High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children

Huber, Michael; Schreiber, Peter W.; Scheier, Thomas; Audigé, Annette; Buonomano, Roberto; Rudiger, Alain; Braun, Dominique L; Eich, Gerhard; Keller, Dagmar I.; Hasse, Barbara; Böni, Jürg; Berger, Christoph; Günthard, Huldrych F.; Manrique, Amapola; Trkola, Alexandra

doi:10.3390/microorganisms9030642

Cited by 46 publications

(69 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In fact, it avoids the discomfort of the nasopharyngeal swab, protects health workers from exposure to the virus and overcomes the problem of the lack of nasopharyngeal swabs. In addition to rapid salivary antigen test which identifies the viral Spike protein based on the lateral flow assay (132), there is salivary RT-PCR test (133,134). The detection of SARS-CoV-2 by RT-PCR in saliva showed a positive percent agreement of 92.5% compared to analysis in nasopharyngeal swabs, underlining that the saliva is a generally reliable specimen for the detection of SARS-CoV-2, with particular advantages for testing children (134).…”

Section: Diagnosismentioning

confidence: 99%

“…In addition to rapid salivary antigen test which identifies the viral Spike protein based on the lateral flow assay (132), there is salivary RT-PCR test (133,134). The detection of SARS-CoV-2 by RT-PCR in saliva showed a positive percent agreement of 92.5% compared to analysis in nasopharyngeal swabs, underlining that the saliva is a generally reliable specimen for the detection of SARS-CoV-2, with particular advantages for testing children (134). Salivary RT-PCR testing could be a valuable tool in mass screening strategies, especially for controlling the pandemic during the reopening period, for providing variant monitoring, and for routine testing of children as well.…”

Section: Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Coronavirus Disease 2019 in Children

et al. 2021

View full text Add to dashboard Cite

Since its appearance in Wuhan in mid-December 2019, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related 19 coronavirus disease (COVID-19) has spread dramatically worldwide. It soon became apparent that the incidence of pediatric COVID-19 was much lower than the adult form. Morbidity in children is characterized by a variable clinical presentation and course. Symptoms are similar to those of other acute respiratory viral infections, the upper airways being more affected than the lower airways. Thus far, over 90% of children who tested positive for the virus presented mild or moderate symptoms and signs. Most children were asymptomatic, and only a few cases were severe, unlike in the adult population. Deaths have been rare and occurred mainly in children with underlying morbidity. Factors as reduced angiotensin-converting enzyme receptor expression, increased activation of the interferon-related innate immune response, and trained immunity have been implicated in the relative resistance to COVID-19 in children, however the underlying pathogenesis and mechanism of action remain to be established. While at the pandemic outbreak, mild respiratory manifestations were the most frequently described symptoms in children, subsequent reports suggested that the clinical course of COVID-19 is more complex than initially thought. Thanks to the experience acquired in adults, the diagnosis of pediatric SARS-CoV-2 infection has improved with time. Data on the treatment of children are sparse, however, several antiviral trials are ongoing. The purpose of this narrative review is to summarize current understanding of pediatric SARS-CoV-2 infection and provide more accurate information for healthcare workers and improve the care of patients.

show abstract

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Coronavirus Disease 2019 in Children

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Therefore, controlled evaluations in large, well-defined cohorts are critical. To this end, we recently conducted a large-scale head-to-head comparison of SARS-CoV-2 detection by RT-PCR in NPS and saliva of adults and children in a test center setting [ 21 ]. We demonstrated that saliva is a reliable alternative specimen for the detection of SARS-CoV-2 by RT-PCR with particular advantages for testing children.…”

