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Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-center cross-sectional study.
Virulence. 2020 12; 11(1):1394-1401.V

Abstract

We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p < 0.01). Patients were divided according to time span from onset of illness to sample collection into the more-than-30-day (n = 26) and less-than-30-day (n = 30) groups. The positive rate for induced sputum was also significantly higher than for throat swabs in the less-than-30-day group (53.3% vs 10.0%, respectively; p < 0.001). For the more-than-30-day group, all paired samples were negative for SARS-CoV-2. Blood oxygen saturation, respiratory rate, and heart rate remained stable during sputum induction and no staff were infected. Because induced sputum is more reliable and has a lower false-negative rate than throat swabs, we believe induced sputum is more useful for the confirmation of COVID-19 and is safer as a criterion for release from quarantine.

Authors+Show Affiliations

Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University , Guangzhou, Guangdong, China.Department of Pulmonary Medicine and Tuberculosis, The Third People's Hospital of Shenzhen , Shenzhen, Guangdong, China.Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University , Nanjing, Jiangsu, China.Department of Respiratory Medicine, Huanggang Central Hospital , Huanggang, Hubei, China.Department of Intensive Care Medicine, The First Affiliated Hospital of Soochow University , Suzhou, Jiangsu, China.Department of Clinical Research, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University , Nanjing, Jiangsu, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33073676

Citation

Lai, Tianwen, et al. "Reliability of Induced Sputum Test Is Greater Than That of Throat Swab Test for Detecting SARS-CoV-2 in Patients With COVID-19: a Multi-center Cross-sectional Study." Virulence, vol. 11, no. 1, 2020, pp. 1394-1401.
Lai T, Xiang F, Zeng J, et al. Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-center cross-sectional study. Virulence. 2020;11(1):1394-1401.
Lai, T., Xiang, F., Zeng, J., Huang, Y., Jia, L., Chen, H., Wu, J., Xie, J., Liu, S., Deng, W., Zheng, W., Huang, Y., Zhang, Q., Luo, Q., Mo, F., Long, L., Zhang, W., Chen, W., & Han, H. (2020). Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-center cross-sectional study. Virulence, 11(1), 1394-1401. https://doi.org/10.1080/21505594.2020.1831342
Lai T, et al. Reliability of Induced Sputum Test Is Greater Than That of Throat Swab Test for Detecting SARS-CoV-2 in Patients With COVID-19: a Multi-center Cross-sectional Study. Virulence. 2020;11(1):1394-1401. PubMed PMID: 33073676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-center cross-sectional study. AU - Lai,Tianwen, AU - Xiang,Fangfei, AU - Zeng,Jianfeng, AU - Huang,Yingzi, AU - Jia,Liping, AU - Chen,Hui, AU - Wu,Jiayuan, AU - Xie,Jianfeng, AU - Liu,Shuna, AU - Deng,Wei, AU - Zheng,Weiqiang, AU - Huang,Yang, AU - Zhang,Qinfu, AU - Luo,Qingfeng, AU - Mo,Fan, AU - Long,Lieming, AU - Zhang,Wuying, AU - Chen,Wenna, AU - Han,Huanqin, PY - 2020/10/19/entrez PY - 2020/10/20/pubmed PY - 2020/11/3/medline KW - COVID-19 KW - SARS-CoV-2 KW - induced sputum KW - reliability KW - throat swab SP - 1394 EP - 1401 JF - Virulence JO - Virulence VL - 11 IS - 1 N2 - We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p < 0.01). Patients were divided according to time span from onset of illness to sample collection into the more-than-30-day (n = 26) and less-than-30-day (n = 30) groups. The positive rate for induced sputum was also significantly higher than for throat swabs in the less-than-30-day group (53.3% vs 10.0%, respectively; p < 0.001). For the more-than-30-day group, all paired samples were negative for SARS-CoV-2. Blood oxygen saturation, respiratory rate, and heart rate remained stable during sputum induction and no staff were infected. Because induced sputum is more reliable and has a lower false-negative rate than throat swabs, we believe induced sputum is more useful for the confirmation of COVID-19 and is safer as a criterion for release from quarantine. SN - 2150-5608 UR - https://www.unboundmedicine.com/medline/citation/33073676/Reliability_of_induced_sputum_test_is_greater_than_that_of_throat_swab_test_for_detecting_SARS_CoV_2_in_patients_with_COVID_19:_A_multi_center_cross_sectional_study_ L2 - https://www.tandfonline.com/doi/full/10.1080/21505594.2020.1831342 DB - PRIME DP - Unbound Medicine ER -