SARS-CoV-2 and Saliva as a Diagnostic Tool: A Real Possibility

Muniz, Ísis de Araújo Ferreira; Linden, Lília Van der; Santos, Mariana Evangelista; Rodrigues, Raíres Chaves da Silva; Souza, Joelma Rodrigues de; Oliveira, Renato Antônio dos Santos; Castellano, Lúcio Roberto Cançado; Bonan, Paulo Rogério Ferreti

doi:10.1590/pboci.2020.126

Cited by 10 publications

(11 citation statements)

References 20 publications

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“…(13) Herein we tested gingival fluid as a specimen for SARS-CoV-2 detection by RT-qPCR, and we found a poor concordance rate (15.38%) among RT-qPCR positive samples from NP swabs. Although our data is in agreement with previous data, our concordance rate among positive results was lower than the those reported by Ku et al (14) and Kam et al (12) . This variation may be due to the study designs that differed regarding the moment of sample collection in relation to NP swab collection, the number of sample collection time points (single or multiple days), and the way (selfor healthcare professional-performed collection) samples were collected.…”

Section: Discussionsupporting

confidence: 85%

“…As for saliva, it has already been shown to be a possible reliable specimen for SARS-CoV-2 detection and this sample type has been previously used for the detection of other respiratory viruses, including SARS-CoV. (14) The main argument behind the use of saliva as a specimen for SARS-CoV-2 detection, apart from the comfort of the patient during sample collection, was biosafety. Therefore, in order to simulate a self-collecting sampling in our cohort, we did not assist every individual collection, although every subject was advised on how to perform the collection.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 diagnosis by RT-qPCR in alternative specimens

Gonçalves

Barroso

Herlinger

et al. 2021

Mem. Inst. Oswaldo Cruz

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BACKGROUNDThe high demand for adequate material for the gold standard reverse transcription real-time polymerase chain reaction (RT-qPCR)-based diagnosis imposed by the Coronavirus disease 2019 (COVID-19) pandemic, combined with the inherent contamination risks for healthcare workers during nasopharyngeal swab (NP) sample collection and the discomfort it causes patients, brought the need to identify alternative specimens suitable for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).OBJECTIVES The aim of this work was to compare saliva and gingival fluid swabs to NP swabs as specimens for RT-qPCR-based SARS-CoV-2 diagnosis.METHODS We compared gingival fluid swabs (n = 158) and saliva (n = 207) to the rayon-tipped NP swabs obtained from mildsymptomatic and asymptomatic subjects as specimens for RT-qPCR for SARS-CoV-2 detection.FINDINGS When compared to NP swabs, gingival fluid swabs had a concordance rate of 15.4% among positive samples, zero among inconclusive, and 100% among negative ones. For saliva samples, the concordance rate was 67.6% among positive samples, 42.9% among inconclusive, and 96.8% among negative ones. However, the concordance rate between saliva and NP swabs was higher (96.9%) within samples with lower cycle threshold (Ct) values (Ct > 10 ≤ 25).MAIN CONCLUSIONS Our data suggests that whereas gingival fluid swabs are not substitutes for NP swabs, saliva might be considered whenever NP swabs are not available or recommended.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

COVID-19 diagnosis by RT-qPCR in alternative specimens

Gonçalves

Barroso

Herlinger

et al. 2021

Mem. Inst. Oswaldo Cruz

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“…The current diagnostic standard involves detection of SARS‐CoV‐2 by reverse‐transcription polymerase chain reaction (RT‐PCR) using nasopharyngeal swabs (NPS). However, NPS are associated with patient's discomfort or complications—such as iatrogenic cerebrospinal fluid leak—as well as an increasing healthcare worker's exposure to SARS‐CoV‐2 1,2 …”

Section: Introductionmentioning

confidence: 99%

“…However, NPS are associated with patient's discomfort or complications-such as iatrogenic cerebrospinal fluid leak-as well as an increasing healthcare worker's exposure to SARS-CoV-2. 1,2 Saliva is an attractive and noninvasive option for diagnosing SARS-CoV-2 and sampling enables self-collection without causing discomfort or pain. In addition, self-collection of saliva can reduce the exposure to healthcare personnel by avoiding cough, sneezing, and/or aerosolization during sampling.…”

Section: Introductionmentioning

confidence: 99%

Self‐collected saliva for SARS‐CoV‐2 detection: A prospective study in the emergency room

Echavarría

Reyes

Rodríguez

et al. 2021

Journal of Medical Virology

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Current diagnostic standards involve severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection in nasopharyngeal swabs (NPS), but saliva is an attractive and noninvasive option for diagnosis. The objectives were to determine the performance of saliva in comparison with NPS for detecting SARS-CoV-2 and to compare the optimized home brew reverse-transcription polymerase chain reaction (RT-PCR) with a commercial RT-PCR. Paired NPS and saliva specimens were prospectively collected and tested by RT-PCR from patients presenting at an emergency room with signs and symptoms compatible with coronavirus disease-2019. A total of 348 samples from 174 patients were tested by RT-PCR assays. Among 174 patients with symptoms, 63 (36%) were SARS-CoV-2 positive in NPS using the optimized home-brew PCR. Of these 63 patients, 61 (98%) were also positive in saliva. An additional positive SARS-CoV-2 saliva was detected in a patient with pneumonia. Kappa Cohen's coefficient agreement between NPS and saliva was 0.96 (95% confidence interval [CI], 0.90-0.99). Median Ct values in NPS versus saliva

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“…Some collection sites provide different features. For instance, saliva samples have been reported as a low cost-effective and noninvasive alternative, since it has been used to detect other respiratory viruses [ 31 ]. The collection made by swabs taken from the throat immediately upon symptom onset is 6.4% less effective than nasal swabs to yield positive results in nasal swabs [ 4 ].…”

Section: Influencing Factors On Sars-cov-2 Detectionmentioning

confidence: 99%

True or false: what are the factors that influence COVID-19 diagnosis by RT-qPCR?

Lima

Mesquita

Oliveira

et al. 2022

Expert Review of Molecular Diagnostics

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Introduction The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease has had a catastrophic impact on the world resulting in several deaths. Since World Health Organization declared the pandemic status of the disease, several molecular diagnostic kits have been developed to help the tracking of viruses spread. Areas Covered This review aims to describe and evaluate the currently reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) diagnosis kit. Several processes used in COVID-19 diagnostic procedures are detailed in further depth to demonstrate optimal practices. Therefore, we debate the main factors that influence the viral detection of SARS-COV-2 and how they can affect the diagnosis of patients. Expert Opinion Here is highlighted and discussed several factors that can interfere in the RT-PCR analysis, such as the viral load of the sample, collection site, collection methodology, sample storage, transport, primer, and probe mismatch/dimerization in different brand kits. This is a pioneer study to discuss the factor that could lead to the wrong interpretation of RT-qPCR diagnosis of SARS-CoV-2. This study aimed to help the readers to understand what very likely is behind a bad result of SARS-CoV-2 detection by RT-PCR and what could be done to reach a reliable diagnosis.

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SARS-CoV-2 and Saliva as a Diagnostic Tool: A Real Possibility

Cited by 10 publications

References 20 publications

COVID-19 diagnosis by RT-qPCR in alternative specimens

COVID-19 diagnosis by RT-qPCR in alternative specimens

Self‐collected saliva for SARS‐CoV‐2 detection: A prospective study in the emergency room

True or false: what are the factors that influence COVID-19 diagnosis by RT-qPCR?

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