Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings
Background: Saliva has been considered a suitable sample material for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA testing, but uncertainty remained regarding sensitivity and reliability of different saliva collection methods. Objectives: This study aimed to investigate the poten...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Journal of Clinical Virology Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667038023000285 |
| _version_ | 1797774722596864000 |
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| author | Olivia Kay Matthias E Futschik Elena Turek David Chapman Simon Carr Malur Sudhanva Paul E. Klapper Tony Cox Michael Hill Joanna Cole-Hamilton Peter Marks Sarah A Tunkel Timothy Peto Lindsey Davies Tom Fowler |
| author_facet | Olivia Kay Matthias E Futschik Elena Turek David Chapman Simon Carr Malur Sudhanva Paul E. Klapper Tony Cox Michael Hill Joanna Cole-Hamilton Peter Marks Sarah A Tunkel Timothy Peto Lindsey Davies Tom Fowler |
| author_sort | Olivia Kay |
| collection | DOAJ |
| description | Background: Saliva has been considered a suitable sample material for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA testing, but uncertainty remained regarding sensitivity and reliability of different saliva collection methods. Objectives: This study aimed to investigate the potential utility of expectorated saliva (ES) and drooled saliva (DS) for community mass testing. Study design: Self-collected ES and DS samples were obtained in a prospective cohort study with 2,878 participants. The utility of saliva for SARS-CoV-2 qRT-PCR testing was assessed by comparing the capacity to detect SARS-CoV-2 positive cases with results for self-collected combined throat and nose (CTN) swabs. Additionally, quantification cycle (Cq) values were compared. Results: ES- and DS-based tests showed the same high level of concordance (98% vs 98%) with CTN swab-based results. Sensitivity was higher for DS (94%) than for ES (83%) or CTN swab (90%) but differences were statistically not significant. Comparing only symptomatic cases, however, a significantly higher sensitivity of DS (96%) than of ES (76%) or CTN swab (91%) was observed. Cq values of saliva and swab specimen were significantly correlated and appeared to be not impacted by age or other potentially confounding factors. Conclusions: Saliva-based SARS-CoV-2 RNA testing showed high diagnostic accuracy and can be considered an alternative where swabbing may not be tolerated or operationally feasible. DS yielded the same or better diagnostic performance compared to ES and may present a preferred option with reduced aerosol risk and increased compliance. |
| first_indexed | 2024-03-12T22:25:17Z |
| format | Article |
| id | doaj.art-0490adae2068491096c2f099867babd1 |
| institution | Directory Open Access Journal |
| issn | 2667-0380 |
| language | English |
| last_indexed | 2024-03-12T22:25:17Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Virology Plus |
| spelling | doaj.art-0490adae2068491096c2f099867babd12023-07-22T04:52:57ZengElsevierJournal of Clinical Virology Plus2667-03802023-08-0133100161Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settingsOlivia Kay0Matthias E Futschik1Elena Turek2David Chapman3Simon Carr4Malur Sudhanva5Paul E. Klapper6Tony Cox7Michael Hill8Joanna Cole-Hamilton9Peter Marks10Sarah A Tunkel11Timothy Peto12Lindsey Davies13Tom Fowler14Public Health England, London, UKUK Health Security Agency, London, UK; University of Plymouth, Faculty of Health, Plymouth, UKDeloitte MCS Ltd, London, UKDeloitte MCS Ltd, London, UKDeloitte MCS Ltd, London, UKKing's College Hospital NHS Foundation Trust, London, UKUniversity of Manchester, Manchester, UKUK Biocentre, Milton Keynes, UKMRC Population Health Research, University of Oxford, Oxford, UKUK Health Security Agency, London, UKUK Health Security Agency, London, UKUK Health Security Agency, London, UKUniversity of Oxford, Oxford, UKUK Health Security Agency, London, UKUK Health Security Agency, London, UK; Queen Mary University of London William Harvey Research Institute, London, UK; Corresponding author.Background: Saliva has been considered a suitable sample material for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA testing, but uncertainty remained regarding sensitivity and reliability of different saliva collection methods. Objectives: This study aimed to investigate the potential utility of expectorated saliva (ES) and drooled saliva (DS) for community mass testing. Study design: Self-collected ES and DS samples were obtained in a prospective cohort study with 2,878 participants. The utility of saliva for SARS-CoV-2 qRT-PCR testing was assessed by comparing the capacity to detect SARS-CoV-2 positive cases with results for self-collected combined throat and nose (CTN) swabs. Additionally, quantification cycle (Cq) values were compared. Results: ES- and DS-based tests showed the same high level of concordance (98% vs 98%) with CTN swab-based results. Sensitivity was higher for DS (94%) than for ES (83%) or CTN swab (90%) but differences were statistically not significant. Comparing only symptomatic cases, however, a significantly higher sensitivity of DS (96%) than of ES (76%) or CTN swab (91%) was observed. Cq values of saliva and swab specimen were significantly correlated and appeared to be not impacted by age or other potentially confounding factors. Conclusions: Saliva-based SARS-CoV-2 RNA testing showed high diagnostic accuracy and can be considered an alternative where swabbing may not be tolerated or operationally feasible. DS yielded the same or better diagnostic performance compared to ES and may present a preferred option with reduced aerosol risk and increased compliance.http://www.sciencedirect.com/science/article/pii/S2667038023000285COVID-19SARS-CoV-2 RNAqRT-PCRMass testingSelf-samplingSaliva |
| spellingShingle | Olivia Kay Matthias E Futschik Elena Turek David Chapman Simon Carr Malur Sudhanva Paul E. Klapper Tony Cox Michael Hill Joanna Cole-Hamilton Peter Marks Sarah A Tunkel Timothy Peto Lindsey Davies Tom Fowler Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings Journal of Clinical Virology Plus COVID-19 SARS-CoV-2 RNA qRT-PCR Mass testing Self-sampling Saliva |
| title | Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings |
| title_full | Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings |
| title_fullStr | Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings |
| title_full_unstemmed | Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings |
| title_short | Performance of self-collected saliva samples for SARS-CoV-2 mass testing in community settings |
| title_sort | performance of self collected saliva samples for sars cov 2 mass testing in community settings |
| topic | COVID-19 SARS-CoV-2 RNA qRT-PCR Mass testing Self-sampling Saliva |
| url | http://www.sciencedirect.com/science/article/pii/S2667038023000285 |
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