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COVID-19 screening test by using random oropharyngeal saliva
Mohan Rao1, Fairuz A Rashid1, Fashihah S A H Sabri1
1Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia.
Journal of Medical Virology
|January 4, 2021
Summary
Self-collected saliva accurately detects SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), outperforming healthcare worker-collected swabs. This method offers a valuable, less hazardous alternative for COVID-19 surveillance.
Area of Science:
- Virology
- Clinical Diagnostics
- Public Health
Background:
- Accurate detection of SARS-CoV-2 is crucial for controlling the pandemic.
- Minimizing consumables and healthcare worker exposure are key priorities in diagnostic testing.
- Nasopharyngeal and oropharyngeal (NP+OP) swabs are common but invasive collection methods.
Purpose of the Study:
- To compare the diagnostic performance of self-collected random saliva versus healthcare worker-collected NP+OP swabs for SARS-CoV-2 detection.
- To assess the feasibility of saliva as an alternative specimen for COVID-19 testing.
- To evaluate the sensitivity, specificity, and detection rates of each specimen type.
Main Methods:
- Two cohort studies involving 562 asymptomatic adults were conducted.
- Paired NP+OP swabs and random saliva samples were collected and processed within 48 hours.
- Real-time reverse-transcription polymerase chain reaction (RT-PCR) targeting ORF1a and N genes was used for detection.
Main Results:
- SARS-CoV-2 was detected in 28.1% of candidates (65/562).
- Random saliva showed a higher detection rate (92.3%) compared to NP+OP swabs (73.8%).
- Saliva demonstrated superior sensitivity (95.0%) and specificity (99.9%) versus NP+OP swabs (72.2% and 99.4%, respectively).
- Lower Ct values for ORF1a and N genes were observed in saliva specimens.
Conclusions:
- Self-collected random saliva is a reliable and accurate alternative specimen for SARS-CoV-2 detection.
- Saliva testing offers improved sensitivity and specificity, potentially reducing false negatives.
- This method enhances COVID-19 surveillance by providing an accessible and less invasive option.
