Comparison of SARS-CoV-2 molecular detection in nasopharyngeal swab, saliva, and gargle samples

Genelhoud, Gustavo; Adamóski, Douglas; Spalanzani, Regiane Nogueira; Bochnia-Bueno, Lucas; Oliveira, Jaqueline Carvalho de; Gradia, Daniela Fiori; Bonatto, Ana Cláudia; Wassem, Roseli; Raboni, Sônia Mara; Nogueira, Meri Bordignon; Araujo-Souza, Patricia Savio de

doi:10.1016/j.diagmicrobio.2022.115678

Cited by 13 publications

(16 citation statements)

References 8 publications

(8 reference statements)

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“…When comparing paired nasopharyngeal swabs and saline gargle specimens, we found that both sample types have a comparable diagnostic performance for common respiratory viruses. This is in accordance with the results of a previous study using an transcription-reverse transcription concerted reaction influenza assay [13], while a study comparing saliva samples and gargle samples showed that the first outperformed the latter compared to nasopharyngeal swabs in detecting SARS-CoV-2 RNA [14]. Overall, gargle samples seem to be an alternative to nasopharyngeal swabs, if they are already included in the manufacturer validated materials for an assay.…”

Section: Discussionsupporting

confidence: 90%

Comparison of common respiratory pathogen detection in nasopharyngeal swabs, saline gargle specimens, pleural effusion and lower respiratory tract samples

Anastasiou

2022

Preprint

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Multiplex PCR panels have been used for the diagnosis of viral respiratory infections in the last years. While the types of manufacturer validated and thus officially approved materials are usually limited, the tested materials in the clinical routine or studies often vary, which presents a challenge in light of the new EU-IVDR guideline. Aim of our present study was to evaluate if testing of lower respiratory tract (LRT) or saline gargle specimens (SGS) provided an advantage compared to the testing of nasopharyngeal swabs (NPS) and if the testing of pleural effusions (PE) provided any advantage compared to the testing of LRT samples. We included 367 NPS vs LRT cases, of which 202 (55%) were negative in both samples, 108 (29%) were positive in both samples, 28 (8%) had a positive NPS and a negative LRT and 29 (8%) had a negative NPS but a positive LRT, with no significant differences between immunocompetent and immunosuppressed cases. We included 46 NPS vs SGS cases, of which 18 (39%) were negative in both samples, 18 (39%) were positive in both samples, 4 (9%) had a positive NPS and a negative SGS and 6 (13%) had a negative NPS but a positive SGS. Out of the 82 tested PE samples, only one (1%) was positive for Influenza B RNA (detected in the PE but not LTR), while for 5 positive LTR samples no viral genome could be detected in the PE. The samples were tested with the FTD respiratory viral panel for common respiratory viruses. Testing of a lower respiratory tract sample after a negative upper respiratory tract sample may have an incremental diagnostic value. Gargle and nasopharyngeal swab samples seem to have a comparable diagnostic performance, while pleural effusion is a substandard material for the diagnosis of common respiratory virus infections.

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Section: Discussionsupporting

confidence: 90%

Comparison of common respiratory pathogen detection in nasopharyngeal swabs, saline gargle specimens, pleural effusion and lower respiratory tract samples

Anastasiou

2022

Preprint

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“…Of important note, the volume of saliva required for this study was greater than that which would be necessary in practice (0.5 – 1 ml), and reducing the volume required may further increase the acceptability of saliva testing. In addition, the large volumes of saline used in this study are likely unnecessary with most other groups using only 2.5 – 5mls [24] , [25] , [26] .…”

Section: Discussionmentioning

confidence: 99%

“…There is limited available literature comparing the validity and acceptability of both saliva and gargle specimens with NTS. Genelhoud et al [26] found saliva had a superior sensitivity, specificity, and accuracy than gargle with saliva performing similarly to nasopharyngeal samples. Conversely, Goldfarb et al [20] found that gargle was significantly more sensitive than saliva when compared to healthcare worker collected NP swabs.…”

Section: Discussionmentioning

confidence: 99%

“…Pharyngeal gargle specimens have also been shown to be a useful sample type for detection of respiratory viruses including coronaviruses [ 7 , [18] , [19] , [20] ] and have shown comparability with NTS in the detection of SARS-CoV-2, although the available literature is more limited [21] , [22] , [23] , [24] , [25] , [26] .…”

Section: Introductionmentioning

confidence: 99%

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

McLennan

Barton

Lang

et al. 2022

Diagnostic Microbiology and Infectious Disease

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“…Turn-around times on test results could be as long as five days leading to patient loss-to-follow-up, increased opportunity for viral spread, and the unnecessary quarantine of uninfected people. In addition, the available tests required nasopharyngeal swab (NPS) samples that increase medical professionals' exposure to potentially contagious patients, caused patient discomfort, and contributed to inadequate sampling leading to inconsistent results [2][3][4]. For certain patient groups, such as pediatric patients and patients with mental disabilities, collection of NPS samples can be difficult or unattainable [3].…”

Section: Introductionmentioning

confidence: 99%

Usability and performance of the MicroGEM Sal6830™, an RT-PCR saliva-based point-of-care platform to detect SARS-CoV-2 in primary healthcare settings with non-laboratory trained operators

Mills

Tyson

Helton

et al. 2023

Preprint

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The beginning of the COVID-19 pandemic demonstrated how few point-of-care diagnostic tools were available that could be safely and easily operated by healthcare workers with no laboratory training. The gold-standard test, and initially the only test, used RT-PCR with nasal pharyngeal swabs (NPS). Two issues quickly emerged: 1) RT-PCR required central laboratory processing leading to significant time delays and 2) NPS collection causes discomfort, is inappropriate for ongoing repeat sampling of individuals (e.g., frontline healthcare workers) and poses difficulty when obtaining samples from some sections of the population (e.g. some elderly and young children). The Sal6830 platform is a fully self-contained, RT-PCR point-of-care device for detecting SARS-CoV-2 from saliva that takes less than thirty minutes to complete. In this study we tested the usability of the Sal6830 platform by healthcare workers unfamiliar with the instrument at two community clinics: Care 4 U Community Health Center (Miami, Florida, USA) and St. Marys Health Wagon (Wise, Virginia, USA). Staff participated in three tests: 1) determining SARS-CoV-2 status from blinded positive and negative saliva samples, 2) a clinical study comparing SARS-CoV-2 detection with a comparator point-of-care technology from the same patient and 3) completing a survey designed to measure comfort and confidence using the Sal6830 point-of-care device having received no training. Participants overwhelming found the Sal6830 platform easy and intuitive to use, successfully called SARS-CoV-2 status of contrived, blinded samples and measured a 93.3% overall percent agreement when comparing patient samples across two point-of-care technologies.

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Comparison of SARS-CoV-2 molecular detection in nasopharyngeal swab, saliva, and gargle samples

Cited by 13 publications

References 8 publications

Comparison of common respiratory pathogen detection in nasopharyngeal swabs, saline gargle specimens, pleural effusion and lower respiratory tract samples

Comparison of common respiratory pathogen detection in nasopharyngeal swabs, saline gargle specimens, pleural effusion and lower respiratory tract samples

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

Usability and performance of the MicroGEM Sal6830™, an RT-PCR saliva-based point-of-care platform to detect SARS-CoV-2 in primary healthcare settings with non-laboratory trained operators

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