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Virulence . Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-

tetano

Editor, Senior Moderator
Virulence


. 2020 Dec;11(1):1394-1401.
doi: 10.1080/21505594.2020.1831342.
Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-center cross-sectional study


Tianwen Lai[SUP] 1 [/SUP], Fangfei Xiang[SUP] 2 [/SUP], Jianfeng Zeng[SUP] 3 [/SUP], Yingzi Huang[SUP] 4 [/SUP], Liping Jia[SUP] 5 [/SUP], Hui Chen[SUP] 6 [/SUP], Jiayuan Wu[SUP] 7 [/SUP], Jianfeng Xie[SUP] 4 [/SUP], Shuna Liu[SUP] 8 [/SUP], Wei Deng[SUP] 8 [/SUP], Weiqiang Zheng[SUP] 8 [/SUP], Yang Huang[SUP] 8 [/SUP], Qinfu Zhang[SUP] 8 [/SUP], Qingfeng Luo[SUP] 8 [/SUP], Fan Mo[SUP] 8 [/SUP], Lieming Long[SUP] 8 [/SUP], Wuying Zhang[SUP] 8 [/SUP], Wenna Chen[SUP] 8 [/SUP], Huanqin Han[SUP] 8 [/SUP]



Affiliations

Abstract

We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p < 0.01). Patients were divided according to time span from onset of illness to sample collection into the more-than-30-day (n = 26) and less-than-30-day (n = 30) groups. The positive rate for induced sputum was also significantly higher than for throat swabs in the less-than-30-day group (53.3% vs 10.0%, respectively; p < 0.001). For the more-than-30-day group, all paired samples were negative for SARS-CoV-2. Blood oxygen saturation, respiratory rate, and heart rate remained stable during sputum induction and no staff were infected. Because induced sputum is more reliable and has a lower false-negative rate than throat swabs, we believe induced sputum is more useful for the confirmation of COVID-19 and is safer as a criterion for release from quarantine.

Keywords: COVID-19; SARS-CoV-2; induced sputum; reliability; throat swab.
 
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