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Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing

Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical to tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in tes...

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Autores principales: Griesemer, Sara B., Van Slyke, Greta, Ehrbar, Dylan, Strle, Klemen, Yildirim, Tugba, Centurioni, Dominick A., Walsh, Anne C., Chang, Andrew K., Waxman, Michael J., St. George, Kirsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091857/
https://www.ncbi.nlm.nih.gov/pubmed/33674284
http://dx.doi.org/10.1128/JCM.01418-20
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author Griesemer, Sara B.
Van Slyke, Greta
Ehrbar, Dylan
Strle, Klemen
Yildirim, Tugba
Centurioni, Dominick A.
Walsh, Anne C.
Chang, Andrew K.
Waxman, Michael J.
St. George, Kirsten
author_facet Griesemer, Sara B.
Van Slyke, Greta
Ehrbar, Dylan
Strle, Klemen
Yildirim, Tugba
Centurioni, Dominick A.
Walsh, Anne C.
Chang, Andrew K.
Waxman, Michael J.
St. George, Kirsten
author_sort Griesemer, Sara B.
collection PubMed
description Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical to tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in testing and consequent supply strain. Therefore, alternative specimen types have been investigated that provide similar detection sensitivity with reduced health care exposure and the potential for self-collection. In this study, the detection sensitivity of SARS-CoV-2 in nasal swabs (NS) and saliva was compared to that of NPS using matched specimens from two outpatient cohorts in New York State (total n = 463). The first cohort showed only a 5.4% positivity, but the second cohort (n = 227) had a positivity rate of 41%, with sensitivity in NPS, NS, and saliva of 97.9%, 87.1%, and 87.1%, respectively. Whether the reduced sensitivity of NS or saliva is acceptable must be assessed in the settings where they are used. However, we sought to improve on it by validating a method to mix the two sample types, as the combination of nasal swab and saliva resulted in 94.6% SARS-CoV-2 detection sensitivity. Spiking experiments showed that combining them did not adversely affect the detection sensitivity in either. Virus stability in saliva was also investigated, with and without the addition of commercially available stabilizing solutions. The virus was stable in saliva at both 4°C and room temperature for up to 7 days. The addition of stabilizing solutions did not enhance stability and, in some situations, reduced detectable virus levels.
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spelling pubmed-80918572021-05-18 Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing Griesemer, Sara B. Van Slyke, Greta Ehrbar, Dylan Strle, Klemen Yildirim, Tugba Centurioni, Dominick A. Walsh, Anne C. Chang, Andrew K. Waxman, Michael J. St. George, Kirsten J Clin Microbiol Virology Identifying SARS-CoV-2 infections through aggressive diagnostic testing remains critical to tracking and curbing the spread of the COVID-19 pandemic. Collection of nasopharyngeal swabs (NPS), the preferred sample type for SARS-CoV-2 detection, has become difficult due to the dramatic increase in testing and consequent supply strain. Therefore, alternative specimen types have been investigated that provide similar detection sensitivity with reduced health care exposure and the potential for self-collection. In this study, the detection sensitivity of SARS-CoV-2 in nasal swabs (NS) and saliva was compared to that of NPS using matched specimens from two outpatient cohorts in New York State (total n = 463). The first cohort showed only a 5.4% positivity, but the second cohort (n = 227) had a positivity rate of 41%, with sensitivity in NPS, NS, and saliva of 97.9%, 87.1%, and 87.1%, respectively. Whether the reduced sensitivity of NS or saliva is acceptable must be assessed in the settings where they are used. However, we sought to improve on it by validating a method to mix the two sample types, as the combination of nasal swab and saliva resulted in 94.6% SARS-CoV-2 detection sensitivity. Spiking experiments showed that combining them did not adversely affect the detection sensitivity in either. Virus stability in saliva was also investigated, with and without the addition of commercially available stabilizing solutions. The virus was stable in saliva at both 4°C and room temperature for up to 7 days. The addition of stabilizing solutions did not enhance stability and, in some situations, reduced detectable virus levels. American Society for Microbiology 2021-04-20 /pmc/articles/PMC8091857/ /pubmed/33674284 http://dx.doi.org/10.1128/JCM.01418-20 Text en Copyright © 2021 American Society for Microbiology. https://doi.org/10.1128/ASMCopyrightv2All Rights Reserved (https://doi.org/10.1128/ASMCopyrightv2) . https://doi.org/10.1128/ASMCopyrightv2This article is made available via the PMC Open Access Subset for unrestricted noncommercial re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Virology
Griesemer, Sara B.
Van Slyke, Greta
Ehrbar, Dylan
Strle, Klemen
Yildirim, Tugba
Centurioni, Dominick A.
Walsh, Anne C.
Chang, Andrew K.
Waxman, Michael J.
St. George, Kirsten
Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
title Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
title_full Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
title_fullStr Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
title_full_unstemmed Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
title_short Evaluation of Specimen Types and Saliva Stabilization Solutions for SARS-CoV-2 Testing
title_sort evaluation of specimen types and saliva stabilization solutions for sars-cov-2 testing
topic Virology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091857/
https://www.ncbi.nlm.nih.gov/pubmed/33674284
http://dx.doi.org/10.1128/JCM.01418-20
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