Relative Sensitivity of Saliva and Upper Airway Swabs for Initial Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Ambulatory Patients: Rapid Review.
Relative Sensitivity of Saliva and Upper Airway Swabs for Initial Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Ambulatory Patients: Rapid Review.
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唾液和上呼吸道拭子对门诊患者严重急性呼吸综合征冠状病毒2（SARS-CoV-2）初始检测的相对灵敏度：快速回顾
DOI：
10.1016/j.jmoldx.2020.12.008
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
O'Leary TJ
中科院分区：
文献类型：
--
作者：
O'Leary TJ
在检测严重急性呼吸综合征冠状病毒2时，唾液被提议作为上呼吸道拭子的替代品。虽然一些研究表明，在检测唾液时，病毒载量和临床敏感性较高，但研究相对较少，并产生了相互矛盾的结果。为了更好地了解唾液和上呼吸道样本的相对性能特征，我进行了一次快速系统回顾（在PROSPERO上注册为CRD 42020205035），重点关注包括至少20名受试者的研究，这些受试者在同一天提供了诊断性唾液和上呼吸道样本，其通过核酸扩增方法进行测试，并且可以基于复合参考标准构建其混淆矩阵。在检索PubMed、medRxiv和bioRxiv后，确定了19项研究，包括21个符合预定验收标准的队列。这些队列中的7个被纳入使用随机效应模型的荟萃分析，这表明鼻咽拭子在诊断门诊患者的早期疾病方面比唾液样本更敏感，例如在免下车中心或社区卫生中心。然而，这种差异是适度的，唾液采样对个人防护设备的需求减少可能证明这种差异是合理的。研究人群中疾病患病率的显著异质性和唾液样本采集方法的变化限制了结论。
Saliva has been proposed as an alternative to upper airway swabs when testing for severe acute respiratory syndrome coronavirus 2. Although some studies have suggested higher viral loads and clinical sensitivity when testing saliva, studies have been relatively small and have given rise to contradictory results. To better understand the relative performance characteristics of saliva and upper airway samples, I performed a rapid systematic review (registered on PROSPERO as CRD42020205035), focusing on studies that included at least 20 subjects who provided diagnostic saliva and upper airway samples on the same day, which were tested by nucleic acid amplification methods and for which a confusion matrix could be constructed for based on a composite reference standard. Nineteen studies comprising 21 cohorts that met predetermined acceptance criteria were identified following a search of PubMed, medRxiv, and bioRxiv. Seven of these cohorts were incorporated into a meta-analysis using a random effects model, which suggests that nasopharyngeal swabs are somewhat more sensitive than saliva samples for the diagnosis of early disease in ambulatory patients, such as in drive-through centers or community health centers. Nevertheless, the difference is modest, and the reduced need for personal protective equipment for saliva sampling may justify the difference. Conclusions are limited by the significant heterogeneity of disease prevalence in the study populations and variation in the approaches to saliva sample collection.
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影响因子：
14.2
作者：
Pasomsub, E.;Watcharananan, S. P.;Phuphuakrat, A.
通讯作者：
Phuphuakrat, A.
影响因子：
8.8
作者：
Landry, Marie L.;Criscuolo, Jody;Peaper, David R.
通讯作者：
Peaper, David R.
影响因子：
3.9
作者：
Czumbel, Laszlo Mark;Kiss, Szabolcs;Varga, Gabor
通讯作者：
Varga, Gabor
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG