Increased SARS-CoV-2 Testing Capacity with Pooled Saliva Samples

Watkins, Anne E.; Fenichel, Eli P.; Weinberger, Daniel M; Vogels, Chantal B.F.; Brackney, Doug E.; Casanovas‐Massana, Arnau; Campbell, Melissa; Fournier, John; Bermejo, Santos; Datta, Rupak; Cruz, Charles S. Dela; Farhadian, Shelli; Iwasaki, Akiko; Ko, Albert Icksang; Grubaugh, Nathan D.; Wyllie, Anne L.

doi:10.3201/eid2704.204200

Cited by 34 publications

(43 citation statements)

References 11 publications

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“…In this study we evaluated a sample pooling strategy for mass screening of groups of individuals, using saliva as sampling material instead of NPSs. The rational for this study relied in the fact that sampling of saliva is considered as reliable as, but easier than sampling with NPS, chiefly for some categories of patients/individuals ( Pasomsub et al, 2021 ; Watkins et al, 2021 Takeuchi et al, 2020 ) . Also, pooling of samples is a strategy that decreases costs and times for laboratory analysis, and proved helpful to screen large numbers of asymptomatic people ( Lohse et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of pool sampling of saliva are several for SARS-CoV-2 systematic and repeated monitoring: i) saliva samples can be self-collected by individuals, even by children, without any stimulation and without rinsing the mouth before sample collection, simply placing the bibula strip inside the buccal cavity for a few seconds; ii) bibula strips ensures an adequate adorbption of saliva in a few seconds, preventing the use of invasive swabs and decreasing the sampling times, and guarantees processing of up to 30 salivary samples in few mL of medium; iii) no restriction on timing or food intake are required for saliva collection ( Nagura-Ikeda et al, 2020 ). Recent studies have already evaluated the saliva pooling strategy, replacing the use of the NPS for sampling ( Lohse et al, 2020 ; Pasomsub et al, 2021 ; Watkins et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pooling saliva samples for detection of SARS-CoV-2 proved to be an inexpensive diagnostic procedure suitable for testing a greater number of individuals even at lower prevalence levels. A pooling strategy was developed by SalivaClear Mirimus Clinical to detect/monitor infection in symptomatic and asymptomatic populations ( Pasomsub et al, 2021 ; Watkins et al, 2021 ). When schools will reopen and commercial and corporate business will resume completely, screening for SARS-CoV-2 must be implemented to increase biosecurity.…”

Section: Introductionmentioning

confidence: 99%

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A simple pooling salivary test for SARS-CoV-2 diagnosis: A Columbus’ egg?

et al. 2021

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Saliva is an appropriate specimen for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) diagnosis. The possibility of pooling samples of saliva, using non-invasive bibula strips for sampling, was explored employing Bovine coronavirus (BCoV) spiked saliva. In laboratory, up to 30 saliva-soaked strips were pooled in a single tube with 2mL of medium. After quick adsorption with the medium and vortexing, the liquid was collected and tested with a quantitative molecular assay to quantify viral RNA genome copies. On testing of single and pooled strips, the difference between the median Ct value of test performed on the single positive saliva sample and the median threshold cycles (Ct) value obtained on the pool of 30 strips, was 3.21 cycles. Saliva pooling with bibula strips could allow monitoring of COVID-19 on a large scale, reducing costs for the health bodies in terms of medical material and skilled personnel. Finally, saliva sampling is noninvasive and less traumatic than nasopharyngeal swabs and can be self-collected.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A simple pooling salivary test for SARS-CoV-2 diagnosis: A Columbus’ egg?

et al. 2021

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“…We industrialized the OS process in the form of an "all-in-one" kit simplifying extraction of the biological liquid (figure 4) and presently intend to clinically validate the performance of this sampling method with the pooling technique [54] for mass screening.…”

Section: Discussionmentioning

confidence: 99%

Salivary detection of COVID-19. Clinical performance of oral sponge sampling for SARS-CoV-2 testing

Marquette

Boutros

Benzaquen

et al. 2021

Preprint

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Background: The current standard for coronavirus 2019 disease (COVID-19) diagnosis is reverse transcriptase-polymerase chain reaction (RT-PCR) testing of naso-pharyngeal swabs (NPS), Sampling with NPS is invasive and requires specialized and trained personnel, which limits rapid and repeated screening for the disease. A less invasive and possibly self-administered sampling method may increase the capacity for testing and be more effective in identifying, isolating, and filtering out currently infected persons. Methods: Over a period of three months, we included volunteers presenting with recent symptoms suggestive of a SARS-CoV-2 infection at a free COVID-19 screening center in the city of Nice, France. NPS as well as nasal and oral sponges were collected in parallel and analyzed by RT-PCR for SARS-CoV-2. Results: One hundred and forty-seven subjects were included, of whom, 41.5% were diag-nosed with COVID-19 using NPS RT-PCR. RT-PCR on nasal and oral sponges showed a sensitivity of 87 to 98% and 72 to 87%, respectively for diagnosis of COVID-19 in symptomat-ic subjects, depending on the type of RT-PCR technique used. The specificity was 100% whatever the RT-PCR test. The viral load determined with the oral samples was significantly lower than with NPS. Conclusion: Taken together, these results demonstrated that the oral sponge sampling method can be standardized, is easy to use and cheap. The acceptability makes it a repeata-ble test, notably for elderly people or children. It may become a high-frequency - low analyti-cal sensitive testing strategy.

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“…Workflows for whole-genome SARS-CoV-2 sequencing begin with sample collection, typically from discarded clinical diagnostic specimens. While nasopharyngeal (NP) swabs are still considered as the 'gold standard' for SARS-CoV-2 diagnostic testing, we have shown that saliva is a sensitive 6,7 and stable 8 sample type, which can be reliably self-collected 9 , for the detection of SARS-CoV-2 RNA by RT-qPCR diagnostic assays in the absence of RNA extraction 10 . As saliva is increasingly being used in diagnostic testing programs, we sought to determine if saliva samples can be used to generate high-quality SARS-CoV-2 genomes.…”

Section: Introductionmentioning

confidence: 99%

Sequencing SARS-CoV-2 Genomes from Saliva

Alpert

Vogels

Breban

et al. 2021

Preprint

Self Cite

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Genomic sequencing is crucial to understanding the epidemiology and evolution of SARS-CoV-2. Often, genomic studies rely on remnant diagnostic material, typically nasopharyngeal swabs, as input into whole genome SARS-CoV-2 next-generation sequencing pipelines. Saliva has proven to be a safe and stable specimen for the detection of SARS-CoV-2 RNA via traditional diagnostic assays, however saliva is not commonly used for SARS-CoV-2 sequencing. Using the ARTIC Network amplicon-generation approach with sequencing on the Oxford Nanopore MinION, we demonstrate that sequencing SARS-CoV-2 from saliva produces genomes comparable to those from nasopharyngeal swabs, and that RNA extraction is necessary to generate complete genomes from saliva. In this study, we show that saliva is a useful specimen type for genomic studies of SARS-CoV-2.

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Increased SARS-CoV-2 Testing Capacity with Pooled Saliva Samples

Cited by 34 publications

References 11 publications

A simple pooling salivary test for SARS-CoV-2 diagnosis: A Columbus’ egg?

A simple pooling salivary test for SARS-CoV-2 diagnosis: A Columbus’ egg?

Salivary detection of COVID-19. Clinical performance of oral sponge sampling for SARS-CoV-2 testing

Sequencing SARS-CoV-2 Genomes from Saliva

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