Feasibility and Diagnostic Accuracy of Saliva-Based SARS-CoV-2 Screening in Educational Settings and Children Aged &lt;12 Years

Hoch, Michael; Vogel, Sebastian; Eberle, Ute; Kolberg, Laura; Gruenthaler, Valerie; Fingerle, Volker; Ackermann, Nikolaus; Sing, Andreas; Liebl, Bernhard; Hüebner, Johannes; S, Kuttiadan; Rack-Hoch, Anita; Meyer-Buehn, Melanie; Schober, Tilmann; Both, Ulrich von

doi:10.3390/diagnostics11101797

Cited by 4 publications

(5 citation statements)

References 35 publications

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“…Accordingly, saliva has been shown to be a well-established diagnostic specimen for detecting SARS-CoV-2 RNA [ 18 , 19 , 20 , 21 , 22 ], a child-friendly sampling alternative to swab-based methods [ 23 , 24 ] and one potentially suitable for the mass screening of children [ 25 ]. The findings in our evaluation of the Salivette ® system confirmed that assessment [ 17 ].…”

Section: Introductionsupporting

confidence: 84%

“…The study has some limitations: First, we cannot rule out false-negative results. Based on our experience from previous investigations (the sensitivity of the Salivette ® method in relation to oropharyngeal swabs was 94.9%), we consider this effect to be low [ 17 , 22 ]. Second, voluntary study participation may be associated with a selection bias, potentially over-representing participants with better adherence to infection control measures when in private or family settings.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, this first feasibility study included a rather small sample size. To allow for larger sample sizes without additional medical staff, in an accompanying sub-study, we evaluated the Salivette ® saliva collection system for children aged 3 to 11 [ 17 ]. Accordingly, saliva has been shown to be a well-established diagnostic specimen for detecting SARS-CoV-2 RNA [ 18 , 19 , 20 , 21 , 22 ], a child-friendly sampling alternative to swab-based methods [ 23 , 24 ] and one potentially suitable for the mass screening of children [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 Saliva Mass Screening in Primary Schools: A 10-Week Sentinel Surveillance Study in Munich, Germany

Vogel¹,

Both

Nowak

et al. 2022

Diagnostics

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Representative, actively collected surveillance data on asymptomatic SARS-CoV-2 infections in primary schoolchildren remain scarce. We evaluated the feasibility of a saliva mass screening concept and assessed infectious activity in primary schools. During a 10-week period from 3 March to 21 May 2021, schoolchildren and staff from 17 primary schools in Munich participated in the sentinel surveillance, cohort study. Participants were tested using the Salivette® system, testing was supervised by trained school staff, and samples were processed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). We included 4433 participants: 3752 children (median age, 8 [range, 6–13] years; 1926 girls [51%]) and 681 staff members (median age, 41 [range, 14–71] years; 592 women [87%]). In total, 23,905 samples were processed (4640 from staff), with participants representing 8.3% of all primary schoolchildren in Munich. Only eight cases were detected: Five out of 3752 participating children (0.13%) and three out of 681 staff members (0.44%). There were no secondary cases. In conclusion, supervised Salivette® self-sampling was feasible, reliable, and safe and thus constituted an ideal method for SARS-CoV-2 mass screenings in primary schoolchildren. Our findings suggest that infectious activity among asymptomatic primary schoolchildren and staff was low. Primary schools appear to continue to play a minor role in the spread of SARS-CoV-2 despite high community incidence rates.

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Section: Introductionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 Saliva Mass Screening in Primary Schools: A 10-Week Sentinel Surveillance Study in Munich, Germany

Vogel¹,

Both

Nowak

et al. 2022

Diagnostics

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“…There are few investigations that examined the suitability of chewed cotton pads, possibly due to an inconvenient workflow in the laboratory. One study demonstrated a significant agreement between nasopharyngeal swabs and saliva collected in a cotton pad device [16], and in other studies, rolled cotton achieved higher performance in the molecular diagnosis of an infection with SARS-CoV-2 [24][25][26][27]. Using a cotton pad to collect saliva was inferior to the collection of native saliva in a sterile container in our study.…”

