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Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019.J Infect Dis. 2020 10 13; 222(10):1612-1619.JI
Abstract
BACKGROUND
Self-collected specimens have been advocated to avoid infectious exposure to healthcare workers. Self-induced sputum in those with a productive cough and saliva in those without a productive cough have been proposed, but sensitivity remains uncertain.
METHODS
We performed a prospective study in 2 regional hospitals in Hong Kong.
RESULTS
We prospectively examined 563 serial samples collected during the virus shedding periods of 50 patients: 150 deep throat saliva (DTS), 309 pooled-nasopharyngeal (NP) and throat swabs, and 104 sputum. Deep throat saliva had the lowest overall reverse-transcriptase polymerase chain reaction (RT-PCR)-positive rate (68.7% vs 89.4% [sputum] and 80.9% [pooled NP and throat swabs]) and the lowest viral ribonucleic acid (RNA) concentration (mean log copy/mL 3.54 vs 5.03 [sputum] and 4.63 [pooled NP and throat swabs]). Analyses with respect to time from symptom onset and severity also revealed similar results. Virus yields of DTS correlated with that of sputum (Pearson correlation index 0.76; 95% confidence interval, 0.62-0.86). We estimated that the overall false-negative rate of DTS could be as high as 31.3% and increased 2.7 times among patients without sputum.
CONCLUSIONS
Deep throat saliva produced the lowest viral RNA concentration and RT-PCR-positive rate compared with conventional respiratory specimens in all phases of illness. Self-collected sputum should be the choice for patients with sputum.
Links
MeSH
AdolescentAdultAgedBetacoronavirusCOVID-19COVID-19 TestingCOVID-19 VaccinesClinical Laboratory TechniquesCoronavirus InfectionsFemaleHong KongHumansMaleMiddle AgedNasopharynxPandemicsPneumonia, ViralProspective StudiesRNA, ViralReal-Time Polymerase Chain ReactionReverse Transcriptase Polymerase Chain ReactionSARS-CoV-2SalivaSpecimen HandlingSputumYoung Adult
Pub Type(s)
Journal Article
Research Support, Non-U.S. Gov't
Language
eng
PubMed ID
32738137
Clinical Trial Links
Citation
Lai, Christopher K C., et al. "Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019." The Journal of Infectious Diseases, vol. 222, no. 10, 2020, pp. 1612-1619.
Lai CKC, Chen Z, Lui G, et al. Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019. J Infect Dis. 2020;222(10):1612-1619.
Lai, C. K. C., Chen, Z., Lui, G., Ling, L., Li, T., Wong, M. C. S., Ng, R. W. Y., Tso, E. Y. K., Ho, T., Fung, K. S. C., Ng, S. T., Wong, B. K. C., Boon, S. S., Hui, D. S. C., & Chan, P. K. S. (2020). Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019. The Journal of Infectious Diseases, 222(10), 1612-1619. https://doi.org/10.1093/infdis/jiaa487
Lai CKC, et al. Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019. J Infect Dis. 2020 10 13;222(10):1612-1619. PubMed PMID: 32738137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019.
AU - Lai,Christopher K C,
AU - Chen,Zigui,
AU - Lui,Grace,
AU - Ling,Lowell,
AU - Li,Timothy,
AU - Wong,Martin C S,
AU - Ng,Rita W Y,
AU - Tso,Eugene Y K,
AU - Ho,Tracy,
AU - Fung,Kitty S C,
AU - Ng,Siu T,
AU - Wong,Barry K C,
AU - Boon,Siaw S,
AU - Hui,David S C,
AU - Chan,Paul K S,
PY - 2020/07/03/received
PY - 2020/07/30/accepted
PY - 2020/8/2/pubmed
PY - 2020/11/3/medline
PY - 2020/8/2/entrez
KW - COVID-19
KW - SARS-CoV-2
KW - coronavirus
KW - diagnosis
KW - saliva
SP - 1612
EP - 1619
JF - The Journal of infectious diseases
JO - J Infect Dis
VL - 222
IS - 10
N2 - BACKGROUND: Self-collected specimens have been advocated to avoid infectious exposure to healthcare workers. Self-induced sputum in those with a productive cough and saliva in those without a productive cough have been proposed, but sensitivity remains uncertain. METHODS: We performed a prospective study in 2 regional hospitals in Hong Kong. RESULTS: We prospectively examined 563 serial samples collected during the virus shedding periods of 50 patients: 150 deep throat saliva (DTS), 309 pooled-nasopharyngeal (NP) and throat swabs, and 104 sputum. Deep throat saliva had the lowest overall reverse-transcriptase polymerase chain reaction (RT-PCR)-positive rate (68.7% vs 89.4% [sputum] and 80.9% [pooled NP and throat swabs]) and the lowest viral ribonucleic acid (RNA) concentration (mean log copy/mL 3.54 vs 5.03 [sputum] and 4.63 [pooled NP and throat swabs]). Analyses with respect to time from symptom onset and severity also revealed similar results. Virus yields of DTS correlated with that of sputum (Pearson correlation index 0.76; 95% confidence interval, 0.62-0.86). We estimated that the overall false-negative rate of DTS could be as high as 31.3% and increased 2.7 times among patients without sputum. CONCLUSIONS: Deep throat saliva produced the lowest viral RNA concentration and RT-PCR-positive rate compared with conventional respiratory specimens in all phases of illness. Self-collected sputum should be the choice for patients with sputum.
SN - 1537-6613
UR - https://www.unboundmedicine.com/medline/citation/32738137/Prospective_Study_Comparing_Deep_Throat_Saliva_With_Other_Respiratory_Tract_Specimens_in_the_Diagnosis_of_Novel_Coronavirus_Disease_2019_
L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiaa487
DB - PRIME
DP - Unbound Medicine
ER -
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