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. 2021 Dec 6;7(4):00396-2021.
doi: 10.1183/23120541.00396-2021. eCollection 2021 Oct.

Salivary detection of COVID-19: clinical performance of oral sponge sampling for SARS-CoV-2 testing

Jacques Boutros  1 , Jonathan Benzaquen  1   2 , Charles Hugo Marquette  1   2 , Marius Ilié  2   3 , Mickelina Labaky  4 , Didier Benchetrit  4 , Thibaut Lavrut  5 , Sylvie Leroy  1   6 , Richard Chemla  7 , Michel Carles  8 , Virginie Tanga  3 , Charlotte Maniel  1 , Olivier Bordone  3 , Maryline Allégra  3 , Virginie Lespinet  3 , Julien Fayada  3 , Jennifer Griffonnet  1 , Véronique Hofman  2   3 , Paul Hofman  2   3
Affiliations

Salivary detection of COVID-19: clinical performance of oral sponge sampling for SARS-CoV-2 testing

Jacques Boutros et al. ERJ Open Res. .

Abstract

Background: The current diagnostic standard for coronavirus disease 2019 (COVID-19) is reverse transcriptase-polymerase chain reaction (RT-PCR) testing with nasopharyngeal (NP) swabs. The invasiveness and need for trained personnel make the NP technique unsuited for repeated community-based mass screening. We developed a technique to collect saliva in a simple and easy way with the sponges that are usually used for tamponade of epistaxis. This study was carried out to validate the clinical performance of oral sponge (OS) sampling for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing.

Methods: Over a period of 22 weeks, we collected prospectively 409 paired NP and OS samples from consecutive subjects presenting to a public community-based free screening centre. Subjects were referred by their attending physician because of recent COVID-19 symptoms (n = 147) or by the contact tracing staff of the French public health insurance because they were considered as close contacts of a laboratory-confirmed COVID-19 case (n = 262).

Results: In symptomatic subjects, RT-PCR SARS-CoV-2 testing with OS showed a 96.5% (95% CI: 89.6-94.8) concordance with NP testing, and a 93.2% (95% CI: 89.1-97.3) sensitivity when using the IdyllaTM platform and a sensitivity of 76.3% (95% CI: 69.4-83.2) on the Synlab Barla laboratory platform. In close contacts the NP-OS concordance (93.8%, 95% CI: 90.9-96.7) and OS sensitivity (71.9%, 95% CI: 66.5-77.3) were slightly lower.

Conclusion: These results strongly suggest that OS testing is a straightforward, low-cost and high-throughput sampling method that can be used for frequent RT-PCR testing of COVID-19 patients and mass screening of populations.

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Conflict of interest statement

Provenance: Submitted article, peer reviewed. Conflict of interest: J. Boutros has nothing to disclose. Conflict of interest: J. Benzaquen has nothing to disclose. Conflict of interest: C.H. Marquette has nothing to disclose. Conflict of interest: M. Ilié has nothing to disclose. Conflict of interest: M. Labaky has nothing to disclose. Conflict of interest: D. Benchetrit has nothing to disclose. Conflict of interest: T. Lavrut has nothing to disclose. Conflict of interest: S. Leroy has nothing to disclose. Conflict of interest: R. Chemla has nothing to disclose. Conflict of interest: M. Carles has nothing to disclose. Conflict of interest: V. Tanga has nothing to disclose. Conflict of interest: C. Maniel has nothing to disclose. Conflict of interest: O. Bordone has nothing to disclose. Conflict of interest: M. Allégra has nothing to disclose. Conflict of interest: V. Lespinet has nothing to disclose. Conflict of interest: J. Fayada has nothing to disclose. Conflict of interest: J. Griffonnet has nothing to disclose. Conflict of interest: V. Hofman has nothing to disclose. Conflict of interest: P. Hofman is a member of the scientific advisory board (group of European experts) of Biocartis; however, this board is totally independent of Biocartis.

Figures

FIGURE 1
FIGURE 1
Trial profile. COVID-19: coronavirus disease 2019; NP: nasopharyngeal swab; OS: oral sponge.
FIGURE 2
FIGURE 2
Self-reported symptoms.
FIGURE 3
FIGURE 3
Viral load of nasopharyngeal swab (NP) and oral sponge (OS) as indirectly assessed by the cycle threshold (Ct) for the a) Orf1b and b) N genes.
FIGURE 4
FIGURE 4
All-in-one saliva sampling technique with a PVA sponge and a flexible, double-capped plastic tube.
See this image and copyright information in PMC

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