Mass Screening of Asymptomatic Persons for Severe Acute Respiratory Syndrome Coronavirus 2 Using Saliva
Mass Screening of Asymptomatic Persons for Severe Acute Respiratory Syndrome Coronavirus 2 Using Saliva
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DOI：
10.1093/cid/ciaa1388
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发表时间：
2021-05-25
影响因子：
11.8
通讯作者：
Teshima, Takanori
中科院分区：
文献类型：
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作者：
Yokota, Isao;Shane, Peter Y.;Teshima, Takanori
背景资料。2019年冠状病毒病(新冠肺炎)已迅速演变为全球大流行，主要是由于其致病病毒通过无症状携带者传播。在无症状人群中检测严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是预防和控制社区疾病暴发的当务之急。然而，关于聚合酶链式反应检测的准确性，在无症状的人中几乎没有数据。此外，尽管自我采集的唾液样本在大规模筛查中具有显著的后勤优势，但它们作为无症状人群的替代标本的有效性尚未确定。我们进行了一项大规模筛查研究，以比较使用鼻咽拭子(NPS)和唾液样本对两组无症状人群进行核酸扩增的实用性，例如逆转录聚合酶链式反应(NPS)。在这项包括1924人的大规模筛查研究中，用NPS和唾液标本进行核酸扩增检测的敏感性分别为86%(90%可信区间，77%~93%)和92%(83%~97%)，特异性为99.9%。考虑到最近机场的流行率为0.3%，NPS和唾液测试之间的真实一致性概率估计为0.998(90%可信区间，0.996-0.999)。在检测阳性的个体中，NPS和唾液样本之间的病毒载量高度相关。NPS和唾液标本均具有较高的敏感性和特异性。自行采集的唾液样本在无症状人群的大规模筛查中对检测SARS-CoV-2很有价值。
Background. Coronavirus disease 2019 (COVID-19) has rapidly evolved to become a global pandemic, largely owing to the transmission of its causative virus through asymptomatic carriers. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic people is an urgent priority for the prevention and containment of disease outbreaks in communities. However, few data are available in asymptomatic persons regarding the accuracy of polymerase chain reaction testing. In addition, although self-collected saliva samples have significant logistical advantages in mass screening, their utility as an alternative specimen in asymptomatic persons is yet to be determined.Methods. We conducted a mass screening study to compare the utility of nucleic acid amplification, such as reverse-transcription polymerase chain reaction testing, using nasopharyngeal swab (NPS) and saliva samples from each individual in 2 cohorts of asymptomatic persons: the contact-tracing cohort and the airport quarantine cohort.Results. In this mass screening study including 1924 individuals, the sensitivities of nucleic acid amplification testing with NPS and saliva specimens were 86% (90% credible interval, 77%-93%) and 92% (83%-97%), respectively, with specificities >99.9%. The true concordance probability between the NPS and saliva tests was estimated at 0.998 (90% credible interval, .996-.999) given the recent airport prevalence of 0.3%. In individuals testing positive, viral load was highly correlated between NPS and saliva specimens.Conclusion. Both NPS and saliva specimens had high sensitivity and specificity. Self-collected saliva specimens are valuable for detecting SARS-CoV-2 in mass screening of asymptomatic persons.