Saliva samples for detection of SARS‐CoV‐2 in mildly symptomatic and asymptomatic patients

Tütüncü, Emin Ediz; Özgür, Didem; Karameşe, Murat

doi:10.1002/jmv.26821

Cited by 37 publications

(33 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Equivalent SARS-CoV-2 Ct values were obtained from NP, AN, and saliva specimens when results from all 63 sets were analyzed. Comparable SARS-CoV-2 Ct values from NP and saliva specimens have also been found in other studies (27,29,(34)(35)(36)(37). Further, no difference was found when SARS-CoV-2 Ct values were compared between specimens collected from symptomatic and asymptomatic patients, consistent with other findings based on Ct values (38) and viral load (39).…”

Section: Discussionsupporting

confidence: 89%

Viral load and infectivity of SARS-CoV-2 in paired respiratory and oral specimens from symptomatic, asymptomatic or post-symptomatic individuals

Tallmadge

Laverack

Cronk

et al. 2021

Preprint

View full text Add to dashboard Cite

In the present study, we assessed the diagnostic sensitivity and determined the viral load and infectivity of SARS-CoV-2 in paired respiratory (nasopharyngeal and anterior nares) and oral samples (saliva and sublingual swab). Samples were collected from 77 individuals of which 75 were diagnosed with COVID-19 and classified as symptomatic (n=29), asymptomatic (n=31), or post-symptomatic (n=15). Specimens were collected at one time point from each individual, between day 1 to 23 after the initial COVID-19 diagnosis, and included self-collected saliva (S), or sublingual (SL) swab, and bilateral anterior nares (AN) swab, followed by healthcare provider collected nasopharyngeal (NP) swab. Sixty-three specimen sets were tested using five assay/platforms. The diagnostic sensitivity of each assay/platform and specimen type was determined. Of the 63 specimen sets, SARS-CoV-2 was detected in 62 NP specimens, 52 AN specimens, 59 saliva specimens, and 31 SL specimens by at least one platform. Infectious SARS-CoV-2 was isolated from 21 NP, 13 AN, 12 saliva, and one SL specimen out of 50 specimen sets. SARS-CoV-2 isolation was most successful up to 5 days after initial COVID-19 diagnosis using NP specimens from symptomatic patients (16 of 24 positives, 66.67%), followed by specimens from asymptomatic patients (5 of 17 positives, 29.41%), while it was not very successful with specimens from post-symptomatic patients. Benefits of self-collected saliva and AN specimens balance the loss of sensitivity relative to NP specimens. Therefore, saliva and AN specimens are acceptable alternatives for symptomatic SARS-CoV-2 diagnostic testing or surveillance with increased sampling frequency of asymptomatic individuals.ImportanceThe dynamics of infection with SARS-CoV-2 has a significant impact on virus infectivity and in the diagnostic sensitivity of molecular and classic virus detection tests. In the present study we determined the diagnostic sensitivity of paired respiratory (nasopharyngeal and anterior nares swabs) and oral secretions (saliva and sublingual swab) and assessed infectious virus shedding patterns by symptomatic, asymptomatic or post-symptomatic individuals. Understanding the diagnostic performance of these specimens and the patterns of infectious virus shedding in these bodily secretions provides critical information to control COVID-19, and may help to refine guidelines on isolation and quarantine of positive individuals and their close contacts identified through epidemiological investigations.

show abstract

Section: Discussionsupporting

confidence: 89%

Viral load and infectivity of SARS-CoV-2 in paired respiratory and oral specimens from symptomatic, asymptomatic or post-symptomatic individuals

Tallmadge

Laverack

Cronk

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…This percentage is in line with other analysis in which the asymptomatic cases vary between 15 and 30% (Byambasuren et al, 2020; Centers for Disease Control and Prevention US, 2021), although other studies found higher frequencies (Byambasuren et al, 2020;Lee et al, 2020). The comparison of expected viral load between symptomatic and asymptomatic cases, using the Ct value, has been also reported as very variable (Trunfio et al, 2021;Tutuncu, Ozgur, & Karamese, 2021). Similar to our findings in which the symptomatic groups had lower Ct values, another study reported that higher viral load was associated with more signs and symptoms at diagnosis and a more frequent pattern of respiratory and systemic complaints (Trunfio et al, 2021).…”

