Evaluating the use of posterior oropharyngeal saliva in a point-of-care assay for the detection of SARS-CoV-2
Evaluating the use of posterior oropharyngeal saliva in a point-of-care assay for the detection of SARS-CoV-2
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DOI：
10.1080/22221751.2020.1775133
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发表时间：
2020-01-01
影响因子：
13.2
通讯作者：
To, Kelvin Kai-Wang
中科院分区：
文献类型：
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作者：
Chen, Jonathan Hon-Kwan;Yip, Cyril Chik-Yan;To, Kelvin Kai-Wang
在2019年冠状病毒病（COVID-19）大流行期间，与标本采集相关的物流问题限制了SARS-CoV-2检测，尤其是在社区。在这项研究中，我们评估了使用后口咽唾液作为标本检测SARS-CoV-2的自动化床旁分子检测。使用Xpert（R）Xpress SARS-CoV-2检测试剂盒检测了58名COVID-19患者的存档鼻咽拭子和后口咽唾液样本。SARS-CoV-2在所有患者的唾液或唾液标本中均检测到。其中唾液和唾液同时阳性者占84.5%（49/58），单纯唾液阳性者占10.3%（6/58），单纯唾液阳性者占5.2%（3/58）。唾液和唾液的检出率无显著差异（McNemar检验p = 0.5078）。在两种标本类型中，N2的检出率（94.8%和93.1%）略高于E基因靶标（唾液：89.7% vs 82.8%）。与唾液相比，在E（26.8vs29.7，p = 0.0002）和N2基因靶点（29.3vs32.3，p = 0.0002）上，观察到唾液中位Ct值显著更早。E基因靶点的Ct值在唾液和唾液中均显著早于N2基因靶点（26.8vs29.3，p <0.0001）。总之，在SARS-CoV-2检测的即时检测中，发现后口咽唾液和唾液具有相似的检测率。由于后口咽唾液可以很容易地收集，建议使用唾液作为SARS-CoV-2检测的替代标本类型。
During the Coronavirus disease 2019 (COVID-19) pandemic, logistic problems associated with specimen collection limited the SARS-CoV-2 testing, especially in the community. In this study, we assessed the use of posterior oropharyngeal saliva as specimens for the detection of SARS-CoV-2 in an automated point-of-care molecular assay. Archived nasopharyngeal swab (NPS) and posterior oropharyngeal saliva specimens of 58 COVID-19 patients were tested with the Xpert(R)Xpress SARS-CoV-2 assay. SARS-CoV-2 was detected in either NPS or saliva specimens of all patients. Among them, 84.5% (49/58) tested positive in both NPS and saliva, 10.3% (6/58) tested positive in NPS only, and 5.2% (3/58) tested positive in saliva only. No significant difference in the detection rate was observed between NPS and saliva (McNemar's testp = 0.5078). The detection rate was slightly higher for N2 (NPS 94.8% and Saliva 93.1%) than that of the E gene target (Saliva: 89.7% vs 82.8%) on both specimen types. Significantly earlier median Ct value was observed for NPS comparing to that of saliva on both E (26.8 vs 29.7,p = 0.0002) and N2 gene target (29.3 vs 32.3,p = 0.0002). The median Ct value of E gene target was significantly earlier than that of the N2 gene target for both NPS (26.8 vs 29.3,p < 0.0001) and saliva (29.7 vs 32.3,p < 0.0001). In conclusion, posterior oropharyngeal saliva and NPS were found to have similar detection rates in the point-of-care test for SARS-CoV-2 detection. Since posterior oropharyngeal saliva can be collected easily, the use of saliva as an alternative specimen type for SARS-CoV-2 detection is recommended.