Adding saliva testing to oropharyngeal and deep nasal swab testing increases PCR detection of SARS-CoV-2 in primary care and children.

To compare the concordance and acceptability of saliva testing with standard-of-care oropharyngeal and bilateral deep nasal swab testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in children and in general practice. Prospective multicentre diagnostic validation study. Royal Children's Hospital, and two general practices (cohealth, West Melbourne; Cirqit Health, Altona North) in Melbourne, July-October 2020. 1050 people who provided paired saliva and oropharyngeal-nasal swabs for SARS-CoV-2 testing. Numbers of cases in which SARS-CoV-2 was detected in either specimen type by real-time polymerase chain reaction; concordance of results for paired specimens; positive percent agreement (PPA) for virus detection, by specimen type. SARS-CoV-2 was detected in 54 of 1050 people with assessable specimens (5%), including 19 cases (35%) in which both specimens were positive. The overall PPA was 72% (95% CI, 58-84%) for saliva and 63% (95% CI, 49-76%) for oropharyngeal-nasal swabs. For the 35 positive specimens from people aged 10 years or more, PPA was 86% (95% CI, 70-95%) for saliva and 63% (95% CI, 45-79%) for oropharyngeal-nasal swabs. Adding saliva testing to standard-of-care oropharyngeal-nasal swab testing increased overall case detection by 59% (95% CI, 29-95%). Providing saliva was preferred to an oropharyngeal-nasal swab by most participants (75%), including 141 of 153 children under 10 years of age (92%). In children over 10 years of age and adults, saliva testing alone may be suitable for SARS-CoV-2 detection, while for children under 10, saliva testing may be suitable as an adjunct to oropharyngeal-nasal swab testing for increasing case detection.

Oliver J ，Tosif S ，Lee LY ，Costa AM ，Bartel C ，Last K ，Clifford V ，Daley A ，Allard N ，Orr C ，Nind A ，Alexander K ，Meagher N ，Sait M ，Ballard SA ，Williams E ，Bond K ，Williamson DA ，Crawford NW ，Gibney KB ... -  《-》

Comparison of SARS-CoV-2 PCR-Based Detection Using Saliva or Nasopharyngeal Swab Specimens in Asymptomatic Populations.

Fan G ，Qin X ，Streblow DN ，Hoyos CM ，Hansel DE ... -  《Microbiology Spectrum》

Validation of saliva sampling as an alternative to oro-nasopharyngeal swab for detection of SARS-CoV-2 using unextracted rRT-PCR with the Allplex 2019-nCoV assay.

Bergevin MA ，Freppel W ，Robert G ，Ambaraghassi G ，Aubry D ，Haeck O ，Saint-Jean M ，Carignan A ... -  《-》

Are Posterior Oropharyngeal Saliva Specimens an Acceptable Alternative to Nasopharyngeal Sampling for the Monitoring of SARS-CoV-2 in Primary-Care Settings?

Masse S ，Bonnet C ，Vilcu AM ，Benamar H ，Swital M ，van der Werf S ，Carrat F ，Hanslik T ，Blanchon T ，Falchi A ... -  《Viruses-Basel》

Saliva is Comparable to Nasopharyngeal Swabs for Molecular Detection of SARS-CoV-2.

Callahan C ，Ditelberg S ，Dutta S ，Littlehale N ，Cheng A ，Kupczewski K ，McVay D ，Riedel S ，Kirby JE ，Arnaout R ... -  《Microbiology Spectrum》