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. 2022 Apr 4:10:840996.
doi: 10.3389/fpubh.2022.840996. eCollection 2022.

Assessment of Saliva Specimens' Reliability for COVID-19 Surveillance

Biancamaria Pierri  1 , Maria Tafuro  1 , Maria Concetta Cuomo  1 , Denise Di Concilio  1 , Lucia Vassallo  1 , Andrea Pierri  1 , Amedeo Ferro  1 , Giuseppe Rofrano  1 , Alfonso Gallo  1 , Antonio Di Stasio  1 , Andrea Mancusi  2 , Lydia Galdi  1 , Annachiara Coppola  1 , Carlo Buonerba  1 , Luigi Atripaldi  3 , Pellegrino Cerino  1
Affiliations

Assessment of Saliva Specimens' Reliability for COVID-19 Surveillance

Biancamaria Pierri et al. Front Public Health. .

Abstract

The aim of the present study is to assess saliva as a reliable specimen for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection by real-time reverse transcription-PCR (RT-PCR), especially in community mass screening programs. The performance analysis considered 1,221 total samples [nasopharyngeal (NP) swabs and corresponding saliva], tested by means of a reference diagnostic real-time RT-PCR assay. Conflicting results were further investigated with a second, more sensitive, reference assay. Analysis of agreement showed a good concordance (95.82%), with a k coefficient value of.74 (p < 0.001); moreover, a follow-up analysis revealed the presence of viral gene targets in saliva samples at the time point the corresponding NP swabs turned negative. Data obtained prove the reliability of this alternative biofluid for SARS-CoV-2 detection in real-time RT-PCR. Considering the role of saliva in the coronavirus disease 2019 (COVID-19) transmission and pathogenesis, and the advantages in the use of salivary diagnostics, the present validation supports the use of saliva as an optimal choice in large-scale population screening and monitoring of the SARS-CoV-2 virus.

Keywords: COVID-19 screening; SARS-CoV-2; nasopharyngeal swab; real-time RT-PCR; saliva.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Analytical workflow of the study.
Figure 2
Figure 2
Timeline with a follow-up analysis on 11 discordant cases (each time point considers an interval of one day).
See this image and copyright information in PMC

References

    1. Matic N, Lawson T, Ritchie G, Stefanovic A, Leung V, Champagne S, et al. . Automated molecular testing of saliva for SARS-CoV-2 detection. Diagn Microbiol Infect Dis. (2021) 100:115324. 10.1016/j.diagmicrobio.2021.115324 - DOI - PMC - PubMed
    1. Böger B, Fachi MM, Vilhena RO, Cobre AF, Tonin FS, Pontarolo R. Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19. Am J Infect Control. (2021) 49:21–9. 10.1016/j.ajic.2020.07.011 - DOI - PMC - PubMed
    1. Teo AKJ, Choudhury Y, Tan IB, Cher CY, Chew SH, Wan ZY, et al. . Saliva is more sensitive than nasopharyngeal or nasal swabs for diagnosis of asymptomatic and mild COVID-19 infection. Sci Rep. (2021) 11:1–8. 10.1038/s41598-021-82787-z - DOI - PMC - PubMed
    1. Harikrishnan P. Saliva as a potential diagnostic specimen for COVID-19 testing. J Cran. (2020) 31:e653–e655. 10.1097/SCS.0000000000006724 - DOI - PMC - PubMed
    1. Baghizadeh Fini M. Oral saliva and CVID-19. Oral Oncol. (2020) 108:104821. 10.1016/j.oraloncology.2020.104821 - DOI - PMC - PubMed