tetano
Editor, Senior Moderator
Eur J Clin Microbiol Infect Dis
. 2021 May 14.
doi: 10.1007/s10096-021-04269-4. Online ahead of print.
Performances, feasibility and acceptability of nasopharyngeal swab, saliva and oral-self sampling swab for the detection of severe acute respiratory syndrome coronavirus 2
Julie Plantamura[SUP] 1 [/SUP], Aurore Bousquet[SUP] 2 [/SUP], Marie-Pierre Otto[SUP] 1 [/SUP], Christine Bigaillon[SUP] 2 [/SUP], Anne-Margaux Legland[SUP] 1 [/SUP], Herv? Delacour[SUP] 2 3 [/SUP], Philippe Vest[SUP] 4 [/SUP], H?l?ne Astier[SUP] 5 [/SUP], Elodie Valero[SUP] 1 [/SUP], Olivier Bylicki[SUP] 6 [/SUP], Christophe Renard[SUP] 3 7 [/SUP], Solenne Martin[SUP] 7 [/SUP], Catherine Verret[SUP] 7 [/SUP], Eric Garnotel[SUP] 3 5 [/SUP], Vincent Foissaud[SUP] 4 [/SUP], Audrey M?rens[SUP] 2 3 [/SUP], Fr?d?ric Janvier[SUP] 8 9 [/SUP]
Affiliations
Abstract
Molecular diagnosis on nasopharyngeal swabs (NPS) is the current standard for COVID-19 diagnosis, but saliva may be an alternative specimen to facilitate access to diagnosis. We compared analytic performances, feasibility and acceptability of NPS, saliva, and oral-self sampling swab for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A prospective, multicenter study was conducted in military hospitals in France among adult outpatients attending COVID-19 diagnosis centers or hospitalized patients. For each patient, all samples were obtained and analyzed simultaneously with RT-PCR or transcription-mediated amplification method. Clinical signs, feasibility, and acceptability for each type of sample were collected. A total of 1220 patients were included, corresponding to 1205 NPS and saliva and 771 OS. Compared to NPS, the sensitivity, specificity, and kappa coefficient for tests performed on saliva were 87.8% (95% CI 83.3-92.3), 97.1% (95% CI 96.1-98.1), and 0.84 (95% CI 0.80-0.88). Analytical performances were better in symptomatic patients. Ct values were significantly lower in NPS than saliva. For OS, sensitivity was estimated to be 61.1% (95% CI 52.7-69.4) and Kappa coefficient to be 0.69 (95% CI 0.62-0.76). OS was the technique preferred by the patients (44.3%) before saliva (42.4%) and NPS (13.4%). Instructions were perceived as simple by patients (> 90%) for saliva and OS. Finally, the painful nature was estimated to be 0.9 for OS, on a scale from 0 to 10, and to be 5.3 for NPS. Performances of OS are not sufficient. Saliva is an acceptable alternative to NPS for symptomatic patient but the process required additional steps to fluidize the sample.
Keywords: COVID-19; Nasopharyngeal swab; Oral-self sampling; SARS-CoV-2; Saliva.
. 2021 May 14.
doi: 10.1007/s10096-021-04269-4. Online ahead of print.
Performances, feasibility and acceptability of nasopharyngeal swab, saliva and oral-self sampling swab for the detection of severe acute respiratory syndrome coronavirus 2
Julie Plantamura[SUP] 1 [/SUP], Aurore Bousquet[SUP] 2 [/SUP], Marie-Pierre Otto[SUP] 1 [/SUP], Christine Bigaillon[SUP] 2 [/SUP], Anne-Margaux Legland[SUP] 1 [/SUP], Herv? Delacour[SUP] 2 3 [/SUP], Philippe Vest[SUP] 4 [/SUP], H?l?ne Astier[SUP] 5 [/SUP], Elodie Valero[SUP] 1 [/SUP], Olivier Bylicki[SUP] 6 [/SUP], Christophe Renard[SUP] 3 7 [/SUP], Solenne Martin[SUP] 7 [/SUP], Catherine Verret[SUP] 7 [/SUP], Eric Garnotel[SUP] 3 5 [/SUP], Vincent Foissaud[SUP] 4 [/SUP], Audrey M?rens[SUP] 2 3 [/SUP], Fr?d?ric Janvier[SUP] 8 9 [/SUP]
Affiliations
- PMID: 33987804
- DOI: 10.1007/s10096-021-04269-4
Abstract
Molecular diagnosis on nasopharyngeal swabs (NPS) is the current standard for COVID-19 diagnosis, but saliva may be an alternative specimen to facilitate access to diagnosis. We compared analytic performances, feasibility and acceptability of NPS, saliva, and oral-self sampling swab for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A prospective, multicenter study was conducted in military hospitals in France among adult outpatients attending COVID-19 diagnosis centers or hospitalized patients. For each patient, all samples were obtained and analyzed simultaneously with RT-PCR or transcription-mediated amplification method. Clinical signs, feasibility, and acceptability for each type of sample were collected. A total of 1220 patients were included, corresponding to 1205 NPS and saliva and 771 OS. Compared to NPS, the sensitivity, specificity, and kappa coefficient for tests performed on saliva were 87.8% (95% CI 83.3-92.3), 97.1% (95% CI 96.1-98.1), and 0.84 (95% CI 0.80-0.88). Analytical performances were better in symptomatic patients. Ct values were significantly lower in NPS than saliva. For OS, sensitivity was estimated to be 61.1% (95% CI 52.7-69.4) and Kappa coefficient to be 0.69 (95% CI 0.62-0.76). OS was the technique preferred by the patients (44.3%) before saliva (42.4%) and NPS (13.4%). Instructions were perceived as simple by patients (> 90%) for saliva and OS. Finally, the painful nature was estimated to be 0.9 for OS, on a scale from 0 to 10, and to be 5.3 for NPS. Performances of OS are not sufficient. Saliva is an acceptable alternative to NPS for symptomatic patient but the process required additional steps to fluidize the sample.
Keywords: COVID-19; Nasopharyngeal swab; Oral-self sampling; SARS-CoV-2; Saliva.