High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children - Huber, M.; Schreiber, P. W.; Scheier, T.; Audige, A.; Buonomano, R.; Rudiger, A.; Braun, D. L.; Eich, G.; Keller, D. I.; Hasse, B.; Boni, J.; Berger, C.; et al. (Microorganisms, 2021)
Rising demands for repetitive SARS-CoV-2 screens and mass testing necessitate additional test strategies. Saliva may serve as an alternative to nasopharyngeal swab (NPS) as its collection is simple, non-invasive and amenable for mass- and home testing, but its rigorous validation, particularly in children, is missing. We conducted a large-scale head-to-head comparison of SARS-CoV-2 detection by RT-PCR in saliva and NPS of 1270 adults and children reporting to outpatient test centers and an emergency unit. In total, 273 individuals were tested positive for SARS-CoV-2 in either NPS or saliva. SARS-CoV-2 RT-PCR results in the two specimens showed a high agreement (overall percent agreement = 97.8%). Despite lower viral loads in the saliva of both adults and children, detection of SARS-CoV-2 in saliva fared well compared to NPS (positive percent agreement = 92.5%). Importantly, in children, SARS-CoV-2 infections were more often detected in saliva than NPS (positive predictive value = 84.8%), underlining that NPS sampling in children can be challenging. The comprehensive parallel analysis reported here establishes saliva as a generally reliable specimen for the detection of SARS-CoV-2, with particular advantages for testing children, that is readily applicable to increase and facilitate repetitive and mass testing in adults and children.
Keywords: journalArticle; Pcr; SARS-CoV-2; children; design of the study; in; in the collection, analyses, or interpretation of data; saliva; the writing of the manuscript, or in the decision to publish the results