1. Diagnostic accuracy of fresh drooled saliva for SARS-CoV-2 in travelers.
- Author
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Mohd Thabit AA, Peariasamy KM, Kuan PX, Fern Ying DK, Nheu N, Cyncynatus C, Mu'iz Arifin MA, Shamsuddin AN, Yamin MA, Mohd Padzil MA, Rajasekaram G, Giddy M, Sivaneson S, Lakhbeer Singh HK, Azman A, Hassan AH, and Chidambaram SK
- Subjects
- Adult, COVID-19 Testing, Humans, Nasopharynx, Saliva, Specimen Handling, COVID-19, SARS-CoV-2
- Abstract
Background: The standard for SARS-CoV-2 diagnosis is RT-PCR from nasopharyngeal or oropharyngeal swabs. Major airports require COVID-19 screening, and saliva has the potential as a substitute specimen for SARS-CoV-2 diagnosis. We investigated the utility of fresh drooled saliva against NPS for COVID-19 screening of travelers., Methods: We recruited 81 travelers and 15 non-travelers (including ten controls) prospectively within a mean of 3·22 days of RT-PCR confirmed COVID-19. Each study participant provided 2 mls of early morning fresh drooled whole saliva separately into a sterile plastic container and GeneFiX™ saliva collection kit. The saliva specimens were processed within 4 h and tested for SARS-CoV-2 genes (E, RdRP, and N2) and the results compared to paired NPS RT-PCR for diagnostic accuracy., Results: Majority of travellers were asymptomatic (75·0%) with a mean age of 34·26 years. 77 travelers were RT-PCR positive at the time of hospitalization whilst three travelers had positive contacts. In this group, the detection rate for SARS-CoV-2 with NPS, whole saliva, and GeneFiX™ were comparable (89·3%, 50/56; 87·8%, 43/49; 89·6%, 43/48). Both saliva collection methods were in good agreement (Kappa = 0·69). There was no statistical difference between the detection rates of saliva and NPS (p > 0·05). Detection was highest for the N2 gene whilst the E gene provided the highest viral load (mean = 27·96 to 30·10, SD = 3·14 to 3·85). Saliva specimens have high sensitivity (80·4%) and specificity (90·0%) with a high positive predictive value of 91·8% for SARS-CoV-2 diagnosis., Conclusion: Saliva for SARS-CoV-2 screening is a simple accurate technique comparable with NPS RT-PCR., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2021
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