Self-Collected Oral Fluid Saliva Is Insensitive Compared With Nasal-Oropharyngeal Swabs in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Outpatients
© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic control will require widespread access to accurate diagnostics. Salivary sampling circumvents swab supply chain bottlenecks, is amenable to self-collection, and is less likely to create an aerosol during collection compared with the nasopharyngeal swab.
METHODS: We compared real-time reverse-transcription polymerase chain reaction Abbott m2000 results from matched salivary oral fluid (gingival crevicular fluid collected in an Oracol device) and nasal-oropharyngeal (OP) self-collected specimens in viral transport media from a nonhospitalized, ambulatory cohort of coronavirus disease 2019 (COVID-19) patients at multiple time points. These 2 sentences should be at the beginning of the results.
RESULTS: There were 171 matched specimen pairs. Compared with nasal-OP swabs, 41.6% of the oral fluid samples were positive. Adding spit to the oral fluid percent collection device increased the percent positive agreement from 37.2% (16 of 43) to 44.6% (29 of 65). The positive percent agreement was highest in the first 5 days after symptoms and decreased thereafter. All of the infectious nasal-OP samples (culture positive on VeroE6 TMPRSS2 cells) had a matched SARS-CoV-2 positive oral fluid sample.
CONCLUSIONS: In this study of nonhospitalized SARS-CoV-2-infected persons, we demonstrate lower diagnostic sensitivity of self-collected oral fluid compared with nasal-OP specimens, a difference that was especially prominent more than 5 days from symptom onset. These data do not justify the routine use of oral fluid collection for diagnosis of SARS-CoV-2 despite the greater ease of collection. It also underscores the importance of considering the method of saliva specimen collection and the time from symptom onset especially in outpatient populations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
Open forum infectious diseases - 8(2021), 2 vom: 02. Feb., Seite ofaa648 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Manabe, Yukari C [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 31.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ofid/ofaa648 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321631854 |
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| 100 | 1 | |a Manabe, Yukari C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Self-Collected Oral Fluid Saliva Is Insensitive Compared With Nasal-Oropharyngeal Swabs in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Outpatients |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Revised 31.03.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic control will require widespread access to accurate diagnostics. Salivary sampling circumvents swab supply chain bottlenecks, is amenable to self-collection, and is less likely to create an aerosol during collection compared with the nasopharyngeal swab | ||
| 520 | |a METHODS: We compared real-time reverse-transcription polymerase chain reaction Abbott m2000 results from matched salivary oral fluid (gingival crevicular fluid collected in an Oracol device) and nasal-oropharyngeal (OP) self-collected specimens in viral transport media from a nonhospitalized, ambulatory cohort of coronavirus disease 2019 (COVID-19) patients at multiple time points. These 2 sentences should be at the beginning of the results | ||
| 520 | |a RESULTS: There were 171 matched specimen pairs. Compared with nasal-OP swabs, 41.6% of the oral fluid samples were positive. Adding spit to the oral fluid percent collection device increased the percent positive agreement from 37.2% (16 of 43) to 44.6% (29 of 65). The positive percent agreement was highest in the first 5 days after symptoms and decreased thereafter. All of the infectious nasal-OP samples (culture positive on VeroE6 TMPRSS2 cells) had a matched SARS-CoV-2 positive oral fluid sample | ||
| 520 | |a CONCLUSIONS: In this study of nonhospitalized SARS-CoV-2-infected persons, we demonstrate lower diagnostic sensitivity of self-collected oral fluid compared with nasal-OP specimens, a difference that was especially prominent more than 5 days from symptom onset. These data do not justify the routine use of oral fluid collection for diagnosis of SARS-CoV-2 despite the greater ease of collection. It also underscores the importance of considering the method of saliva specimen collection and the time from symptom onset especially in outpatient populations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a coronavirus | |
| 650 | 4 | |a outpatient | |
| 650 | 4 | |a saliva | |
| 700 | 1 | |a Reuland, Carolyn |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Tong |e verfasserin |4 aut | |
| 700 | 1 | |a Azamfirei, Razvan |e verfasserin |4 aut | |
| 700 | 1 | |a Hardick, Justin P |e verfasserin |4 aut | |
| 700 | 1 | |a Church, Taylor |e verfasserin |4 aut | |
| 700 | 1 | |a Brown, Diane M |e verfasserin |4 aut | |
| 700 | 1 | |a Sewell, Thelio T |e verfasserin |4 aut | |
| 700 | 1 | |a Antar, Annuka |e verfasserin |4 aut | |
| 700 | 1 | |a Blair, Paul W |e verfasserin |4 aut | |
| 700 | 1 | |a Heaney, Chris D |e verfasserin |4 aut | |
| 700 | 1 | |a Pekosz, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Thomas, David L |e verfasserin |4 aut | |
| 700 | 0 | |a Ambulatory COVID Team |e verfasserin |4 aut | |
| 700 | 1 | |a Cox, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Keller, Sara |e investigator |4 oth | |
| 700 | 1 | |a Keruly, Jeanne |e investigator |4 oth | |
| 700 | 1 | |a Klein, Sabra |e investigator |4 oth | |
| 700 | 1 | |a Mehta, Shruti |e investigator |4 oth | |
| 700 | 1 | |a Mostafa, Heba |e investigator |4 oth | |
| 700 | 1 | |a Pisanic, Nora |e investigator |4 oth | |
| 700 | 1 | |a Sauer, Lauren |e investigator |4 oth | |
| 700 | 1 | |a Tornheim, Jeffrey |e investigator |4 oth | |
| 700 | 1 | |a Townsend, Jennifer |e investigator |4 oth | |
| 700 | 1 | |a Armstrong, Derek |e investigator |4 oth | |
| 700 | 1 | |a Bachu, Vismaya |e investigator |4 oth | |
| 700 | 1 | |a Barnaba, Brittany |e investigator |4 oth | |
| 700 | 1 | |a Charles, Curtisha |e investigator |4 oth | |
| 700 | 1 | |a Dai, Weiwei |e investigator |4 oth | |
| 700 | 1 | |a Ganesan, Abhinaya |e investigator |4 oth | |
| 700 | 1 | |a Holden, Jeffrey |e investigator |4 oth | |
| 700 | 1 | |a Jang, Minyoung |e investigator |4 oth | |
| 700 | 1 | |a Johnstone, J R |e investigator |4 oth | |
| 700 | 1 | |a Kruczynski, Kate |e investigator |4 oth | |
| 700 | 1 | |a Kusemiju, Oyinkansola |e investigator |4 oth | |
| 700 | 1 | |a Lambrou, Anastasia |e investigator |4 oth | |
| 700 | 1 | |a Li, Lucy |e investigator |4 oth | |
| 700 | 1 | |a Littlefield, Kirsten |e investigator |4 oth | |
| 700 | 1 | |a Park, Han-Sol |e investigator |4 oth | |
| 700 | 1 | |a Tuchler, Amanda |e investigator |4 oth | |
| 700 | 1 | |a Montana, Manuela Plazas |e investigator |4 oth | |
| 700 | 1 | |a Prizzi, Michelle |e investigator |4 oth | |
| 700 | 1 | |a Ursin, Rebecca |e investigator |4 oth | |
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