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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2022
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.
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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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