tetano
Editor, Senior Moderator
BMC Infect Dis
. 2023 May 5;23(1):295.
doi: 10.1186/s12879-023-08271-3. Accuracy of saliva for SARS-CoV-2 detection in outpatients and their household contacts during the circulation of the Omicron variant of concern
Guilherme Calvet[SUP] 1 [/SUP], Maria Ogrzewalska[SUP] 2 3 [/SUP], Wagner Tassinari[SUP] 4 [/SUP], Lusiele Guaraldo[SUP] 5 [/SUP], Paola Resende[SUP] 2 3 [/SUP], Trevon Fuller[SUP] 5 [/SUP], Stephanie Penetra[SUP] 5 [/SUP], Michele Borges[SUP] 5 [/SUP], Anielle Pina-Costa[SUP] 5 [/SUP], Ezequias Martins[SUP] 5 [/SUP], Isabella Moraes[SUP] 5 [/SUP], Heloisa Santos[SUP] 5 [/SUP], Luana Damasceno[SUP] 5 [/SUP], Fernando Medeiros-Filho[SUP] 5 [/SUP], Otavio Espindola[SUP] 5 [/SUP], Fernando Mota[SUP] 2 3 [/SUP], Valéria Nacife[SUP] 2 3 [/SUP], Alex Pauvolid-Corrêa[SUP] 2 3 [/SUP], Jimmy Whitworth[SUP] 6 [/SUP], Chris Smith[SUP] 6 [/SUP], Marilda Siqueira[SUP] 2 3 [/SUP], Patrícia Brasil[SUP] 5 [/SUP]
Affiliations
Background: While nasopharyngeal (NP) swabs are considered the gold standard for severe acute respiratory coronavirus 2 (SARS-CoV-2) real-time reverse transcriptase-polymerase chain reaction (RT-PCR) detection, several studies have shown that saliva is an alternative specimen for COVID-19 diagnosis and screening.
Methods: To analyze the utility of saliva for the diagnosis of COVID-19 during the circulation of the Omicron variant, participants were enrolled in an ongoing cohort designed to assess the natural history of SARS-CoV-2 infection in adults and children. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa coefficient were calculated to assess diagnostic performance.
Results: Overall, 818 samples were collected from 365 outpatients from January 3 to February 2, 2022. The median age was 32.8 years (range: 3-94 years). RT-PCR for SARS-CoV-2 was confirmed in 97/121 symptomatic patients (80.2%) and 62/244 (25.4%) asymptomatic patients. Substantial agreement between saliva and combined nasopharyngeal/oropharyngeal samples was observed with a Cohen's kappa value of 0.74 [95% confidence interval (CI): 0.67-0.81]. Sensitivity was 77% (95% CI: 70.9-82.2), specificity 95% (95% CI: 91.9-97), PPV 89.8% (95% CI: 83.1-94.4), NPV 87.9% (95% CI: 83.6-91.5), and accuracy 88.5% (95% CI: 85.0-91.4). Sensitivity was higher among samples collected from symptomatic children aged three years and older and adolescents [84% (95% CI: 70.5-92)] with a Cohen's kappa value of 0.63 (95% CI: 0.35-0.91).
Conclusions: Saliva is a reliable fluid for detecting SARS-CoV-2, especially in symptomatic children and adolescents during the circulation of the Omicron variant.
Keywords: Accuracy; COVID-19; Omicron; SARS-CoV-2; Saliva.
. 2023 May 5;23(1):295.
doi: 10.1186/s12879-023-08271-3. Accuracy of saliva for SARS-CoV-2 detection in outpatients and their household contacts during the circulation of the Omicron variant of concern
Guilherme Calvet[SUP] 1 [/SUP], Maria Ogrzewalska[SUP] 2 3 [/SUP], Wagner Tassinari[SUP] 4 [/SUP], Lusiele Guaraldo[SUP] 5 [/SUP], Paola Resende[SUP] 2 3 [/SUP], Trevon Fuller[SUP] 5 [/SUP], Stephanie Penetra[SUP] 5 [/SUP], Michele Borges[SUP] 5 [/SUP], Anielle Pina-Costa[SUP] 5 [/SUP], Ezequias Martins[SUP] 5 [/SUP], Isabella Moraes[SUP] 5 [/SUP], Heloisa Santos[SUP] 5 [/SUP], Luana Damasceno[SUP] 5 [/SUP], Fernando Medeiros-Filho[SUP] 5 [/SUP], Otavio Espindola[SUP] 5 [/SUP], Fernando Mota[SUP] 2 3 [/SUP], Valéria Nacife[SUP] 2 3 [/SUP], Alex Pauvolid-Corrêa[SUP] 2 3 [/SUP], Jimmy Whitworth[SUP] 6 [/SUP], Chris Smith[SUP] 6 [/SUP], Marilda Siqueira[SUP] 2 3 [/SUP], Patrícia Brasil[SUP] 5 [/SUP]
Affiliations
- PMID: 37147601
- DOI: 10.1186/s12879-023-08271-3
Background: While nasopharyngeal (NP) swabs are considered the gold standard for severe acute respiratory coronavirus 2 (SARS-CoV-2) real-time reverse transcriptase-polymerase chain reaction (RT-PCR) detection, several studies have shown that saliva is an alternative specimen for COVID-19 diagnosis and screening.
Methods: To analyze the utility of saliva for the diagnosis of COVID-19 during the circulation of the Omicron variant, participants were enrolled in an ongoing cohort designed to assess the natural history of SARS-CoV-2 infection in adults and children. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa coefficient were calculated to assess diagnostic performance.
Results: Overall, 818 samples were collected from 365 outpatients from January 3 to February 2, 2022. The median age was 32.8 years (range: 3-94 years). RT-PCR for SARS-CoV-2 was confirmed in 97/121 symptomatic patients (80.2%) and 62/244 (25.4%) asymptomatic patients. Substantial agreement between saliva and combined nasopharyngeal/oropharyngeal samples was observed with a Cohen's kappa value of 0.74 [95% confidence interval (CI): 0.67-0.81]. Sensitivity was 77% (95% CI: 70.9-82.2), specificity 95% (95% CI: 91.9-97), PPV 89.8% (95% CI: 83.1-94.4), NPV 87.9% (95% CI: 83.6-91.5), and accuracy 88.5% (95% CI: 85.0-91.4). Sensitivity was higher among samples collected from symptomatic children aged three years and older and adolescents [84% (95% CI: 70.5-92)] with a Cohen's kappa value of 0.63 (95% CI: 0.35-0.91).
Conclusions: Saliva is a reliable fluid for detecting SARS-CoV-2, especially in symptomatic children and adolescents during the circulation of the Omicron variant.
Keywords: Accuracy; COVID-19; Omicron; SARS-CoV-2; Saliva.