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Comparative Study
. 2021 Jan 21;59(2):e02686-20.
doi: 10.1128/JCM.02686-20. Print 2021 Jan 21.

Saliva Is a Promising Alternative Specimen for the Detection of SARS-CoV-2 in Children and Adults

Rebecca Yee #  1 , Thao T Truong #  1 , Pia S Pannaraj  2   3 , Natalie Eubanks  1 , Emily Gai  1 , Jaycee Jumarang  2 , Lauren Turner  2 , Ariana Peralta  2 , Yesun Lee  2 , Jennifer Dien Bard  4   2
Affiliations
Comparative Study

Saliva Is a Promising Alternative Specimen for the Detection of SARS-CoV-2 in Children and Adults

Rebecca Yee et al. J Clin Microbiol. .

Abstract

Testing efforts for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been burdened by the scarcity of testing materials and personal protective equipment for health care workers. The simple and painless process of saliva collection allows for widespread testing, but enthusiasm is hampered by variable performance compared to that of nasopharyngeal swab (NPS) samples. We prospectively collected paired NPS and saliva samples from a total of 300 unique adult and pediatric patients. SARS-CoV-2 RNA was detected in 32.2% (97/300) of the individuals using the TaqPath COVID-19 Combo kit (Thermo Fisher). Performance of saliva and NPS was compared against the total number of positives regardless of specimen type. The overall concordances for saliva and NPS were 91.0% (273/300) and 94.7% (284/300), respectively. The values for positive percent agreement (PPA) for saliva and NPS were 81.4% (79/97) and 89.7% (87/97), respectively. Saliva yielded detection of 10 positive cases that were negative by NPS. For symptomatic and asymptomatic pediatric patients not previously diagnosed with COVID-19, the performances of saliva and NPS were comparable (PPA, 82.4% versus 85.3%). The overall values for PPA for adults were 83.3% and 90.7% for saliva and NPS, respectively, with saliva yielding detection of 4 fewer cases than NPS. However, saliva performance for symptomatic adults was identical to NPS performance (PPA of 93.8%). With lower cost and self-collection capabilities, saliva can be an appropriate sample choice alternative to NPS for detection of SARS-CoV-2 in children and adults.

Keywords: COVID-19; SARS-CoV-2; nasopharyngeal swab; pediatric; saliva.

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Figures

FIG 1
FIG 1
Comparison of CT values from paired saliva and nasopharyngeal swab specimens from adult (A) and pediatric (B) patients that were positive for SARS-CoV-2. Each line represents the corresponding paired specimen. (C) Regression curve plotting CT values from paired saliva and nasopharyngeal swab specimens that were positive for SARS-CoV-2 reveals a linear association between the CT values obtained for the two specimen types.
FIG 2
FIG 2
CT values from saliva and nasopharyngeal swab specimens collected from our SARS-CoV-2-positive asymptomatic (open circles) and symptomatic (filled circles) patients in our adult (A) populations and pediatric cohort (B).
FIG 3
FIG 3
CT values of adult (A) and pediatric (B) patients tested positive by both nasopharyngeal swab and saliva, nasopharyngeal swab only, and saliva only are depicted in reference to when they were tested since symptom onset (days).
See this image and copyright information in PMC

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