Abstract
Background: Nasopharyngeal specimens (NPS) are commonly used for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing but can be uncomfortable for patients. Self-collected saliva specimens (SS) or anterior nasal specimens (ANS) for SARS-CoV-2 detection are less invasive, but the sensitivity of these specimen types has not been thoroughly evaluated.
Methods: During September-November 2020, 730 adults undergoing SARS-CoV-2 testing at community testing events and homeless shelters in Denver provided self-collected SS and ANS before NPS collection and answered a short survey about symptoms and specimen preference. Specimens were tested for SARS-CoV-2 by means of real-time reverse-transcription polymerase chain reaction (rRT-PCR); viral culture was performed on a subset of specimens positive by rRT-PCR. The sensitivity of SS and ANS for SARS-CoV-2 detection by rRT-PCR was measured against that of NPS. Subgroup analyses included test outcomes by symptom status and culture results.
Results: Sensitivity for SARS-CoV-2 detection by rRT-PCR appeared higher for SS than for ANS (85% vs 80%) and higher among symptomatic participants than among those without symptoms (94% vs 29% for SS; 87% vs 50% for ANS). Among participants with culture-positive SARS-CoV-2 by any specimen type, the sensitivities of SS and ANS by rRT-PCR were 94% and 100%, respectively. SS and ANS were equally preferred by participants; most would undergo NPS collection again despite this method’s being the least preferred.
Conclusions: SS were slightly more sensitive than ANS for SARS-CoV-2 detection with rRT-PCR. With both SS and ANS, SARS-CoV-2 was reliably detected among participants with symptoms. Self-collected SS and ANS offer practical advantages, are preferred by patients, and might be most useful for testing people with coronavirus disease 2019 symptoms.
Keywords: COVID-19; SARS-CoV-2; anterior nasal; nasopharyngeal; saliva.
【저자키워드】 COVID-19, SARS-CoV-2, Saliva, nasopharyngeal, anterior nasal, 【초록키워드】 coronavirus disease, Saliva, Coronavirus disease 2019, coronavirus, nasal, Symptom, outcome, severe acute respiratory syndrome Coronavirus, Symptoms, polymerase chain reaction, SARS-CoV-2 detection, sensitivity, rRT-PCR, Culture, SARS-CoV-2 testing, Community, viral culture, patients, Chain Reaction, Subgroup analyses, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, specimen, participant, symptomatic participants, subgroup analysis, symptom status, sensitivities, positive, offer, NPs, event, invasive, polymerase chain, was measured, tested, evaluated, provided, was performed, undergo, less, subset, saliva specimen, symptomatic participant, without symptom, 【제목키워드】 detection, coronavirus 2, respiratory, Anterior,