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Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection
Early detection of SARS-CoV-2 infection is critical to reduce asymptomatic and presymptomatic transmission, curb the spread of variants, and maximize treatment efficacy. Low-analytical-sensitivity nasal-swab testing is commonly used for surveillance and symptomatic testing, but the ability of these...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Society for Microbiology
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849374/ https://www.ncbi.nlm.nih.gov/pubmed/34911366 http://dx.doi.org/10.1128/jcm.01785-21 |
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author | Savela, Emily S. Viloria Winnett, Alexander Romano, Anna E. Porter, Michael K. Shelby, Natasha Akana, Reid Ji, Jenny Cooper, Matthew M. Schlenker, Noah W. Reyes, Jessica A. Carter, Alyssa M. Barlow, Jacob T. Tognazzini, Colten Feaster, Matthew Goh, Ying-Ying Ismagilov, Rustem F. |
author_facet | Savela, Emily S. Viloria Winnett, Alexander Romano, Anna E. Porter, Michael K. Shelby, Natasha Akana, Reid Ji, Jenny Cooper, Matthew M. Schlenker, Noah W. Reyes, Jessica A. Carter, Alyssa M. Barlow, Jacob T. Tognazzini, Colten Feaster, Matthew Goh, Ying-Ying Ismagilov, Rustem F. |
author_sort | Savela, Emily S. |
collection | PubMed |
description | Early detection of SARS-CoV-2 infection is critical to reduce asymptomatic and presymptomatic transmission, curb the spread of variants, and maximize treatment efficacy. Low-analytical-sensitivity nasal-swab testing is commonly used for surveillance and symptomatic testing, but the ability of these tests to detect the earliest stages of infection has not been established. In this study, conducted between September 2020 and June 2021 in the greater Los Angeles County, California, area, initially SARS-CoV-2-negative household contacts of individuals diagnosed with COVID-19 prospectively self-collected paired anterior-nares nasal-swab and saliva samples twice daily for viral-load quantification by high-sensitivity reverse-transcription quantitative PCR (RT-qPCR) and digital-RT-PCR assays. We captured viral-load profiles from the incidence of infection for seven individuals and compared diagnostic sensitivities between respiratory sites. Among unvaccinated persons, testing saliva with a high-analytical-sensitivity assay detected infection up to 4.5 days before viral loads in nasal swabs reached concentrations detectable by low-analytical-sensitivity nasal-swab tests. For most participants, nasal swabs reached higher peak viral loads than saliva but were undetectable or at lower loads during the first few days of infection. High-analytical-sensitivity saliva testing was most reliable for earliest detection. Our study illustrates the value of acquiring early (within hours after a negative high-sensitivity test) viral-load profiles to guide the appropriate analytical sensitivity and respiratory site for detecting earliest infections. Such data are challenging to acquire but critical to designing optimal testing strategies with emerging variants in the current pandemic and to respond to future viral pandemics. |
format | Online Article Text |
id | pubmed-8849374 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Society for Microbiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-88493742022-03-03 Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection Savela, Emily S. Viloria Winnett, Alexander Romano, Anna E. Porter, Michael K. Shelby, Natasha Akana, Reid Ji, Jenny Cooper, Matthew M. Schlenker, Noah W. Reyes, Jessica A. Carter, Alyssa M. Barlow, Jacob T. Tognazzini, Colten Feaster, Matthew Goh, Ying-Ying Ismagilov, Rustem F. J Clin Microbiol Epidemiology Early detection of SARS-CoV-2 infection is critical to reduce asymptomatic and presymptomatic transmission, curb the spread of variants, and maximize treatment efficacy. Low-analytical-sensitivity nasal-swab testing is commonly used for surveillance and symptomatic testing, but the ability of these tests to detect the earliest stages of infection has not been established. In this study, conducted between September 2020 and June 2021 in the greater Los Angeles County, California, area, initially SARS-CoV-2-negative household contacts of individuals diagnosed with COVID-19 prospectively self-collected paired anterior-nares nasal-swab and saliva samples twice daily for viral-load quantification by high-sensitivity reverse-transcription quantitative PCR (RT-qPCR) and digital-RT-PCR assays. We captured viral-load profiles from the incidence of infection for seven individuals and compared diagnostic sensitivities between respiratory sites. Among unvaccinated persons, testing saliva with a high-analytical-sensitivity assay detected infection up to 4.5 days before viral loads in nasal swabs reached concentrations detectable by low-analytical-sensitivity nasal-swab tests. For most participants, nasal swabs reached higher peak viral loads than saliva but were undetectable or at lower loads during the first few days of infection. High-analytical-sensitivity saliva testing was most reliable for earliest detection. Our study illustrates the value of acquiring early (within hours after a negative high-sensitivity test) viral-load profiles to guide the appropriate analytical sensitivity and respiratory site for detecting earliest infections. Such data are challenging to acquire but critical to designing optimal testing strategies with emerging variants in the current pandemic and to respond to future viral pandemics. American Society for Microbiology 2022-02-16 /pmc/articles/PMC8849374/ /pubmed/34911366 http://dx.doi.org/10.1128/jcm.01785-21 Text en Copyright © 2022 Savela et al. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Epidemiology Savela, Emily S. Viloria Winnett, Alexander Romano, Anna E. Porter, Michael K. Shelby, Natasha Akana, Reid Ji, Jenny Cooper, Matthew M. Schlenker, Noah W. Reyes, Jessica A. Carter, Alyssa M. Barlow, Jacob T. Tognazzini, Colten Feaster, Matthew Goh, Ying-Ying Ismagilov, Rustem F. Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection |
title | Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection |
title_full | Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection |
title_fullStr | Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection |
title_full_unstemmed | Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection |
title_short | Quantitative SARS-CoV-2 Viral-Load Curves in Paired Saliva Samples and Nasal Swabs Inform Appropriate Respiratory Sampling Site and Analytical Test Sensitivity Required for Earliest Viral Detection |
title_sort | quantitative sars-cov-2 viral-load curves in paired saliva samples and nasal swabs inform appropriate respiratory sampling site and analytical test sensitivity required for earliest viral detection |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849374/ https://www.ncbi.nlm.nih.gov/pubmed/34911366 http://dx.doi.org/10.1128/jcm.01785-21 |
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