Diagnostic Yield of Saliva for SARS-CoV-2 Molecular Testing in Children

Banerjee, Dithi; Sasidharan, Anjana; Abdulhamid, Ayah; Orosco, Esmeralda M; Watts, Jennifer L.; Schuster, Jennifer E; Myers, Angela; Weddle, Gina; Selvarangan, Rangaraj

doi:10.1093/jpids/piab058

Cited by 10 publications

(9 citation statements)

References 12 publications

(11 reference statements)

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“…Select studies show similar detection between the 2 approaches, with a high sensitivity of saliva when using nasopharyngeal as a reference standard. 2,[5][6][7] In contrast, other studies found lower rates, but were limited by small sample sizes. 8,9 Further more, no studies to date have evaluated the optimum timing for testing after exposure or symptom onset in the adult or pediatric populations.…”

mentioning

confidence: 87%

“…13,14 Self-collected samples were obtained at least 30 minutes after abstinence from food or drink. 5,6 These kits are designed for self-or parent-supported collection without expert assistance and can preserve viral material at room temperature for transport and analysis for up to 3 weeks after collection. 13,14 Saliva samples were collected according to the manufacturer recommendations (Appendix 1, Supplementary Appendix B).…”

Section: Study Proceduresmentioning

confidence: 99%

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Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study

Hua¹,

Corsten

Bello

et al. 2022

cmajo

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Diagnostic testing for SARS-CoV-2 is crucial in the management of the COVID-19 pandemic. According to the Public Health Agency of Canada (PHAC), nasopharyngeal swabs are the specimen of choice for routine testing for SARS-CoV-2. 1 Nasopharyngeal swabbing is an uncomfortable procedure, which may decrease patient willingness to comply with repeat testing, and increase use of health care personnel, costs and exposure risk. 2,3 The need for mass testing also creates bottlenecks in sample collection and depletes availability of protective equipment. Therefore, alternative testing methods are needed.Salivary testing has been proposed as an alternative to nasopharyngeal swabs. We previously compared detection rates of nasopharyngeal swabs with self-collection saliva kits for SARS-CoV-2 in adults. 4 However, limited literature is available to support salivary testing in the pediatric population, and those published show conflicting results. Select studies show similar detection between the 2 approaches, with a high sensitivity of saliva when using nasopharyngeal as a reference standard. 2,[5][6][7] In contrast, other studies found lower rates, but were limited by small sample sizes. 8,9 Further more, no studies to date have evaluated the optimum timing for testing after exposure or symptom onset in the adult or pediatric populations. Previous studies have shown variability of results produced at different time points. 10 New studies are needed to determine the optimum timing for testing for these diagnostic modalities.To date, children younger than 19 years account for about 20% of SARS-CoV-2 infections in Canada. 11 As such, the need for effective and reliable repeat sampling in children is critical as restrictions ease and the prevalence of variants of concern increases, especially for distinguishing SARS-CoV-2 infection from other respiratory pathogens in children. As a less invasive testing method, saliva testing may prove an effective alternative to repeat testing by nasopharyngeal swab

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mentioning

confidence: 87%

Section: Study Proceduresmentioning

confidence: 99%

Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study

Hua¹,

Corsten

Bello

et al. 2022

cmajo

View full text Add to dashboard Cite

show abstract

“…We [2] and others [3][4][5][6] have demonstrated the diagnostic utility of saliva for SARS-CoV-2 testing, and several have demonstrated comparable sensitivities for SARS-CoV-2 detection in saliva versus NP specimens [5,7]; but few have assessed performance in children [4,5] whose saliva can be impacted by dietary and oral hygiene behaviors distinct from adults. With routine self-collection, robust detection of viruses are vulnerable to inhibitors found in saliva secondary to foods, dental care, or native salivary environment [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Food for thought: Eating before saliva collection and interference with SARS-CoV-2 detection

