Introduction Non-invasive sample collection and viral sterilizing buffers have independently enabled workflows for more widespread COVID-19 testing by reverse-transcriptase polymerase chain reaction (RT-PCR). Gap Statement The combined use of sterilizing buffers across non-invasive sample types to optimize sensitive, accessible, and biosafe sampling methods has not been directly and systematically compared. Aim We aimed to evaluate diagnostic yield across different non-invasive samples with standard viral transport media (VTM) versus a sterilizing buffer eNAT- (Copan diagnostics Murrieta, CA) in a point-of-care diagnostic assay system. Methodos We prospectively collected 84 sets of nasal swabs, oral swabs, and saliva, from 52 COVID-19 RT-PCR-confirmed patients, and nasopharyngeal (NP) swabs from 37 patients. Nasal swabs, oral swabs, and saliva were placed in either VTM or eNAT, prior to testing with the Xpert Xpress SARS-CoV-2 (Xpert). The sensitivity of each sampling strategy was compared using a composite positive standard. Results Swab specimens collected in eNAT showed an overall superior sensitivity compared to swabs in VTM (70 % vs 57 %, P =0.0022). Direct saliva 90.5 %, (95 % CI: 82 %, 95 %), followed by NP swabs in VTM and saliva in eNAT, was significantly more sensitive than nasal swabs in VTM (50 %, P <0.001) or eNAT (67.8 %, P =0.0012) and oral swabs in VTM (50 %, P <0.0001) or eNAT (58 %, P <0.0001). Saliva and use of eNAT buffer each increased detection of SARS-CoV-2 with the Xpert; however, no single sample matrix identified all positive cases. Conclusion Saliva and eNAT sterilizing buffer can enhance safe and sensitive detection of COVID-19 using point-of-care GeneXpert instruments.
【저자키워드】 Saliva, nasal, inactivation, oral, eNAT, 【초록키워드】 COVID-19, SARS-CoV-2, diagnostic, RT-PCR, diagnostics, point-of-care, sensitivity, COVID-19 testing, VTM, nasopharyngeal, swabs, viral transport media, Swab, nasal swab, NP swab, patients, Safe, Non-invasive, specimen, positive, nasal swabs, oral swab, oral swabs, buffer, combined use, Direct, widespread, polymerase chain, ENhance, Result, collected, evaluate, significantly more, Gap, 【제목키워드】 COVID-19, biosafety, Transport, RT-PCR testing, sample collection, ENhance,