |a Results: Routine bi-weekly NP testing, once every two weeks, identified an average of 90.7% (SD: 0.18) of cases during the infectious period and 19.7% (SD: 0.98) during the pre-symptomatic stage. With a weekly NP testing frequency, the corresponding case detection percentages were 95.9% (SD: 0.18) and 32.9% (SD: 1.23), respectively. A 5-day saliva testing schedule had a similar case detection percentage as weekly NP testing during the infectious period, but identified about 10% more cases (mean: 42.5%; SD: 1.10) during the pre-symptomatic stage | ||
| 520 | |a Conclusion: Our findings highlight the utility of routine non-invasive saliva testing for frontline healthcare workers to protect vulnerable patient populations. A 5-day saliva testing schedule should be considered to help identify silent infections and prevent outbreaks in nursing homes and healthcare facilities | ||
| 650 | 4 | |a Preprint | |
| 650 | 4 | |a COVID-19 | |
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| 650 | 4 | |a outbreak | |
| 650 | 4 | |a saliva | |
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| 700 | 1 | |a Langley, Joanne M |e verfasserin |4 aut | |
| 700 | 1 | |a Galvani, Alison P |e verfasserin |4 aut | |
| 700 | 1 | |a Moghadas, Seyed M |e verfasserin |4 aut | |
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