Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on Self-Collected Saliva or Anterior Nasal Specimens Compared With Healthcare Personnel–Collected Nasopharyngeal Specimens

Abstract

Background Nasopharyngeal specimens (NPS) are commonly used for SARS-CoV-2 testing but can be uncomfortable for patients. Self-collected saliva 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 saliva and ANS specimens before NPS collection and answered a short survey about symptoms and specimen preference. Specimens were tested for SARS-CoV-2 by rRT-PCR; viral culture was performed on a subset of specimens positive by rRT-PCR. Sensitivity of saliva and ANS for SARS-CoV-2 detection by rRT-PCR was measured against 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 saliva than for ANS (85% vs. 80%) and among symptomatic participants than among those without symptoms (94% vs. 29% for saliva; 87% vs. 50% for ANS). Among participants with culture-positive SARS-CoV-2 by any specimen type, sensitivity of saliva and ANS by rRT-PCR was 94% and 100%, respectively. Saliva and ANS were equally preferred by participants; most would undergo NPS again despite being least preferred. Conclusions Saliva was slightly more sensitive than ANS for SARS-CoV-2 detection by rRT-PCR. Both saliva and ANS reliably detected SARS-CoV-2 among participants with symptoms. Self-collected saliva and ANS offer practical advantages, are preferred by patients, and might be most useful for testing people with COVID-19 symptoms.

The evaluation of the utility of the GENECUBE HQ SARS-CoV-2 for anterior nasal samples and saliva samples with a new rapid examination protocol

“…The method has been reported as less painful and induced fewer coughs or sneezes compared with nasopharyngeal sampling [12]. The application of self-collected anterior nasal sampling has also been reported [23]. In the current study, the analytical performance of the GENECUBE 1 examination was almost identical to the reference RT-PCR.…”

Preclinical Validation of a Novel Injection-Molded Swab for the Molecular Assay Detection of SARS-CoV-2

“…The NP collection process is often reported to be uncomfortable [ 5 ]. Due to supply chain limitations and increased demand, anterior nasal (AN) specimens have been successfully adopted as an effective alternative to address NP swab shortages [ 6 ], and nasal swabs have been found to be equivalent to NP swabs for the detection of SARS-CoV-2; high sensitivity and specificity have been indicated for that sample type [ 7 ]. AN swabs offer similar testing sensitivity to NP swabs, as well as being easier to administer and more comfortable for the patients, supporting their use in large-scale screening and testing [ 5 ].…”

Preclinical and clinical validation of a novel injected molded swab for molecular assay detection of SARS-CoV-2 virus

“…The NP collection process is often reported as uncomfortable (5). Due to supply chain limitations and increased demand, anterior nasal (AN) specimens have been successfully adopted as an effective alternative to solve the NP swab shortage (6), and nasal swabs have been found to be equivalent to NP swabs for the detection of SARS-CoV-2, as studies have indicated high sensitivity and specificity for that sample type (7).…”