Section: Introductionmentioning

confidence: 99%

Reduced Relative Sensitivity of the Elecsys SARS-CoV-2 Antigen Assay in Saliva Compared to Nasopharyngeal Swabs

et al. 2021

Self Cite

View full text Add to dashboard Cite

Early identification and isolation of SARS-CoV-2-infected individuals is central to contain the COVID-19 pandemic. Nasopharyngeal swabs (NPS) serve as a specimen for detection by RT-PCR and rapid antigen screening tests. Saliva has been confirmed as a reliable alternative specimen for RT-PCR and has been shown to be valuable for diagnosing children and in repetitive mass testing due to its non-invasive collection. Combining the advantages of saliva with those of antigen tests would be highly attractive to further increase test capacities. Here, we evaluated the performance of the Elecsys SARS-CoV-2 Antigen assay (Roche) in RT-PCR-positive paired NPS and saliva samples (N = 87) and unpaired NPS (N = 100) with confirmed SARS-CoV-2 infection (Roche cobas SARS-CoV-2 IVD test). We observed a high positive percent agreement (PPA) of the antigen assay with RT-PCR in NPS, reaching 87.2% across the entire cohort, whereas the overall PPA for saliva was insufficient (40.2%). At Ct values ≤ 28, PPA were 100% and 91.2% for NPS and saliva, respectively. At lower viral loads, the sensitivity loss of the antigen assay in saliva was striking. At Ct values ≤ 35, the PPA for NPS remained satisfactory (91.5%), whereas the PPA for saliva dropped to 46.6%. In conclusion, saliva cannot be recommended as a reliable alternative to NPS for testing with the Elecsys Anti-SARS-CoV-2 Antigen assay. As saliva is successfully used broadly in combination with RT-PCR testing, it is critical to create awareness that suitability for RT-PCR cannot be translated to implementation in antigen assays without thorough evaluation of each individual test system.

show abstract

“…While immunological tests describe the antibody response to infection, the direct identification of the virus in respiratory or saliva specimens can be carried out by antigenic tests or by amplification of its genome through RT-qPCR or ddPCR. The latter approaches, currently called “molecular tests”, are indicated as the gold standard in defining positive cases when the viral load is low [ 8 , 9 , 10 , 11 , 12 ]. Nevertheless, individual screening of large asymptomatic cohorts by RNA extraction and RT-qPCR can be expensive and wasteful when pathogens are present in the population at low carriage rates.…”

Section: Introductionmentioning

confidence: 99%

Sample-Pooling Strategy for SARS-CoV-2 Detection among Students and Staff of the University of Sannio

et al. 2021

View full text Add to dashboard Cite

Since the beginning of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, it has been clear that testing large groups of the population was the key to stem infection and prevent the effects of the coronavirus disease of 2019, mostly among sensitive patients. On the other hand, time and cost-sustainability of virus detection by molecular analysis such as reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) may be a major issue if testing is extended to large communities, mainly asymptomatic large communities. In this context, sample-pooling and test grouping could offer an effective solution. Here we report the screening on 1195 oral-nasopharyngeal swabs collected from students and staff of the Università degli Studi del Sannio (University of Sannio, Benevento, Campania, Italy) and analyzed by an in-house developed multiplex RT-qPCR for SARS-CoV-2 detection through a simple monodimensional sample pooling strategy. Overall, 400 distinct pools were generated and, within 24 h after swab collection, five positive samples were identified. Out of them, four were confirmed by using a commercially available kit suitable for in vitro diagnostic use (IVD). High accuracy, sensitivity and specificity were also determined by comparing our results with a reference IVD assay for all deconvoluted samples. Overall, we conducted 463 analyses instead of 1195, reducing testing resources by more than 60% without lengthening diagnosis time and without significant losses in sensitivity, suggesting that our strategy was successful in recognizing positive cases in a community of asymptomatic individuals with minor requirements of reagents and time when compared to normal testing procedures.

show abstract

High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children

Cited by 46 publications

References 48 publications

Coronavirus Disease 2019 in Children

Coronavirus Disease 2019 in Children

Reduced Relative Sensitivity of the Elecsys SARS-CoV-2 Antigen Assay in Saliva Compared to Nasopharyngeal Swabs

Sample-Pooling Strategy for SARS-CoV-2 Detection among Students and Staff of the University of Sannio

Contact Info

Product

Resources

About