Routine saliva testing for the identification of silent coronavirus disease 2019 (COVID-19) in healthcare workers.
Routine saliva testing for the identification of silent coronavirus disease 2019 (COVID-19) in healthcare workers.
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DOI：
10.1017/ice.2020.1413
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发表时间：
2021-10
影响因子：
4.5
通讯作者：
Moghadas SM
中科院分区：
文献类型：
--
作者：
Zhang K;Shoukat A;Crystal W;Langley JM;Galvani AP;Moghadas SM
目前的COVID-19指南建议对高危环境中的卫生保健人员进行基于症状的筛查和定期鼻咽检测。我们试图通过各种常规NP和唾液检测频率来估计病例检出率。仿真建模研究。我们基于2019年症状性冠状病毒病（COVID-19）病例的平均传染性特征构建了敏感性函数，以确定在检测时被识别的概率。该函数拟合使用NP检测的有症状的COVID-19患者阳性百分比的报告数据。然后，我们模拟了不同NP和唾液检测频率的常规检测程序，以确定感染期和症状前阶段的病例检出率。两周常规NP检测，每2周1次，平均90.7% （SD, 0.18）的病例出现在感染期，19.7% （SD, 0.98）的病例出现在症状前阶段。每周NP检测频率下，相应的病例检出率分别为95.9% （SD, 0.18）和32.9% （SD, 1.23）。在感染期，5天唾液检测计划的病例检出率与每周NP检测相似，但在症状前阶段发现的病例多10%（平均42.5%；标准差1.10）。我们的研究结果强调了常规无创唾液检测对一线医护人员保护弱势患者群体的效用。应考虑5天唾液检测时间表，以帮助识别隐性感染，并防止在养老院和医疗机构爆发。
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. Simulation modeling study. We constructed a sensitivity function based on the average infectiousness profile of symptomatic coronavirus disease 2019 (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 presymptomatic stage. Routine biweekly NP testing, once every 2 weeks, identified an average of 90.7% (SD, 0.18) of cases during the infectious period and 19.7% (SD, 0.98) during the presymptomatic 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 ~10% more cases (mean, 42.5%; SD, 1.10) during the presymptomatic stage. Our findings highlight the utility of routine noninvasive 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.
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