Section: Discussionsupporting

confidence: 89%

“…Similar to our findings in which the symptomatic groups had lower Ct values, another study reported that higher viral load was associated with more signs and symptoms at diagnosis and a more frequent pattern of respiratory and systemic complaints (Trunfio et al, 2021). However, no associations between viral load and symptoms state have been also suggested in other works (Lee et al, 2020;Tutuncu et al, 2021). The situation of very diverse patterns of Ct values and clinical outcome is a drawback that can be explained not only by the individual factors, but also the technology, sample quality, and the time of sampling after infection (Buchan et al, 2020).…”

Section: (Which Was Not Cesupporting

confidence: 88%

Clinical profiles at the time of diagnosis of COVID-19 in Costa Rica during the pre-vaccination period using a machine learning approach

Molina-Mora

González

Jiménez-Morgan

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: The clinical manifestations of COVID-19 disease, caused by the SARS-CoV-2 virus, define a large spectrum of symptoms that are mainly dependent on the human host conditions. In Costa Rica, almost 319 000 cases have been reported during the first third of 2021, contrasting to the 590 000 fully vaccinated people. In the pre-vaccination period (the year 2020), this country accumulated 169 321 cases and 2185 deaths. Methods: To describe the clinical presentations at the time of diagnosis of COVID-19 in Costa Rica during the pre-vaccination period, we implemented a symptom-based clustering using machine learning to identify clusters or clinical profiles among 18 974 records of positive cases. Profiles were compared based on symptoms, risk factors, viral load, and genomic features of the SARS-CoV-2 sequence. Results: A total of seven COVID-19 clinical profiles were identified, which were characterized by a specific composition of symptoms. In the comparison between clusters, a lower viral load was found for the asymptomatic group, while the risk factors and the SARS-CoV-2 genomic features were distributed among all the clusters. No other distribution patterns were found for age, sex, vital status, and hospitalization. Conclusion: During the pre-vaccination time in Costa Rica, the clinical manifestations at the time of diagnosis of COVID-19 were described in seven profiles. The host co-morbidities and the SARS-CoV-2 genotypes are not specific of a particular profile, rather they are present in all the groups, including asymptomatic cases. In further analyses, these results will be compared against the profiles of cases during the vaccination period.

show abstract

“…Moreover, we have much to learn about the behavior of viral loads in the large numbers of asymptomatic cases now being detected during mass screening of personnel and pre-procedure patients. A few studies have recently become available on the relative sensitivities of various specimen types for SARS-CoV-2 detection in asymptomatic individuals and suggest that saliva may be considered an acceptable alternative sample type in these populations (31)(32)(33)(34). The findings of our study, that the combination of NS and saliva provide similar sensitivity to NPS while alleviating many of its limitations, should be carefully considered based on the setting and the study population being tested.…”

Section: Downloaded Frommentioning

confidence: 80%

Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing

et al. 2021

View full text Add to dashboard Cite

Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical in tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in testing and consequential supply strain. Therefore, alternative specimen types have been investigated, that provide similar detection sensitivity with reduced health care exposure and potential for self-collection. In this study, the detection sensitivity of SARS-CoV-2 in nasal swabs (NS) and saliva was compared to that of NPS, using matched specimens from two outpatient cohorts in New York State (total n = 463). The first cohort showed only a 5.4% positivity but the second cohort (n=227) had a positivity rate of 41%, with sensitivity in NPS, NS and saliva of 97.9%, 87.1%, and 87.1%, respectively. Whether the reduced sensitivity of NS or saliva is acceptable must be assessed in the settings where they are used. However, we sought to improve on it by validating a method to mix the two sample types, as the combination of nasal swab and saliva resulted in 94.6% SARS-CoV-2 detection sensitivity. Spiking experiments showed that combining them did not adversely affect the detection sensitivity in either. Virus stability in saliva was also investigated, with and without the addition of commercially available stabilizing solutions. The virus was stable in saliva at both 4°C and room temperature for up to 7 days. The addition of stabilizing solutions did not enhance stability and in some situations reduced detectable virus levels.

show abstract

Saliva samples for detection of SARS‐CoV‐2 in mildly symptomatic and asymptomatic patients

Cited by 37 publications

References 18 publications

Viral load and infectivity of SARS-CoV-2 in paired respiratory and oral specimens from symptomatic, asymptomatic or post-symptomatic individuals

Viral load and infectivity of SARS-CoV-2 in paired respiratory and oral specimens from symptomatic, asymptomatic or post-symptomatic individuals

Clinical profiles at the time of diagnosis of COVID-19 in Costa Rica during the pre-vaccination period using a machine learning approach

Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing

Contact Info

Product

Resources

About