Hernandez

Riollano‐Cruz

Boyle

et al. 2021

Preprint

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BackgroundSaliva is an optimal specimen for detection of viruses that cause upper respiratory infections including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to its cost-effectiveness and non-invasive collection. However, together with intrinsic enzymes and oral microbiota, children’s unique dietary habits may introduce substances that interfere with diagnostic testing.MethodsTo determine whether children’s dietary choices impact SARS-CoV-2 detection in saliva, we performed a diagnostic study that simulates testing of real-life specimens provided from healthy children (n=5) who self-collected saliva at home before and at 0, 20, and 60 minutes after eating from 20 foods they selected. Each of seventy-two specimens was split into two volumes and spiked with SARS-CoV-2-negative or -positive standards prior to side-by-side testing by reverse-transcription polymerase chain reaction matrix-assisted laser desorption ionization time-of-flight (RT-PCR/MALDI-TOF) assay.ResultsDetection of internal extraction control and SARS-CoV-2 nucleic acids was reduced in replicates of saliva collected at 0 minutes after eating 11 of 20 foods. Interference resolved at 20 and 60 minutes after eating all foods except hot dog in one participant. This represented a significant improvement in detection of nucleic acids compared to saliva collected at 0 minutes after eating (P=0.0005).ConclusionsWe demonstrate successful detection of viral nucleic acids in saliva self-collected by children before and after eating a variety of foods. Fasting is not required before saliva collection for SARS-CoV-2 testing by RT-PCR/MALDI-TOF, but waiting 20 minutes after eating is sufficient for accurate testing. These findings should be considered for SARS-CoV-2 testing and broader viral diagnostics in saliva specimens.

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“…We 2 and others 3 , 4 , 5 , 6 have demonstrated the diagnostic utility of saliva for SARS‐CoV‐2 testing, and several have demonstrated comparable sensitivities for SARS‐CoV‐2 detection in saliva versus NP specimens, 5 , 7 but few have assessed performance in children 4 , 5 whose saliva can be impacted by dietary and oral hygiene behaviors distinct from adults. With routine self‐collection, robust detection of viruses is vulnerable to various inhibitors found in saliva secondary to dental care, microbiota, native salivary environment, and foods in everyday diets.…”

Section: Introductionmentioning

confidence: 99%

Food for thought: Eating before saliva collection and interference with SARS‐CoV‐2 detection

Hernandez

Riollano‐Cruz

Boyle

et al. 2022

Journal of Medical Virology

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Saliva is a promising specimen for the detection of viruses that cause upper respiratory infections including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to its cost-effectiveness and noninvasive collection. However, together with intrinsic enzymes and oral microbiota, children's unique dietary habits may introduce substances that interfere with diagnostic testing. To determine whether children's dietary choices impact SARS-CoV-2 molecular detection in saliva, we performed a diagnostic study that simulates testing of real-life specimens provided from healthy children (n = 5) who self-collected saliva at home before and at 0, 20, and 60 min after eating 20 foods they selected. Each of 72 specimens was split into two volumes and spiked with SARS-CoV-2-negative or SARS-CoV-2-positive clinical standards before side-by-side testing by reverse-transcription polymerase chain reaction matrix-assisted laser desorption ionization time-of-flight (RT-PCR/ MALDI-TOF) assay. Detection of internal extraction control and SARS-CoV-2 nucleic acids was reduced in replicates of saliva collected at 0 min after eating 11 of 20 foods. Interference resolved at 20 and 60 min after eating all foods except hot dogs in one participant. This represented a significant improvement in the detection of nucleic acids compared to saliva collected at 0 min after eating (p = 0.0005). We demonstrate successful detection of viral nucleic acids in saliva self-collected by children before and after eating a variety of foods. Fasting is not required before saliva collection for SARS-CoV-2 testing by RT-PCR/MALDI-TOF, but waiting for 20 min after eating is sufficient for accurate testing. These findings should be considered for SARS-CoV-2 testing and broader viral diagnostics in saliva specimens.

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Diagnostic Yield of Saliva for SARS-CoV-2 Molecular Testing in Children

Cited by 10 publications

References 12 publications

Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study

Salivary testing for SARS-CoV-2 in the pediatric population: a diagnostic accuracy study

Food for thought: Eating before saliva collection and interference with SARS-CoV-2 detection

Food for thought: Eating before saliva collection and interference with SARS‐CoV‐2 detection

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