User acceptability of saliva and gargle samples for identifying COVID-19 positive high-risk workers and household contacts

Comparison of Nasal Swabs, Nasopharyngeal Swabs, and Saliva Samples for the Detection of SARS-CoV-2 and other Respiratory Virus Infections

“…The strength of our study is that we compared viral concentrations in paired samples comprising two nasal swabs (particularly, using different number of rubs), two NPSs, and two saliva samples. Numerous studies have compared two sample types [ 11 – 14 , 20 , 21 ]; however, few studies have compared three or more sample types [ 9 , 10 , 22 ]. In particular, it is difficult to find studies comparing sample types for respiratory viruses and SARS-CoV-2.…”

“…RATs of saliva and nasal swabs tended to have lower diagnostic accuracy than NPS-based PCR. However, some studies have shown that nasal swabs and saliva samples showed equally effective diagnostic performance as NPS samples for SARS-CoV-2 infection detection [3][4][5][6][7][8][9][10][11][12][13]. These different sensitivities of nasal swabs and saliva samples compared with that of NPSs may arise from differences among subjects, study periods, sampling and detection methods, and SARS-CoV-2 variants.…”

Clinical Performance of Self-Collected Purified Water Gargle for Detection of Influenza a Virus Infection by Real-Time RT-PCR

“…This was also the reason why NPS&OPS was chosen as the comparison specimen in this study. However, in contrast to the standardized sampling process of NPS or OPS, the methods of PWG collection were varied, such as gargling 3 times with 3 mL of normal saline, 14 5 mL of normal saline gargling for 20s 15 or 30s, 17 , 18 10 mL of normal saline for 20s, 10 20 mL of injection water for 5s, 19 5 mL of natural spring water for 20s, 13 5–7 mL of tap water for 30s, 12 10 mL of tap water for 15s, 16 1/4 of a glass water for 5 to 20s. 5 Some studies asked patients to swish for few seconds followed by tilting their heads back and gargling for few seconds and repeated swish/gargle cycle.…”

“…However, saliva still has shortcomings in practical applications; for instance, some patients who experience dry mouth cannot spit out a sufficient volume of saliva and the obtained saliva with different viscosities needs to be liquefied and centrifuged during pretreatment, which is both time consuming and increases the detection difficulty for home detection and automatic equipment detection. 10–15 In view of this, we speculated that gargle may be a potential alternative that is easier to obtain from individuals having difficulty in providing saliva and more favorable for laboratory handling. Gargle samples appear more attractive because they are non-viscous in nature, minimizing cross-contamination during resuspension and transfer, which poses the risk of false-positive results and reduces the chance of clogging liquid-handling systems that would result in testing failure.…”

“…Gargle samples appear more attractive because they are non-viscous in nature, minimizing cross-contamination during resuspension and transfer, which poses the risk of false-positive results and reduces the chance of clogging liquid-handling systems that would result in testing failure. According to previous studies, gargles have been used to detect respiratory viruses, especially SARS-CoV-2, 5 , 10–18 while their application in other respiratory virus testing is more limited. 19 , 20 In this study, we performed a prospective head-to-head comparison of the clinical performance of self-collected gargle specimens in detecting influenza A Virus (IAVs) by real-time reverse transcription PCR (rRT-PCR) during the influenza season.…”