Self-collected saliva for SARS-CoV-2 detection: A prospective study in the emergency room

ECHAVARRIA, MARCELA; REYES, NOELIA SOLEDAD; RODRIGUEZ, PAMELA ELIZABETH; YPAS, MARTIN; RICARTE, CARMEN; RODRIGUEZ, MARÍA P.; PEREZ, MATIAS G.; SEOANE, ALEJANDRO; MARTINEZ, ALFREDO; VIDELA, CRISTINA; STRYJEWSKI, MARTIN E.; CARBALLAL, GUADALUPE

JOURNAL OF MEDICAL VIROLOGY

WILEY-LISS, DIV JOHN WILEY & SONS INC

Año: 2021

0146-6615

Current diagnostic standards involve severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection in nasopharyngeal swabs (NPS), but saliva is an attractive and noninvasive option for diagnosis. The objectives were to determine the performance of saliva in comparison with NPS for detecting SARS-CoV-2 and to compare the optimized home brew reverse-transcription polymerase chain reaction (RT-PCR) with a commercial RT-PCR. Paired NPS and saliva specimens were prospectively collected and tested by RT-PCR from patients presenting at an emergency room with signs and symptoms compatible with coronavirus disease-2019. A total of 348 samples from 174 patients were tested by RT-PCR assays. Among 174 patients with symptoms, 63 (36%) were SARS-CoV-2 positive in NPS using the optimized home-brew PCR. Of these 63 patients, 61 (98%) were also positive in saliva. An additional positive SARS-CoV-2 saliva was detected in a patient with pneumonia. Kappa Cohen´s coefficient agreement between NPS and saliva was 0.96 (95% confidence interval [CI], 0.90?0.99). Median Ct values in NPS versus saliva were 18.88 (interquartile range [IQR], 15.60?23.58; range, 11.97?38.10) versus 26.10 (IQR, 22.75?30.06; range, 13.78?39.22), respectively (p