Saliva sample as a non-invasive specimen for the diagnosis of coronavirus disease 2019: a cross-sectional study
Saliva sample as a non-invasive specimen for the diagnosis of coronavirus disease 2019: a cross-sectional study
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DOI：
10.1016/j.cmi.2020.05.001
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发表时间：
2021-02-15
影响因子：
14.2
通讯作者：
Phuphuakrat, A.
中科院分区：
文献类型：
--
作者：
Pasomsub, E.;Watcharananan, S. P.;Phuphuakrat, A.
目的：在2019年冠状病毒病（COVID-19）病例数量不断增加的情况下，需要一种快速简便的方法来获得用于检测这种新型冠状病毒（严重急性呼吸综合征冠状病毒2; SARS-CoV-2）的非侵入性样本。我们的目的是调查唾液样本作为COVID-19诊断的非侵入性工具的潜在用途。方法：从2020年3月27日至4月4日，我们前瞻性地收集了COVID-19爆发期间在大学医院急性呼吸道感染门诊寻求治疗的人的唾液样本和标准鼻咽和咽拭子。采用实时荧光定量聚合酶链反应（Real-time polymerase chain reaction，RT-PCR）检测两种标本的PCR产物，并进行比较。69例（34.5%）为男性，中位（四分位数）年龄为36（28-48）岁。以鼻咽和咽拭子RT-PCR为参考标准，经鼻咽和咽拭子RT-PCR确诊的COVID-19患病率为9.5%。RT-PCR检测唾液标本的敏感性和特异性分别为84.2%（95%CI 60.4%~ 96.6%）和98.9%（95%CI 96.1%~ 99.9%）。对两种标本之间的一致性分析显示，观察到的一致性为97.5%（K系数0.851，95%CI 0.723-0.979; p < 0.001）。结论：唾液可能是诊断COVID-19的替代标本。收集是非侵入性的，并且不产生气溶胶。该方法标本采集简单，诊断效果好，可用于该病的诊断。(C)2020年欧洲临床微生物学和传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Amid the increasing number of pandemic coronavirus disease 2019 (COVID-19) cases, there is a need for a quick and easy method to obtain a non-invasive sample for the detection of this novel coronavirus (severe acute respiratory syndrome coronavirus 2; SARS-CoV-2). We aimed to investigate the potential use of saliva samples as a non-invasive tool for the diagnosis of COVID-19.Methods: From 27 March to 4 April 2020, we prospectively collected saliva samples and a standard nasopharyngeal and throat swab in persons seeking care at an acute respiratory infection clinic in a university hospital during the outbreak of COVID-19. Real-time polymerase chain reaction (RT-PCR) was performed, and the results of the two specimens were compared.Results: Two-hundred pairs of samples were collected. Sixty-nine (34.5%) individuals were male, and the median (interquartile) age was 36 (28-48) years. Using nasopharyngeal and throat swab RT-PCR as the reference standard, the prevalence of COVID-19 diagnosed by nasopharyngeal and throat swab RT-PCR was 9.5%. The sensitivity and specificity of the saliva sample RT-PCR were 84.2% (95% CI 60.4%-96.6%), and 98.9% (95% CI 96.1%-99.9%), respectively. An analysis of the agreement between the two specimens demonstrated 97.5% observed agreement (K coefficient 0.851, 95% CI 0.723-0.979; p < 0.001).Conclusions: Saliva might be an alternative specimen for the diagnosis of COVID-19. The collection is non-invasive, and non-aerosol generating. This method could facilitate the diagnosis of the disease, given the simplicity of specimen collection and good diagnostic performance. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.