tetano
Editor, Senior Moderator
Keio J Med
. 2021 Mar 19.
doi: 10.2302/kjm.2021-0003-OA. Online ahead of print.
RT-PCR Screening Tests for SARS-CoV-2 with Saliva Samples in Asymptomatic People: Strategy to Maintain Social and Economic Activities while Reducing the Risk of Spreading the Virus
Junna Oba[SUP] 1 [/SUP], Hiroaki Taniguchi[SUP] 1 2 3 [/SUP], Masae Sato[SUP] 1 [/SUP], Reika Takamatsu[SUP] 1 [/SUP], Satoru Morikawa[SUP] 4 [/SUP], Taneaki Nakagawa[SUP] 4 [/SUP], Hiromasa Takaishi[SUP] 5 [/SUP], Hideyuki Saya[SUP] 3 6 [/SUP], Koichi Matsuo[SUP] 7 [/SUP], Hiroshi Nishihara[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
The year 2020 will be remembered for the coronavirus disease 2019 (COVID-19) pandemic, which continues to affect the whole world. Early and accurate identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is fundamental to combat the disease. Among the current diagnostic tests, real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) is the most reliable and frequently used method. Herein, we discuss the interpretation of RT-qPCR results relative to viral infectivity. Although nasopharyngeal swab samples are often used for RT-qPCR testing, they require collection by trained medical staff. Saliva samples are emerging as an inexpensive and efficient alternative for large-scale screening. Pooled-sample testing of saliva has been applied for mass screening of SARS-CoV-2 infection. Current policies recommend isolating people with borderline cycle threshold (Ct) values (35<Ct <40), despite these Ct values indicating minimal infection risk. We propose the new concept of a "social cut-off" Ct value and risk stratification based on the correlation of Ct with infectivity. We also describe the experience of RT-qPCR screening of saliva samples at our institution. It is important to implement a scientific approach to minimize viral transmission while allowing economic and social activities to continue.
Keywords: COVID-19; SARS-CoV-2; mass screening; real-time polymerase chain reaction; saliva.
. 2021 Mar 19.
doi: 10.2302/kjm.2021-0003-OA. Online ahead of print.
RT-PCR Screening Tests for SARS-CoV-2 with Saliva Samples in Asymptomatic People: Strategy to Maintain Social and Economic Activities while Reducing the Risk of Spreading the Virus
Junna Oba[SUP] 1 [/SUP], Hiroaki Taniguchi[SUP] 1 2 3 [/SUP], Masae Sato[SUP] 1 [/SUP], Reika Takamatsu[SUP] 1 [/SUP], Satoru Morikawa[SUP] 4 [/SUP], Taneaki Nakagawa[SUP] 4 [/SUP], Hiromasa Takaishi[SUP] 5 [/SUP], Hideyuki Saya[SUP] 3 6 [/SUP], Koichi Matsuo[SUP] 7 [/SUP], Hiroshi Nishihara[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 33746151
- DOI: 10.2302/kjm.2021-0003-OA
Abstract
The year 2020 will be remembered for the coronavirus disease 2019 (COVID-19) pandemic, which continues to affect the whole world. Early and accurate identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is fundamental to combat the disease. Among the current diagnostic tests, real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) is the most reliable and frequently used method. Herein, we discuss the interpretation of RT-qPCR results relative to viral infectivity. Although nasopharyngeal swab samples are often used for RT-qPCR testing, they require collection by trained medical staff. Saliva samples are emerging as an inexpensive and efficient alternative for large-scale screening. Pooled-sample testing of saliva has been applied for mass screening of SARS-CoV-2 infection. Current policies recommend isolating people with borderline cycle threshold (Ct) values (35<Ct <40), despite these Ct values indicating minimal infection risk. We propose the new concept of a "social cut-off" Ct value and risk stratification based on the correlation of Ct with infectivity. We also describe the experience of RT-qPCR screening of saliva samples at our institution. It is important to implement a scientific approach to minimize viral transmission while allowing economic and social activities to continue.
Keywords: COVID-19; SARS-CoV-2; mass screening; real-time polymerase chain reaction; saliva.