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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Self-Collected Oral Fluid Saliva Is Insensitive Compared with Nasal-Oropharyngeal Swabs in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Outpatients
Open Forum Infectious Diseases, Volume 8, No. 2, Article ofaa648, Year 2021
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Description
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic control will require widespread access to accurate diagnostics. Salivary sampling circumvents swab supply chain bottlenecks, is amenable to self-collection, and is less likely to create an aerosol during collection compared with the nasopharyngeal swab. Methods: We compared real-time reverse-transcription polymerase chain reaction Abbott m2000 results from matched salivary oral fluid (gingival crevicular fluid collected in an Oracol device) and nasal-oropharyngeal (OP) self-collected specimens in viral transport media from a nonhospitalized, ambulatory cohort of coronavirus disease 2019 (COVID-19) patients at multiple time points. These 2 sentences should be at the beginning of the results. Results: There were 171 matched specimen pairs. Compared with nasal-OP swabs, 41.6% of the oral fluid samples were positive. Adding spit to the oral fluid percent collection device increased the percent positive agreement from 37.2% (16 of 43) to 44.6% (29 of 65). The positive percent agreement was highest in the first 5 days after symptoms and decreased thereafter. All of the infectious nasal-OP samples (culture positive on VeroE6 TMPRSS2 cells) had a matched SARS-CoV-2 positive oral fluid sample. Conclusions: In this study of nonhospitalized SARS-CoV-2-infected persons, we demonstrate lower diagnostic sensitivity of self-collected oral fluid compared with nasal-OP specimens, a difference that was especially prominent more than 5 days from symptom onset. These data do not justify the routine use of oral fluid collection for diagnosis of SARS-CoV-2 despite the greater ease of collection. It also underscores the importance of considering the method of saliva specimen collection and the time from symptom onset especially in outpatient populations. © 2020 The Author(s).
Authors & Co-Authors
Manabe, Yukari C.
United States, Baltimore
Johns Hopkins University
Yu, Tong
United States, Baltimore
Johns Hopkins University
Hardick, Justin P.
United States, Baltimore
Johns Hopkins University
Brown, Diane M.
United States, Baltimore
Johns Hopkins University
Antar, Annukka A.R.
United States, Baltimore
Johns Hopkins University
Blair, Paul W.
United States, Baltimore
Johns Hopkins University
United States, Rockville
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Pekosz, Andrew S.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Thomas, David L.
United States, Baltimore
Johns Hopkins University
Cox, Andrea L.
Unknown Affiliation
Keruly, Jeanne C.
Unknown Affiliation
Klein, Sabra L.
Unknown Affiliation
Mehta, Shruti H.
Unknown Affiliation
Mostafa, Heba H.
Unknown Affiliation
Pisanic, Nora
Unknown Affiliation
Sauer, Lauren M.
Unknown Affiliation
Tornheim, Jeffrey A.
Unknown Affiliation
Armstrong, Derek T.
Unknown Affiliation
Statistics
Citations: 13
Authors: 17
Affiliations: 3
Identifiers
Doi:
10.1093/ofid/ofaa648
ISSN:
23288957
Research Areas
Covid
Health System And Policy
Study Design
Cohort Study