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. 2020 Sep 24;383(13):1283-1286.
doi: 10.1056/NEJMc2016359. Epub 2020 Aug 28.

Saliva or Nasopharyngeal Swab Specimens for Detection of SARS-CoV-2

Anne L Wyllie  1 , John Fournier  2 , Arnau Casanovas-Massana  3 , Melissa Campbell  2 , Maria Tokuyama  2 , Pavithra Vijayakumar  2 , Joshua L Warren  3 , Bertie Geng  2 , M Catherine Muenker  3 , Adam J Moore  3 , Chantal B F Vogels  3 , Mary E Petrone  3 , Isabel M Ott  3 , Peiwen Lu  2 , Arvind Venkataraman  2 , Alice Lu-Culligan  2 , Jonathan Klein  2 , Rebecca Earnest  3 , Michael Simonov  2 , Rupak Datta  2 , Ryan Handoko  2 , Nida Naushad  2 , Lorenzo R Sewanan  2 , Jordan Valdez  2 , Elizabeth B White  3 , Sarah Lapidus  3 , Chaney C Kalinich  3 , Xiaodong Jiang  2 , Daniel J Kim  2 , Eriko Kudo  2 , Melissa Linehan  2 , Tianyang Mao  2 , Miyu Moriyama  2 , Ji E Oh  2 , Annsea Park  2 , Julio Silva  2 , Eric Song  2 , Takehiro Takahashi  2 , Manabu Taura  2 , Orr-El Weizman  2 , Patrick Wong  2 , Yexin Yang  2 , Santos Bermejo  2 , Camila D Odio  4 , Saad B Omer  5 , Charles S Dela Cruz  2 , Shelli Farhadian  2 , Richard A Martinello  2 , Akiko Iwasaki  2 , Nathan D Grubaugh  6 , Albert I Ko  6
Affiliations

Saliva or Nasopharyngeal Swab Specimens for Detection of SARS-CoV-2

Anne L Wyllie et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. SARS-CoV-2 RNA Titers in Saliva Specimens and Nasopharyngeal Swab Specimens.
Samples were obtained from 70 hospital inpatients who had a diagnosis of Covid-19. Panel A shows SARS-CoV-2 RNA titers in the first available nasopharyngeal and saliva samples. The lines indicate samples from the same patient. Results were compared with the use of a Wilcoxon signed-rank test (P<0.001). Panel B shows percentages of positivity for SARS-CoV-2 in tests of the first matched nasopharyngeal and saliva samples at 1 to 5 days, 6 to 10 days, and 11 or more days (maximum, 53 days) after the diagnosis of Covid-19. Panel C shows longitudinal SARS-CoV-2 RNA copies per milliliter in 97 saliva samples, according to days since symptom onset. Each circle represents a separate sample. Dashed lines indicate additional samples from the same patient. The red line indicates a negative saliva sample that was followed by a positive sample at the next collection of a specimen. Panel D shows longitudinal SARS-CoV-2 RNA copies per milliliter in 97 nasopharyngeal swab specimens, according to days since symptom onset. The red lines indicate negative nasopharyngeal swab specimens there were followed by a positive swab at the next collection of a specimen. The gray area in Panels C and D indicates samples that were below the lower limit of detection of 5610 virus RNA copies per milliliter of sample, which is at cycle threshold 38 of our quantitative reverse-transcriptase polymerase chain reaction assay targeting the SARS-CoV-2 N1 sequence recommended by the Centers for Disease Control and Prevention. To analyze these data, we used a linear mixed-effects regression model (see Supplementary Appendix 1) that accounts for the correlation between samples collected from the same person at a single time point (i.e., multivariate response) and the correlation between samples collected across time from the same patient (i.e., repeated measures). All the data used to generate this figure, including the raw cycle thresholds, are provided in Supplementary Data 1 in Supplementary Appendix 2.
See this image and copyright information in PMC

Comment in

  • Saliva sampling for chasing SARS-CoV-2: A Game-changing strategy.
    Borghi E, Massa V, Carmagnola D, Dellavia C, Parodi C, Ottaviano E, Sangiorgio A, Barcellini L, Gambacorta G, Forlanini F, Zuccotti GV; UNIMI SAL Study group. Borghi E, et al. Pharmacol Res. 2021 Mar;165:105380. doi: 10.1016/j.phrs.2020.105380. Epub 2020 Dec 16. Pharmacol Res. 2021. PMID: 33338623 Free PMC article. No abstract available.
  • Saliva for Detection of SARS-CoV-2.
    Markewitz RDH, Wandinger KP, Junker R. Markewitz RDH, et al. N Engl J Med. 2021 Mar 4;384(9):e31. doi: 10.1056/NEJMc2032165. Epub 2021 Feb 3. N Engl J Med. 2021. PMID: 33534973 No abstract available.
  • Saliva for Detection of SARS-CoV-2. Reply.
    Wyllie AL, Vogels CBF, Grubaugh ND. Wyllie AL, et al. N Engl J Med. 2021 Mar 4;384(9):e31. doi: 10.1056/NEJMc2032165. Epub 2021 Feb 3. N Engl J Med. 2021. PMID: 33534974 No abstract available.

References

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    1. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020;382:1177-1179. - PMC - PubMed

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