Diagnostic accuracy of SARS-CoV-2 saliva antigen testing in a real-life clinical setting

Jegerlehner, Sabrina; Suter‐Riniker, Franziska; Jent, Philipp; Bittel, Pascal; Nagler, Michael

doi:10.1016/j.ijid.2022.03.037

Cited by 8 publications

(7 citation statements)

References 11 publications

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“…Nasal swab samples are widely used for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) rapid antigen tests (RATs), and several studies have compared the sensitivity of tests using nasal swab and saliva samples with that of tests using NPSs [3][4][5][6][7][8][9]. RATs of saliva and nasal swabs tended to have lower diagnostic accuracy than NPS-based PCR.…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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Background: Nasal swabs and saliva samples are being considered alternatives to nasopharyngeal swabs (NPSs) for detecting severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2); however, few studies have compared the usefulness of nasal swabs, NPSs, and saliva samples for detecting SARS-CoV-2 and other respiratory virus infections. We compared the positivity rates and concentrations of viruses detected in nasal swabs, NPSs, and saliva samples using cycle threshold (Ct) values from real-time PCR tests for respiratory viruses.Methods: In total, 236 samples (48 five-rub and 10 10-rub nasal swabs, 96 NPSs collected using two different products, 48 saliva swabs, and 34 undiluted saliva samples) from 48 patients (34 patients with SARS-CoV-2 and 14 with other respiratory virus infections) and 40 samples from eight healthy controls were obtained. The PCR positivity and Ct values were compared using Allplex Respiratory Panels 1/2/3 and Allplex SARS-CoV-2 real-time PCR.Results: NPSs showed the lowest Ct values (indicating the highest virus concentrations); however, nasal and saliva samples yielded positive results for SARS-CoV-2 and other respiratory viruses. The median Ct value for SARS-CoV-2 E gene PCR using nasal swab samples collected with 10 rubs was significantly different from that obtained using nasal swabs collected with five rubs (Ct = 24.3 vs. 28.9; P = 0.002), but not from that obtained using NPSs.Conclusions: Our results confirm that the NPS is the best sample type for detecting respiratory viruses, but nasal swabs and saliva samples can be alternatives to NPSs. Vigorously and sufficiently rubbed nasal swabs can provide SARS-CoV-2 concentrations similar to those obtained with NPSs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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“…However, RNAseP was detected in all but one (nasopharyngeal) sample (data not shown), and thus cannot explain the differences between the nasopharyngeal samples and the ORAcollect TM samples [19]. Another explanation could be that the time interval between sampling and last food or drink intake was not respected, despite the instructions, as was the case for two false negative patients in the study of Jegerlehner et al [20].…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Saliva as a Matrix for RT-PCR Analysis and Two Rapid Antigen Tests for the Detection of SARS-CoV-2

Meyer

Goris

Mortelé

et al. 2022

Viruses

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The use of saliva for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sparks debate due to presumed lower sensitivity and lack of standardization. Our aim was to evaluate the performance characteristics of (i) saliva collected by the ORAcollectTM device as a matrix for SARS-CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR), and (ii) 2 saliva rapid antigen tests (AgRDT). From 342 ambulatory individuals, both a nasopharyngeal swab and saliva sample via ORAcollectTM were obtained for a SARS-CoV-2 RT-PCR test. Furthermore, 54 and 123 additionally performed the V-ChekTM or WhistlingTM saliva AgRDT. In total, 35% of individuals screened positive for SARS-CoV-2 via nasopharyngeal swab. Saliva, as a matrix for the RT-PCR, had a specificity of 96.5% and a negative predictive value (NPV) of 91.3%. Interestingly, 6 out of 8 patients thought to be false positive in saliva re-tested positive by nasopharyngeal sampling after 2 to 9 days. Both V-ChekTM and WhistlingTM AgRDT had a lack of sensitivity, resulting in an NPV of 66.9 and 67.3%, respectively. Saliva proved to be a sensitive and specific matrix for SARS-CoV-2 detection by the RT-PCR. In this setting, saliva might have an earlier window of detection than the nasopharyngeal swab. By contrast, both AgRDT showed an unacceptably low sensitivity and NPV.

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“…The current diagnostic tests for SARS-CoV-2 infection are based on molecular detection of viral RNA via (polymerase chain reaction) PCR analysis, and rapid-antigen tests that detect viral protein. In general, PCR tests are more accurate, but the technique is slower than detection of viral antigen, and PCR can detect nucleic acids when the individuals are no longer infectious ( 83 – 89 ). However, newer molecular tests based on CRISPR nucleases can measure viral nucleic acids faster than traditional PCR tests ( 90 ).…”

Section: Salivary Diagnostics For Covid-19mentioning

confidence: 99%

Infection of the oral cavity with SARS-CoV-2 variants: Scope of salivary diagnostics

Iyer

Chino²,

Ojcius³

2022

Front. Oral. Health

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Coronaviruses, including SARS-CoV-2, have caused pandemics in the past two decades. The most prevalent SARS-CoV-2 variants of concern can re-infect individuals who have been previously infected with other variants or had protection from vaccines targeting the original SARS-CoV-2 variant. Given the high risk of transmission of coronavirus via aerosols produced during dental procedures, it is important to understand the future risk of coronavirus infection for oral health professionals and to diagnose quickly early stages of outbreaks. Testing of saliva for coronavirus may be the least invasive and most convenient method for following the outbreak at the individual and community level. This review will describe strategies for diagnosis of coronavirus in saliva.

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Diagnostic accuracy of SARS-CoV-2 saliva antigen testing in a real-life clinical setting

Cited by 8 publications

References 11 publications

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

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

Evaluation of Saliva as a Matrix for RT-PCR Analysis and Two Rapid Antigen Tests for the Detection of SARS-CoV-2

Infection of the oral cavity with SARS-CoV-2 variants: Scope of salivary diagnostics

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