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Viruses . Evaluation of Saliva as a Matrix for RT-PCR Analysis and Two Rapid Antigen Tests for the Detection of SARS-CoV-2

tetano

Editor, Senior Moderator
Viruses


. 2022 Aug 30;14(9):1931.
doi: 10.3390/v14091931.
Evaluation of Saliva as a Matrix for RT-PCR Analysis and Two Rapid Antigen Tests for the Detection of SARS-CoV-2


Julie De Meyer[SUP] 1 [/SUP], Hanne Goris[SUP] 1 [/SUP], Olivier Mortelé[SUP] 1 [/SUP], An Spiessens[SUP] 1 [/SUP], Guy Hans[SUP] 2 [/SUP], Hilde Jansens[SUP] 1 [/SUP], Herman Goossens[SUP] 1 [/SUP], Veerle Matheeussen[SUP] 1 [/SUP], Sarah Vandamme[SUP] 1 [/SUP]



Affiliations

Abstract

The use of saliva for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sparks debate due to presumed lower sensitivity and lack of standardization. Our aim was to evaluate the performance characteristics of (i) saliva collected by the ORAcollect[SUP]TM[/SUP] device as a matrix for SARS-CoV-2 reverse-transcriptase polymerase chain reaction (RT-PCR), and (ii) 2 saliva rapid antigen tests (AgRDT). From 342 ambulatory individuals, both a nasopharyngeal swab and saliva sample via ORAcollect[SUP]TM[/SUP] were obtained for a SARS-CoV-2 RT-PCR test. Furthermore, 54 and 123 additionally performed the V-Chek[SUP]TM[/SUP] or Whistling[SUP]TM[/SUP] saliva AgRDT. In total, 35% of individuals screened positive for SARS-CoV-2 via nasopharyngeal swab. Saliva, as a matrix for the RT-PCR, had a specificity of 96.5% and a negative predictive value (NPV) of 91.3%. Interestingly, 6 out of 8 patients thought to be false positive in saliva re-tested positive by nasopharyngeal sampling after 2 to 9 days. Both V-Chek[SUP]TM[/SUP] and Whistling[SUP]TM[/SUP] AgRDT had a lack of sensitivity, resulting in an NPV of 66.9 and 67.3%, respectively. Saliva proved to be a sensitive and specific matrix for SARS-CoV-2 detection by the RT-PCR. In this setting, saliva might have an earlier window of detection than the nasopharyngeal swab. By contrast, both AgRDT showed an unacceptably low sensitivity and NPV.

Keywords: SARS-CoV-2; rapid antigen test; saliva.
 
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