Challenges in use of saliva for detection of SARS CoV-2 RNA in symptomatic outpatients
Challenges in use of saliva for detection of SARS CoV-2 RNA in symptomatic outpatients
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DOI：
10.1016/j.jcv.2020.104567
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发表时间：
2020-09-01
影响因子：
8.8
通讯作者：
Peaper, David R.
中科院分区：
文献类型：
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作者：
Landry, Marie L.;Criscuolo, Jody;Peaper, David R.
背景：SARS CoV-2检测的大规模扩展是迫切需要的。唾液是鼻咽拭子的一个有吸引力的选择，因为唾液可以自我采集，是非侵入性的，样本质量不依赖于采集者的专业知识。目的：比较配对的鼻咽拭子和唾液样本中SARS CoV-2的阳性率。前瞻性地从疑似患有COVID-19的有症状的门诊患者中收集唾液样本和配对唾液样本，并通过实时RT-PCR进行检测。总计，35/124 RT-PCR阳性率为26.6%，其中33/35份为PCR阳性（敏感性= 94.3%（95%CI 81.4%-99.0%）），30/35例为纯唾液（灵敏度= 85.7%（95%CI 70.6%-93.7%）），总体一致率为117/124（94.4%）。唾液的中位循环阈值显著低于唾液（p = 0.0331）。三分之一或更多的纯唾液样本有症状的患者厚，stringy，和难以pipet.Conclusions：实时RT-PCR纯唾液SARS CoV-2 RNA检测的总体灵敏度为85.7%相比，同时收集的唾液。我们的研究强调了在唾液可用于高容量检测之前优化收集和处理的必要性。
Background: A major expansion in SARS CoV-2 testing is urgently needed. Saliva is an attractive option as an alternative for nasopharyngeal swabs (NPS), since saliva can be self-collected, is non-invasive, and sample quality is not dependent on the expertise of the collector.Objective: To compare SARS CoV-2 positivity on paired NPS and saliva samples.Study design: NPS and paired saliva samples were prospectively collected from symptomatic outpatients suspected of having COVID-19 and were tested by real-time RT-PCR.Results: In total, 35/124 (26.6 %) samples were RT-PCR positive, with 33/35 positive by NPS (sensitivity = 94.3 % (95 % CI 81.4%-99.0%)) and 30/35 by pure saliva (sensitivity = 85.7 % (95 % CI 70.6%-93.7%)), for an overall agreement of 117/124 (94.4 %). The median cycle threshold value was significantly lower for NPS than for saliva (p = 0.0331). A third or more of pure saliva samples from symptomatic patients were thick, stringy, and difficult to pipet.Conclusions: Real-time RT-PCR of pure saliva had an overall sensitivity for SARS CoV-2 RNA detection of 85.7 % when compared to simultaneously collected NPS. Our study highlighted the need to optimize collection and processing before saliva can be used for high volume testing.