Performance of saliva compared with nasopharyngeal swab for diagnosis of COVID-19 by NAAT in cross-sectional studies: Systematic review and meta-analysis

Duncan, D Brody; Mackett, Katharine; Ali, Muhammad Usman; Yamamura, Deborah; Balion, Cynthia

doi:10.1016/j.clinbiochem.2022.08.004

Cited by 10 publications

(8 citation statements)

References 90 publications

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“…Most of these studies however were based on a small number of participants and only a few large cohort studies have been conducted. While meta-analyses have attempted to pool evidence across individual studies and indicate a sensitivity of around 85% and a speci city of 99% for saliva with NP swabs as reference [12,17], the large heterogeneity between individual studies makes a comparison of saliva sampling methods or the analysis of potential confounding factors challenging. Our large prospective cohort study addressed this limitation and enabled a detailed statistical analysis of the performance of saliva-based qPCR testing for SARS-Cov-2 qPCR.…”

Section: Discussionmentioning

confidence: 99%

“…Saliva has been suggested as an alternative to NP/MT/OP swabs to obtain specimens for SARS-Cov-2 qPCR testing and various studies have compared their diagnostic performance [6,8,13,[15][16][17]. Most of these studies however were based on a small number of participants and only a few large cohort studies have been conducted.…”

Section: Discussionmentioning

confidence: 99%

“…However, the direct comparison between studies remained challenging because of great heterogeneity in terms of saliva collection. Saliva collection methodologies have included spit/drool saliva collection, direct saliva sampling and saliva-based swabbing, expectorated saliva and gargling saline [8,17]. Saliva samples may contain whole saliva, sputum and gingival crevicular uid [18].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the performance of SARS-CoV-2 RNA qRT-PCR testing based on expectorated and drooled saliva samples

Kay

Futschik²,

Turek

et al. 2023

Preprint

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Purpose Saliva has been considered a suitable sample material for SARS-CoV-2 testing but uncertainty remained regarding the sensitivity and reliability of different saliva collection methods for community mass testing. This study aimed to investigate the potential utility of expectorated saliva (ES) and drooled saliva (DS) through a large cohort study. Methods ES and DS samples were collected in a two-stage non-randomized prospective cohort study. Their utility for SARS-CoV-2 RNA qRT-PCR testing was assessed by comparison with results for combined throat and nose (CTN) swabs. A total of 2,878 subjects were recruited, from which 2,747 were evaluable for statistical analyses. Results Using CTN swab-based results as reference,DS- and ES-based tests showed the same high level of concordance (98% vs 98%) or specificity (99% vs 99%). Sensitivity seemed to be higher for DS than for ES (93% vs 80%) but not significantly once viral concentration was taken into account. Multivariable analysis indicated however an inferior sensitivity of saliva-based testing for female compared to male subjects with low viral burden. Assuming no false positive qRT-PCR results, an unbiased comparison showed no significant difference in sensitivity between saliva- and swab-based testing. Conclusion SARS-CoV-2 RNA testing based on saliva showed high diagnostic accuracy and can be considered an alternative where swabbing may not be tolerated or operationally feasible. Drooled saliva yielded the same diagnostic performance compared to expectorated saliva and may present a preferred option with reduced aerosol risk and increased compliance. Observed sex-specific difference in detection performance however warrant further investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the performance of SARS-CoV-2 RNA qRT-PCR testing based on expectorated and drooled saliva samples

Kay

Futschik²,

Turek

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…For NAATs, the most common of which use polymerase chain reaction (PCR) technology, a variety of sample sources have been evaluated including nasopharyngeal swabs (NP), oropharyngeal swabs (OP), and saliva samples. Pre-omicron meta-analyses showed either equivalence in saliva and NP testing 9 , or slightly increased sensitivity of NP testing compared with saliva 10–12 . However, some studies involving early omicron strains showed better sensitivity with saliva swabs compared to mid-turbinate swabs 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Comparative performance of COVID-19 Test Methods in Healthcare Workers during the Omicron Wave

