1. Clinical Validation of a Sensitive Test for Saliva Collected in Healthcare and Community Settings with Pooling Utility for Severe Acute Respiratory Syndrome Coronavirus 2 Mass Surveillance.
- Author
-
Sahajpal NS, Mondal AK, Ananth S, Njau A, Ahluwalia P, Kota V, Caspary K, Ross TM, Farrell M, Shannon MP, Fulzele S, Chaubey A, Hegde M, Rojiani AM, and Kolhe R
- Subjects
- COVID-19 epidemiology, COVID-19 virology, Diagnostic Tests, Routine methods, Georgia epidemiology, Humans, Limit of Detection, RNA, Viral genetics, RNA, Viral isolation & purification, Real-Time Polymerase Chain Reaction, Sensitivity and Specificity, COVID-19 diagnosis, COVID-19 Nucleic Acid Testing methods, Delivery of Health Care, Mass Screening methods, Population Surveillance methods, Residence Characteristics, SARS-CoV-2 genetics, Saliva virology
- Abstract
The clinical performance of saliva compared with nasopharyngeal swabs (NPSs) has shown conflicting results in healthcare and community settings. In the present study, a total of 429 matched NPS and saliva sample pairs, collected in either healthcare or community setting, were evaluated. Phase-1 (protocol U) tested 240 matched NPS and saliva sample pairs; phase 2 (SalivaAll protocol) tested 189 matched NPS and saliva sample pairs, with an additional sample homogenization step before RNA extraction. A total of 85 saliva samples were evaluated with both protocols. In phase-1, 28.3% (68/240) samples tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from saliva, NPS, or both. The detection rate from saliva was lower compared with that from NPS samples (50.0% versus 89.7%). In phase-2, 50.2% (95/189) samples tested positive for SARS-CoV-2 from saliva, NPS, or both. The detection rate from saliva was higher compared with that from NPS samples (97.8% versus 78.9%). Of the 85 saliva samples evaluated with both protocols, the detection rate was 100% for samples tested with SalivaAll, and 36.7% with protocol U. The limit of detection with SalivaAll protocol was 20 to 60 copies/mL. The pooled testing approach demonstrated a 95% positive and 100% negative percentage agreement. This protocol for saliva samples results in higher sensitivity compared with NPS samples and breaks the barrier to using pooled saliva for SARS-CoV-2 testing., (Copyright © 2021 Association for Molecular Pathology and American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF