The reliability of saliva for the detection of SARS-CoV-2 in symptomatic and asymptomatic patients: Insights on the diagnostic performance and utility for COVID-19 screening

Alkhateeb, Khaled J.; Cahill, Meredith; Ross, Adam; Arnold, Forest W.; Snyder, James W.

doi:10.1016/j.diagmicrobio.2021.115450

Cited by 15 publications

(14 citation statements)

References 47 publications

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“…To determine if chemical interferants could be sufficiently reduced by dilution, which is often used to reduce viscosity 13 and aid with automated sample processing 14 , saliva samples were diluted 50% before the 50% dilution step incorporated in the RT-PCR processing method creating a 25% saliva solution prior to addition to the RT-PCR reaction. The saliva samples chosen for examination were four SARS-CoV-2 positive samples that tested negative using the RT-PCR method and two healthy volunteer samples whose saliva remained negative after spiking with SARS-CoV-2.…”

Section: Resultsmentioning

confidence: 99%

Investigation of discordant SARS-CoV-2 RT-PCR results using minimally processed saliva

White

Steinberg

et al. 2022

Sci Rep

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Saliva is an attractive sample for coronavirus disease 2019 testing due its ease of collection and amenability to detect viral RNA with minimal processing. Using a direct-to-RT-PCR method with saliva self-collected from confirmed COVID-19 positive volunteers, we observed 32% false negative results. Confirmed negative and healthy volunteer samples spiked with 106 genome copies/mL of heat-inactivated severe acute respiratory syndrome coronavirus 2 showed false negative results of 10% and 13%, respectively. Additional sample heating or dilution of the false negative samples conferred only modest improvements. These results highlight the potential to significantly underdiagnose COVID-19 infections when testing directly from minimally processed heterogeneous saliva samples.

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Section: Resultsmentioning

confidence: 99%

Investigation of discordant SARS-CoV-2 RT-PCR results using minimally processed saliva

White

Steinberg

et al. 2022

Sci Rep

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“…Regrettably, the research by Park et al [ 21 ] and the results of meta-analyses [ 22 ] confirm a high proportion of oligosymptomatic and asymptomatic people in the COVID-19 pandemic, which may be up to one-quarter of all cases. In asymptomatic individuals, the SARS-CoV-2 virus can be isolated from saliva; therefore, there is a potential chance of viral transmission [ 23 ]. For this very reason, the National Institute for Occupational Safety and Health (NIOSH) of the United States Centers for Disease Control and Prevention (CDC) suggests extreme caution when employing respirators with exhalation valves.…”

Section: Discussionmentioning

confidence: 99%

The Seroprevalence of SARS-CoV-2 Antibodies among HealthCare Workers in University Hospital in Krakow before the Era of Vaccination

Żółtowska

Barańska

Jachowicz

et al. 2022

IJERPH

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Background: Knowledge of occupational health is crucial to the safety of healthcare workers in the pandemic period. The aim of our study was the rating of SARS-CoV-2 seroprevalence in connection with selected demographic, social, and organizational factors, as well as the identification of key elements determining the safety of HCWs and patients of the University Hospital in Krakow. Methods: This was a non-interventional, uncontrolled, open, single-center, cross-sectional online survey on the preparedness for the COVID-19 epidemic and the seroprevalence of medical and non-medical HCWs and students. Serum specimens from 1221 persons were tested using an immunoassay analyzer based on the ECLIA technique for the anti-SARS-CoV-2 antibodies IgM + IgG. Results: The total seroprevalence was 42.7%. In medical students it was 25.2%, while in physicians it was 43.4% and in nurses/midwives it was 48.1%. Of those who tested positive, 21.5% did not know their serological status. The use of personal protective equipment did not have any significant impact on the result of testing for anti-SARS-CoV-2 antibodies. The risk of developing the disease was not influenced by sex, professional work experience, workplace, or intensity of contact with the patient. Among the studied elements, only care of COVID-19 patients significantly increased the risk. The protective factor was starting work between the waves of the epidemic (June–September 2020). Conclusions: PPE is only one element of infection prevention and control—without other components, such as hand hygiene, it can be dangerous and contribute to self-infection. It is also very important to test healthcare workers. Not being aware of the COVID-19 status of HCWs poses a threat to other staff members, as well as patients and the family and friends of the infected. Thus, extreme caution should be applied when employing respirators with exhalation valves during the COVID-19 pandemic.

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“…To determine if chemical interferants could be su ciently reduced by dilution, which is often used to reduce viscosity 11 and aid with automated sample processing 12 , saliva samples were diluted 50% before the 50% dilution step incorporated in the RT-PCR processing method creating a 25% saliva solution prior to addition to the RT-PCR reaction. The saliva samples chosen for examination were four SARS-CoV-2 positive samples that tested negative using the RT-PCR method and two healthy volunteer samples whose saliva remained negative after spiking with SARS-CoV-2.…”

Section: Resultsmentioning

confidence: 99%

Investigation of Discordant SARS-CoV-2 RT-PCR Results Using Neat Saliva

White

Steinberg

et al. 2021

Preprint

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Saliva is an attractive sample for coronavirus disease 2019 testing due its ease of collection and amenability to detect viral RNA without processing. Using a direct-to-RT-PCR method with saliva self-collected from confirmed COVID-19 positive volunteers, we observed 32% false negative results. Confirmed negative and healthy volunteer samples spiked with 106 genome copies/mL of heat-inactivated severe acute respiratory syndrome coronavirus 2 showed false negative results of 10% and 13%, respectively. Additional sample heating or dilution of the false negative samples conferred modest improvement. These results highlight the potential to significantly underdiagnose COVID-19 infections when testing directly from heterogeneous neat saliva samples.

show abstract

The reliability of saliva for the detection of SARS-CoV-2 in symptomatic and asymptomatic patients: Insights on the diagnostic performance and utility for COVID-19 screening

Cited by 15 publications

References 47 publications

Investigation of discordant SARS-CoV-2 RT-PCR results using minimally processed saliva

Investigation of discordant SARS-CoV-2 RT-PCR results using minimally processed saliva

The Seroprevalence of SARS-CoV-2 Antibodies among HealthCare Workers in University Hospital in Krakow before the Era of Vaccination

Investigation of Discordant SARS-CoV-2 RT-PCR Results Using Neat Saliva

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