Wong Sally Cheuk Ying, Tse Herman, Siu Hon Kei, Kwong Tsz Shan, Chu Man Yee, Yau Felix Yat Sun, Cheung Ingrid Yu Ying, Tse Cindy Wing Sze, Poon Kin Chiu, Cheung Kwok Chi, Wu Tak Chiu, Chan Johnny Wai Man, Cheuk Wah, Lung David Christopher
Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, Hong Kong.
Infection Control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, Hong Kong.
Clin Infect Dis. 2020 Dec 31;71(11):2939-2946. doi: 10.1093/cid/ciaa797.
The coronavirus disease 2019 (COVID-19) pandemic has put tremendous pressure on the healthcare system worldwide. Diagnostic testing remained one of the limiting factors for early identification and isolation of infected patients. This study aimed to evaluate posterior oropharyngeal saliva (POPS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection among patients with confirmed or suspected COVID-19.
The laboratory information system was searched retrospectively for all respiratory specimens and POPS requested for SARS-CoV-2 RNA detection between 1 February 2020 and 15 April 2020. The agreement and diagnostic performance of POPS against NPsp were evaluated.
A total of 13772 specimens were identified during the study period, including 2130 POPS and 8438 nasopharyngeal specimens (NPsp). Two hundred and twenty-nine same-day POPS-NPsp paired were identified with POPS and NPsp positivity of 61.5% (95% confidence interval [CI] 55.1-67.6%) and 53.3% (95% CI 46.8-59.6%). The overall, negative and positive percent agreement were 76.0% (95% CI 70.2-80.9%), 65.4% (95% CI 55.5-74.2%), 85.2% (95% CI 77.4-90.8%). Better positive percent agreement was observed in POPS-NPsp obtained within 7 days (96.6%, 95% CI 87.3-99.4%) compared with after 7 days of symptom onset (75.0%, 95% CI 61.4-85.2%). Among the 104 positive pairs, the mean difference in Cp value was 0.26 (range: 12.63 to -14.74), with an overall higher Cp value in NPsp (Pearson coefficient 0.579). No significant temporal variation was noted between the 2 specimen types.
POPS is an acceptable alternative specimen to nasopharyngeal specimen for the detection of SARS-CoV-2.
2019年冠状病毒病（COVID-19）大流行给全球医疗系统带来了巨大压力。诊断检测仍然是早期识别和隔离感染患者的限制因素之一。本研究旨在评估后口咽唾液（POPS）在确诊或疑似COVID-19患者中检测严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的情况。
回顾性检索实验室信息系统，查找2020年2月1日至2020年4月15日期间所有用于SARS-CoV-2 RNA检测的呼吸道标本和POPS。评估POPS与鼻咽拭子（NPsp）的一致性和诊断性能。
研究期间共识别出13772份标本，包括2130份POPS和8438份鼻咽标本（NPsp）。确定了229对同日的POPS-NPsp，其中POPS和NPsp的阳性率分别为61.5%（95%置信区间[CI]55.1-67.6%）和53.3%（95%CI 46.8-59.6%）。总体、阴性和阳性百分比一致性分别为76.0%（95%CI 70.2-80.9%）、65.4%（95%CI 55.5-74.2%）、85.2%（95%CI 77.4-90.8%）。与症状出现7天后获得的POPS-NPsp相比，在7天内获得的POPS-NPsp中观察到更好的阳性百分比一致性（96.6%，95%CI 87.3-99.4%）（75.0%，95%CI 61.4-85.2%）。在104对阳性配对中，Cp值的平均差异为0.26（范围：12.63至-14.74），NPsp中的Cp值总体较高（皮尔逊系数0.579）。两种标本类型之间未观察到明显的时间变化。
POPS是用于检测SARS-CoV-2的鼻咽标本的可接受替代标本。
