Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing.
Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing.
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DOI：
10.1128/jcm.01418-20
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发表时间：
2021-04-20
影响因子：
9.4
通讯作者：
St George K
中科院分区：
文献类型：
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作者：
Griesemer SB;Van Slyke G;Ehrbar D;Strle K;Yildirim T;Centurioni DA;Walsh AC;Chang AK;Waxman MJ;St George K
通过积极的诊断测试识别SARS-CoV-2感染对于追踪和遏制COVID-19大流行的传播仍然至关重要。收集鼻咽拭子（拭子），SARS-CoV-2检测的首选样本类型，已变得困难，由于测试和随之而来的供应菌株急剧增加。通过积极的诊断检测识别SARS-CoV-2感染对于跟踪和遏制COVID-19大流行的传播仍然至关重要。收集鼻咽拭子（拭子），SARS-CoV-2检测的首选样本类型，已变得困难，由于测试和随之而来的供应菌株急剧增加。因此，已研究了替代标本类型，这些类型可提供相似的检测灵敏度，同时降低医疗保健暴露和自我采集的可能性。在这项研究中，使用来自纽约州两个门诊队列的匹配标本（总n = 463），将鼻拭子（NS）和唾液中SARS-CoV-2的检测灵敏度与鼻拭子（NS）和唾液中SARS-CoV-2的检测灵敏度进行比较。第一个队列仅显示5.4%的阳性率，但第二个队列（n = 227）的阳性率为41%，在唾液、NS和唾液中的敏感性分别为97.9%、87.1%和87.1%。NS或唾液的敏感性降低是否可接受，必须在使用它们的环境中进行评估。然而，我们试图通过验证混合两种样本类型的方法来改进它，因为鼻拭子和唾液的组合导致94.6%的SARS-CoV-2检测灵敏度。加标实验表明，将它们组合在一起不会对检测灵敏度产生不利影响。还研究了在添加和不添加市售稳定溶液的情况下唾液中的病毒稳定性。该病毒在唾液中在4°C和室温下稳定长达7天。添加稳定溶液并不能提高稳定性，在某些情况下，会降低可检测的病毒水平。
Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical to tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in testing and consequent supply strain. Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical to tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in testing and consequent supply strain. Therefore, alternative specimen types have been investigated that provide similar detection sensitivity with reduced health care exposure and the potential for self-collection. In this study, the detection sensitivity of SARS-CoV-2 in nasal swabs (NS) and saliva was compared to that of NPS using matched specimens from two outpatient cohorts in New York State (total n = 463). The first cohort showed only a 5.4% positivity, but the second cohort (n = 227) had a positivity rate of 41%, with sensitivity in NPS, NS, and saliva of 97.9%, 87.1%, and 87.1%, respectively. Whether the reduced sensitivity of NS or saliva is acceptable must be assessed in the settings where they are used. However, we sought to improve on it by validating a method to mix the two sample types, as the combination of nasal swab and saliva resulted in 94.6% SARS-CoV-2 detection sensitivity. Spiking experiments showed that combining them did not adversely affect the detection sensitivity in either. Virus stability in saliva was also investigated, with and without the addition of commercially available stabilizing solutions. The virus was stable in saliva at both 4°C and room temperature for up to 7 days. The addition of stabilizing solutions did not enhance stability and, in some situations, reduced detectable virus levels.