1. Saliva is a reliable and accessible source for the detection of SARS-CoV-2
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Rosaura Ruiz, Michael Gastelum-Ramos, Diana Vilar-Compte, Imelda López-Villaseñor, Renato León-Rodríguez, Mireya Cisneros-Villanueva, Sergio A. Román-González, Rogelio Montiel-Manríquez, Noe Escobar-Escamilla, Jacquelina Fernández, Andrea Soriano-Ríos, Hiram Olivera-Díaz, Maricarmen Quirasco-Baruch, Cristian Arriaga-Canon, Nelly Medina-Molotla, Lissania Guerra-Calderas, Fernando Peñaloza, Blanca H. Ruiz-Ordaz, Jorge Morales-Baez, Rafael Valdez-Vazquez, Ana Paula Alarcón-Zendejas, Vasti T. Juárez-González, Jennifer Bertin-Montoya, Emmanuel Frias-Jimenez, Michel Montalvo-Casimiro, Juliana Herrera, Yair Alfaro-Mora, Carlos Amador-Bedolla, Antonia Sánchez-Vizcarra, Patricia Rosas-Escobar, Diana I. Aparicio-Bautista, Karla Torres-Arciga, Laura Tolentino-García, Luis A. Herrera, Armando Cruz-Rangel, Eduardo Hurtado-Cordova, Abelardo A. Meneses-García, Laura Contreras-Espinosa, Fernando Luna-Maldonado, Mariana Cendejas-Orozco, Mariano García-Martínez, Diana R. Ortiz-Soriano, Juan Pablo Reyes-Grajeda, Marco Antonio Meraz-Rodríguez, Alfredo Hidalgo-Miranda, Ana D. González-Barrera, Alberto Cedro-Tanda, Irwin A. Hernández-Cruz, Nancy Reynoso-Noverón, Paulina Munguia-Garza, Patricia Cornejo, Rodrigo Peña González, Ernesto Ramírez-Gonzalez, Irma López-Martínez, María García-Rodríguez, Marco A Escobar-Arrazola, Israel Canela-Pérez, Alfredo Mendoza-Vargas, Liudmila Villegas-Acosta, Miguel A. González-Woge, Daniela López-Castillo, Erik Nieto-Patlán, Daniela Venegas, María Niembro-Ortega, Felipe Vadillo-Ortega, César A. Herrera, Verónica Monroy-Martínez, Francisco Garcia, Bernardo Moreno, José S. Hernández-Morales, Julieta Domínguez-Ortiz, Julio C. Canseco-Méndez, Tonatiuh Zamora-Barandas, Daniel Guillen, Xiadani Guajardo-Barreto, Rodrigo E. Cáceres-Gutiérrez, Vincent G. Osnaya, and Ofelia Angulo
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Saliva ,Concordance ,Sample (material) ,030106 microbiology ,Infectious and parasitic diseases ,RC109-216 ,Saliva testing ,Asymptomatic ,Gastroenterology ,Article ,Specimen Handling ,03 medical and health sciences ,0302 clinical medicine ,Nasopharynx ,Internal medicine ,medicine ,Humans ,Sampling (medicine) ,030212 general & internal medicine ,Reproducibility ,SARS-CoV-2 ,business.industry ,Reproducibility of Results ,COVID-19 ,General Medicine ,Diagnostic test ,Cross-Sectional Studies ,Infectious Diseases ,medicine.symptom ,business ,Pooling strategy ,Kappa - Abstract
Objectives The aim of this study was to investigate the feasibility of saliva sampling as a non-invasive and safer tool to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to compare its reproducibility and sensitivity with nasopharyngeal swab samples (NPS). The use of sample pools was also investigated. Methods A total of 2107 paired samples were collected from asymptomatic healthcare and office workers in Mexico City. Sixty of these samples were also analyzed in two other independent laboratories for concordance analysis. Sample processing and analysis of virus genetic material were performed according to standard protocols described elsewhere. A pooling analysis was performed by analyzing the saliva pool and the individual pool components. Results The concordance between NPS and saliva results was 95.2% (kappa 0.727, p = 0.0001) and 97.9% without considering inconclusive results (kappa 0.852, p = 0.0001). Saliva had a lower number of inconclusive results than NPS (0.9% vs 1.9%). Furthermore, saliva showed a significantly higher concentration of both total RNA and viral copies than NPS. Comparison of our results with those of the other two laboratories showed 100% and 97% concordance. Saliva samples are stable without the use of any preservative, and a positive SARS-CoV-2 sample can be detected 5, 10, and 15 days after collection when the sample is stored at 4 °C. Conclusions The study results indicate that saliva is as effective as NPS for the identification of SARS-CoV-2-infected asymptomatic patients. Sample pooling facilitates the analysis of a larger number of samples, with the benefit of cost reduction.
- Published
- 2021
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