Section: Discussionsupporting

confidence: 39%

Self-Collected Samples to Detect SARS-CoV-2: Direct Comparison of Saliva, Tongue Swab, Nasal Swab, Chewed Cotton Pads and Gargle Lavage

Kohmer

Eckermann

Böddinghaus³

et al. 2021

JCM

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Testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by RT-PCR is a vital public health tool in the pandemic. Self-collected samples are increasingly used as an alternative to nasopharyngeal swabs. Several studies suggested that they are sufficiently sensitive to be a useful alternative. However, there are limited data directly comparing several different types of self-collected materials to determine which material is preferable. A total of 102 predominantly symptomatic adults with a confirmed SARS-CoV-2 infection self-collected native saliva, a tongue swab, a mid-turbinate nasal swab, saliva obtained by chewing a cotton pad and gargle lavage, within 48 h of initial diagnosis. Sample collection was unsupervised. Both native saliva and gargling with tap water had high diagnostic sensitivity of 92.8% and 89.1%, respectively. Nasal swabs had a sensitivity of 85.1%, which was not significantly inferior to saliva (p = 0.092), but 16.6% of participants reported they had difficult in self-collection of this sample. A tongue swab and saliva obtained by chewing a cotton pad had a significantly lower sensitivity of 74.2% and 70.2%, respectively. Diagnostic sensitivity was not related to the presence of clinical symptoms or to age. When comparing self-collected specimens from different material, saliva, gargle lavage or mid-turbinate nasal swabs may be considered for most symptomatic patients. However, complementary experiments are required to verify that differences in performance observed among the five sampling modes were not attributed to collection impairment.

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“…In addition, this study could help saliva garner attention as a potential alternative specimen for diagnosing respiratory infections, despite the previously reported inconsistent diagnostic accuracy of saliva-based SARS-CoV-2 being dependent on the studied population or clinical settings. 3,4,14,15 Moreover, saliva collection is a noninvasive, easy, specimen acquirement method that requires no specific preparation, transportation, or storage.…”

Section: Discussionmentioning

confidence: 99%

Saliva‐based Proteinase K method: A rapid and reliable diagnostic tool for the detection of SARS‐COV‐2 in children

Kim,

Park,

Hwang

et al. 2024

Journal of Medical Virology

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Early and accurate detection of viruses in children might help prevent transmission and severe diseases. In this study, the severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) detection in children was evaluated using saliva specimens with a Proteinase K (PTK)‐based RNA preparation, as saliva collection is a simple and noninvasive procedure, even in young children, with fewer concerns about sample contamination. The saliva‐based PTK and the conventional paired nasopharyngeal aspiration (NPA)‐based detection methods were compared between COVID‐19‐positive and ‐negative children. In addition, the detection rate for SARS‐COV‐2 and the difference between admission and discharge by the saliva‐based PTK method was tested in COVID‐19 patients. The diagnostic accuracy of the saliva‐based PTK method was 98.8% compared to NP swab‐based reverse transcriptase polymerase chain reaction. Saliva samples showed high sensitivity (94.1%) and specificity (100%) when using the PTK method. Furthermore, the saliva‐based PTK method significantly reduced the test processing time by 2 h. Notably, Ct values at discharge increased in saliva samples compared with those at admission, which might indicate patients' clinical conditions or virus activity. In conclusion, the saliva‐based PTK implemented in this study streamlines RNA extraction, making the process faster, safer, and more cost‐effective, demonstrating that this method is a rapid and reliable diagnostic tool for SARS‐CoV‐2 detection in children.

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Feasibility and Diagnostic Accuracy of Saliva-Based SARS-CoV-2 Screening in Educational Settings and Children Aged <12 Years

Cited by 4 publications

References 35 publications

SARS-CoV-2 Saliva Mass Screening in Primary Schools: A 10-Week Sentinel Surveillance Study in Munich, Germany

SARS-CoV-2 Saliva Mass Screening in Primary Schools: A 10-Week Sentinel Surveillance Study in Munich, Germany

Self-Collected Samples to Detect SARS-CoV-2: Direct Comparison of Saliva, Tongue Swab, Nasal Swab, Chewed Cotton Pads and Gargle Lavage

Saliva‐based Proteinase K method: A rapid and reliable diagnostic tool for the detection of SARS‐COV‐2 in children

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