Validating saliva as a biological sample for cost-effective, rapid and routine screening for SARS-CoV-2.
Title | Validating saliva as a biological sample for cost-effective, rapid and routine screening for SARS-CoV-2. |
Publication Type | Journal Article |
Year of Publication | 2023 |
Authors | Ansil BR, George CElizabeth, Chandrasingh S, Viswanathan A, Thattai M, Raghu P, Devadiga S, Harikumar AGeetha, Harsha PKandi, Nair I, Ramakrishnan U, Mayor S |
Journal | Indian J Med Microbiol |
Volume | 45 |
Pagination | 100384 |
Date Published | 2023 Sep-Oct |
ISSN | 1998-3646 |
Keywords | Cost-Benefit Analysis, COVID-19, Humans, India, Nasopharynx, Saliva, SARS-CoV-2, Specimen Handling |
Abstract | PURPOSE: Compared to nasopharyngeal/oropharyngeal swabs (N/OPS-VTM), non-invasive saliva samples have enormous potential for scalability and routine population screening of SARS-CoV-2. In this study, we investigate the efficacy of saliva samples relative to N/OPS-VTM for use as a direct source for RT-PCR based SARS-CoV-2 detection. METHODS: We collected paired nasopharyngeal/oropharyngeal swabs and saliva samples from suspected positive SARS-CoV-2 patients and tested using RT-PCR. We used generalized linear models to investigate factors that explain result agreement. Further, we used simulations to evaluate the effectiveness of saliva-based screening in restricting the spread of infection in a large campus such as an educational institution. RESULTS: We observed a 75.4% agreement between saliva and N/OPS-VTM, that increased drastically to 83% in samples stored for less than three days. Such samples processed within two days of collection showed 74.5% test sensitivity. Our simulations suggest that a test with 75% sensitivity, but high daily capacity can be very effective in limiting the size of infection clusters in a workspace. Guided by these results, we successfully implemented a saliva-based screening in the Bangalore Life Sciences Cluster (BLiSC) campus. CONCLUSION: These results suggest that saliva may be a viable alternate source for SARS-CoV-2 surveillance if samples are processed immediately. Although saliva shows slightly lower sensitivity levels when compared to N/OPS-VTM, saliva collection is logistically advantageous. We strongly recommend the implementation of saliva-based screening strategies for large workplaces and in schools, as well as for population-level screening and routine surveillance as we learn to live with the SARS-CoV-2 virus. |
DOI | 10.1016/j.ijmmb.2023.100384 |
Alternate Journal | Indian J Med Microbiol |
PubMed ID | 37573057 |
PubMed Central ID | PMC10231307 |
Grant List | / WT_ / Wellcome Trust / United Kingdom |