From the Department of Laboratory Medicine (Jo, Jungrok Kim, S. Kim, Jingyeong Kim, H. Kwon, Y. Kwon, H. Kim, J. Lee), Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
The Infectious Disease Laboratory Research Center (Jo, S. Kim, Jingyeong Kim, J. Lee), Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Arch Pathol Lab Med. 2022 Dec 1;146(12):1435-1440. doi: 10.5858/arpa.2022-0298-SA.
CONTEXT.—: The use of saliva samples for diagnosis of SARS-CoV-2 infection offers several advantages, including ease of sample collection, feasibility of self-collection, and minimization of medical staff exposure to infection. The emergence of new SARS-CoV-2 variants has had an impact on the viral load of specimens and the results of real-time reverse transcription-polymerase chain reaction (rRT-PCR).
OBJECTIVE.—: To compare nasopharyngeal swab and saliva samples for the diagnosis of SARS-CoV-2 using rRT-PCR.
DESIGN.—: In this study, participants were recruited prospectively, and paired nasopharyngeal swab and saliva samples were collected simultaneously from each participant. After adding universal transport medium, RNA was extracted in an identical manner for both sample types, and samples were tested using rRT-PCR. In addition, samples with positive results were tested for SARS-CoV-2 variants.
RESULTS.—: Of the 338 paired samples, 100 nasopharyngeal swab and 101 saliva samples tested positive for SARS-CoV-2. The rRT-PCR results of the saliva and nasopharyngeal swab samples showed a positive percent agreement of 95.0% (95% CI, 88.7%-98.4%), a negative percent agreement of 97.9% (95% CI, 95.2%-99.3%), and an overall percent agreement of 96.8% (95% CI, 94.3%-98.4%). SARS-CoV-2 was detected in the saliva samples of 6 participants with negative nasopharyngeal sample results. In addition, the sensitivity of saliva samples was similar to that of nasopharyngeal samples for detecting various SARS-CoV-2 variants, including the Omicron variant.
CONCLUSIONS.—: Saliva samples can be used as an alternative to nasopharyngeal samples for convenient and effective detection of various SARS-CoV-2 variants.
唾液样本用于 SARS-CoV-2 感染的诊断具有多项优势，包括采集样本的便利性、自我采集的可行性以及最大限度减少医务人员感染的风险。新的 SARS-CoV-2 变异株的出现对标本的病毒载量和实时逆转录聚合酶链反应（rRT-PCR）的结果产生了影响。
比较鼻咽拭子和唾液样本用于 rRT-PCR 检测 SARS-CoV-2 的效果。
在这项研究中，前瞻性地招募了参与者，并对每位参与者同时采集了配对的鼻咽拭子和唾液样本。在添加通用转运培养基后，以相同的方式从两种样本类型中提取 RNA，并使用 rRT-PCR 对样本进行检测。此外，对阳性结果样本进行了 SARS-CoV-2 变异株的检测。
在 338 对样本中，100 份鼻咽拭子和 101 份唾液样本检测出 SARS-CoV-2 呈阳性。唾液和鼻咽拭子样本的 rRT-PCR 结果显示，阳性符合率为 95.0%（95%置信区间，88.7%-98.4%），阴性符合率为 97.9%（95%置信区间，95.2%-99.3%），总符合率为 96.8%（95%置信区间，94.3%-98.4%）。在鼻咽拭子样本结果为阴性的 6 名参与者的唾液样本中检测到了 SARS-CoV-2。此外，唾液样本的灵敏度与鼻咽样本相似，可用于检测各种 SARS-CoV-2 变异株，包括奥密克戎变异株。
唾液样本可替代鼻咽样本，用于方便、有效地检测各种 SARS-CoV-2 变异株。