Tornberg,

Tomlinson,

Oshiro

et al. 2023

Preprint

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IntroductionThe COVID-19 pandemic presents unique requirements for accessible, reliable testing, and many testing platforms and sampling techniques have been developed. However, not all test methods have been systematically compared to each other or a common gold standard, and the performance of tests developed in the early epidemic have not been consistently re-evaluated in the context of newly emerging SARS-CoV-2 variants.MethodsWe conducted a repeated measures study with adult healthcare workers presenting for SARS-CoV-2 testing. Participants were tested using seven test modalities: PCR with samples from the nasopharynx, oropharynx, and saliva; and BinaxNOW and iHealth antigen–based rapid detection tests (AgRDT) sampling the oropharynx and the nares. Test sensitivity was compared using any positive PCR test as the gold standard.Results325 individuals participated in the study. PCR tests were the most sensitive with saliva PCR at 0.957 ± 0.048, nasopharyngeal PCR at 0.877 ± 0.075, and oropharyngeal PCR at 0.849 ± 0.082. Standard nasal rapid antigen tests were less sensitive but roughly equivalent at 0.613 ± 0.110 for BinaxNOW brand and 0.627 ± 0.109 for iHealth. Oropharyngeal rapid antigen tests were the least sensitive with BinaxNOW and iHealth brands at 0.400 ± 0.111 and 0.311 ± 0.105 respectively.ConclusionPCR remains the most sensitive testing modality for COVID-19, with saliva PCR being significantly more sensitive than oropharyngeal PCR and equivalent to nasopharyngeal PCR. Saliva testing has patient comfort and financial benefits, making it a preferred testing modality. Nasal AgRDTs are less sensitive than PCR though more accessible and convenient.

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“…The fast-spreading virus SARS-CoV-2 virus is the main culprit of this phenomenon, and detection of the virus in human populations is crucial for curbing the pandemic [ 2 ]. Traditional detection approaches include the nucleic acid amplification test (NAAT) [ 3 ] and antigen detection [ 4 ] techniques. Currently, the mainstream is quantitative polymerase chain reaction (qPCR) [ 5 ], which is a kind of NAAT that has high sensitivity and specificity, but requires a clean environment, bulky and expensive equipment, and trained personnel.…”

Section: Introductionmentioning

confidence: 99%

Machine Learning Techniques for Effective Pathogen Detection Based on Resonant Biosensors

Rong,

Xu,

Sawan

2023

Biosensors

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We describe a machine learning (ML) approach to processing the signals collected from a COVID-19 optical-based detector. Multilayer perceptron (MLP) and support vector machine (SVM) were used to process both the raw data and the feature engineering data, and high performance for the qualitative detection of the SARS-CoV-2 virus with concentration down to 1 TCID50/mL was achieved. Valid detection experiments contained 486 negative and 108 positive samples, and control experiments, in which biosensors without antibody functionalization were used to detect SARS-CoV-2, contained 36 negative samples and 732 positive samples. The data distribution patterns of the valid and control detection dataset, based on T-distributed stochastic neighbor embedding (t-SNE), were used to study the distinguishability between positive and negative samples and explain the ML prediction performance. This work demonstrates that ML can be a generalized effective approach to process the signals and the datasets of biosensors dependent on resonant modes as biosensing mechanism.

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Performance of saliva compared with nasopharyngeal swab for diagnosis of COVID-19 by NAAT in cross-sectional studies: Systematic review and meta-analysis

Cited by 10 publications

References 90 publications

Comparison of the performance of SARS-CoV-2 RNA qRT-PCR testing based on expectorated and drooled saliva samples

Comparison of the performance of SARS-CoV-2 RNA qRT-PCR testing based on expectorated and drooled saliva samples

Comparative performance of COVID-19 Test Methods in Healthcare Workers during the Omicron Wave

Machine Learning Techniques for Effective Pathogen Detection Based on Resonant Biosensors

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