Performance of at-home self-collected saliva and nasal-oropharyngeal swabs in the surveillance of COVID-19

Paulo H Braz-Silva; Ana C Mamana; Camila M Romano; Alvina C Felix; Anderson V de Paula; Noeli E Fereira; Lewis F Buss; Tania R Tozetto-Mendoza; Rafael A V Caixeta; Fabio E Leal; Regina M Z Grespan; João C S Bizário; Andrea B C Ferraz; Dipak Sapkota; Simone Giannecchini; Kelvin K To; Alain Doglio; Maria C Mendes-Correa

doi:10.1080/20002297.2020.1858002

Performance of at-home self-collected saliva and nasal-oropharyngeal swabs in the surveillance of COVID-19

J Oral Microbiol. 2020 Dec 9;13(1):1858002. doi: 10.1080/20002297.2020.1858002.

Authors

Paulo H Braz-Silva^{1

2}, Ana C Mamana¹, Camila M Romano¹, Alvina C Felix¹, Anderson V de Paula¹, Noeli E Fereira¹, Lewis F Buss¹, Tania R Tozetto-Mendoza¹, Rafael A V Caixeta², Fabio E Leal³, Regina M Z Grespan³, João C S Bizário³, Andrea B C Ferraz³, Dipak Sapkota⁴, Simone Giannecchini⁵, Kelvin K To^{6

7

8}, Alain Doglio⁹, Maria C Mendes-Correa¹

Affiliations

¹ Laboratory of Virology (LIM-52), Institute of Tropical Medicine of São Paulo, School of Medicine, University of São Paulo, São Paulo, Brazil.
² Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil.
³ Department of Medicine, Municipal University of São Caetano do Sul, São Caetano Do Sul, Brazil.
⁴ Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
⁵ Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
⁶ State Key Laboratory for Emerging Infectious Diseases, Department of Microbiology, Carol Yu Centre for Infection, Li KaShing Faculty of Medicine of the University of Hong Kong, Special Administrative Region, China.
⁷ Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.
⁸ Department of Clinical Microbiology and Infection Control, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
⁹ Laboratory MICORALIS (Microbiologie Orale, Immunité Et Santé) School of Dentistry, University of Côte d'Azur, Nice, France.

Abstract

Background: SARS-CoV-2 quickly spreads in the worldwide population, imposing social restrictions to control the infection, being the massive testing another essential strategy to break the chain of transmission. Aim: To compare the performance of at-home self-collected samples - saliva and combined nasal-oropharyngeal swabs (NOP) - for SARS-CoV-2 detection in a telemedicine platform for COVID-19 surveillance. Material and methods: We analyzed 201 patients who met the criteria of suspected COVID-19. NOP sampling was combined (nostrils and oropharynx) and saliva collected using a cotton pad device. Detection of SARS-COV-2 was performed by using the Altona RealStar® SARS-CoV-2 RT-PCR Kit 1.0. Results: There was an overall significant agreement (κ coefficient value of 0.58) between saliva and NOP. Considering results in either sample, 70 patients positive for SARS-CoV-2 were identified, with 52/70 being positive in NOP and 55/70 in saliva. This corresponds to sensitivities of 74.2% (95% CI; 63.7% to 83.1%) for NOP and 78.6% (95% CI; 67.6% to 86.6%) for saliva. Conclusion: Our data show the feasibility of using at-home self-collected samples (especially saliva), as an adequate alternative for SARS-CoV-2 detection. This new approach of testing can be useful to develop strategies for COVID-19 surveillance and for guiding public health decisions.

Keywords: PCR; Saliva; coronavirus; infection control; primary health care; telemedicine.

Grants and funding

This work was supported by the Laboratórios de Investigação Médica - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.