Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on Self-Collected Saliva or Anterior Nasal Specimens Compared With Healthcare Personnel–Collected Nasopharyngeal Specimens. (29th April 2021)

• Record Type: Journal Article
• Authors: Marx, Grace E; Biggerstaff, Brad J; Nawrocki, Courtney C; Totten, Sarah E; Travanty, Emily A; Burakoff, Alexis W; Scott, Tracy; De Hey, Jesse Chavez-Van; Carlson, Jesse J; Wendel, Karen A; Harcourt, Jennifer L; Tamin, Azaibi; Thomas, Jennifer D; Rowan, Sarah E
• Is Part Of: Clinical infectious diseases. Volume 73:Supplement 1(2021)
• Page Start: S65
• Page End: S73
• Publication Date: 2021-04-29
• Subjects: SARS-CoV-2 -- COVID-19 -- nasopharyngeal -- anterior nasal -- saliva; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciab330
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Nasopharyngeal specimens (NPS) are commonly used for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing but can be uncomfortable for patients. Self-collected saliva specimens (SS) or anterior nasal specimens (ANS) for SARS-CoV-2 detection are less invasive, but the sensitivity of these specimen types has not been thoroughly evaluated. Methods: During September–November 2020, 730 adults undergoing SARS-CoV-2 testing at community testing events and homeless shelters in Denver provided self-collected SS and ANS before NPS collection and answered a short survey about symptoms and specimen preference. Specimens were tested for SARS-CoV-2 by means of real-time reverse-transcription polymerase chain reaction (rRT-PCR); viral culture was performed on a subset of specimens positive by rRT-PCR. The sensitivity of SS and ANS for SARS-CoV-2 detection by rRT-PCR was measured against that of NPS. Subgroup analyses included test outcomes by symptom status and culture results. Results: Sensitivity for SARS-CoV-2 detection by rRT-PCR appeared higher for SS than for ANS (85% vs 80%) and higher among symptomatic participants than among those without symptoms (94% vs 29% for SS; 87% vs 50% for ANS). Among participants with culture-positive SARS-CoV-2 by any specimen type, the sensitivities of SS and ANS by rRT-PCR were 94% and 100%, respectively. SS and ANS were equally preferred by participants; most would undergo NPS collection again despite this method's being the least preferred. Conclusions: SS were slightly more sensitive than ANS for SARS-CoV-2 detection with rRT-PCR. With both SS and ANS, SARS-CoV-2 was reliably detected among participants with symptoms. Self-collected SS and ANS offer practical advantages, are preferred by patients, and might be most useful for testing people with coronavirus disease 2019 symptoms.