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Saliva specimen complements anal swab in assessing patients with COVID-19 for discharge from hospital.
Emerg Microbes Infect. 2021 Dec; 10(1):2090-2097.EM

Abstract

Since December 2019, coronavirus disease 2019 (COVID-19) caused by SARS coronavirus 2 (SARS-CoV-2) has spread and threatens public health worldwide. The recurrence of SARS-CoV-2 RNA detection in patients after discharge from hospital signals a risk of transmission from such patients to the community and challenges the current discharge criteria of COVID-19 patients. A wide range of clinical specimens has been used to detect SARS-CoV-2. However, to date, a consensus has not been reached regarding the most appropriate specimens to use for viral RNA detection in assessing COVID-19 patients for discharge. An anal swab sample was proposed as the standard because of prolonged viral detection. In this retrospective longitudinal study of viral RNA detection in 60 confirmed COVID-19 patients, we used saliva, oropharyngeal/nasopharyngeal swab (O/N swab) and anal swab procedures from admission to discharge. The conversion times of saliva and anal swab were longer than that of O/N swab. The conversion time of hyper sensitive-CRP was the shortest and correlated with that of CT scanning and viral detection. Some patients were found to be RNA-positive in saliva while RNA-negative in anal swab while the reverse was true in some other patients, which indicated that false negatives were inevitable if only the anal swab is used for evaluating suitability for discharge. These results indicated that double-checking for viral RNA using multiple and diverse specimens was essential, and saliva could be a candidate to supplement anal swabs to reduce false-negative results and facilitate pandemic control.

Authors+Show Affiliations

Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.Shanghai Public Health Clinical Center, Fudan University, Shanghai, People's Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34689717

Citation

Qiu, Chenghao, et al. "Saliva Specimen Complements Anal Swab in Assessing Patients With COVID-19 for Discharge From Hospital." Emerging Microbes & Infections, vol. 10, no. 1, 2021, pp. 2090-2097.
Qiu C, Song Z, Wang J, et al. Saliva specimen complements anal swab in assessing patients with COVID-19 for discharge from hospital. Emerg Microbes Infect. 2021;10(1):2090-2097.
Qiu, C., Song, Z., Wang, J., Tian, C., Liu, X., Wu, T., Li, W., Zhang, S., & Lu, H. (2021). Saliva specimen complements anal swab in assessing patients with COVID-19 for discharge from hospital. Emerging Microbes & Infections, 10(1), 2090-2097. https://doi.org/10.1080/22221751.2021.1997339
Qiu C, et al. Saliva Specimen Complements Anal Swab in Assessing Patients With COVID-19 for Discharge From Hospital. Emerg Microbes Infect. 2021;10(1):2090-2097. PubMed PMID: 34689717.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Saliva specimen complements anal swab in assessing patients with COVID-19 for discharge from hospital. AU - Qiu,Chenghao, AU - Song,Zhigang, AU - Wang,Jing, AU - Tian,Cheng, AU - Liu,Xingzhe, AU - Wu,Tingting, AU - Li,Weisong, AU - Zhang,Shulin, AU - Lu,Hongzhou, PY - 2021/10/26/pubmed PY - 2021/11/16/medline PY - 2021/10/25/entrez KW - COVID-19 KW - clinical specimen KW - conversion days KW - discharge KW - recurrent of viral detection SP - 2090 EP - 2097 JF - Emerging microbes & infections JO - Emerg Microbes Infect VL - 10 IS - 1 N2 - Since December 2019, coronavirus disease 2019 (COVID-19) caused by SARS coronavirus 2 (SARS-CoV-2) has spread and threatens public health worldwide. The recurrence of SARS-CoV-2 RNA detection in patients after discharge from hospital signals a risk of transmission from such patients to the community and challenges the current discharge criteria of COVID-19 patients. A wide range of clinical specimens has been used to detect SARS-CoV-2. However, to date, a consensus has not been reached regarding the most appropriate specimens to use for viral RNA detection in assessing COVID-19 patients for discharge. An anal swab sample was proposed as the standard because of prolonged viral detection. In this retrospective longitudinal study of viral RNA detection in 60 confirmed COVID-19 patients, we used saliva, oropharyngeal/nasopharyngeal swab (O/N swab) and anal swab procedures from admission to discharge. The conversion times of saliva and anal swab were longer than that of O/N swab. The conversion time of hyper sensitive-CRP was the shortest and correlated with that of CT scanning and viral detection. Some patients were found to be RNA-positive in saliva while RNA-negative in anal swab while the reverse was true in some other patients, which indicated that false negatives were inevitable if only the anal swab is used for evaluating suitability for discharge. These results indicated that double-checking for viral RNA using multiple and diverse specimens was essential, and saliva could be a candidate to supplement anal swabs to reduce false-negative results and facilitate pandemic control. SN - 2222-1751 UR - https://www.unboundmedicine.com/medline/citation/34689717/Saliva_specimen_complements_anal_swab_in_assessing_patients_with_COVID_19_for_discharge_from_hospital_ L2 - https://www.tandfonline.com/doi/full/10.1080/22221751.2021.1997339 DB - PRIME DP - Unbound Medicine ER -