Multiplatform Assessment of Saliva for SARS-CoV-2 Molecular Detection in Symptomatic Healthcare Personnel and Patients Presenting to the Emergency Department

Robert F. Potter, Eric M. Ransom, Meghan A. Wallace, Caitlin Johnson, Jennie H. Kwon, Hilary M. Babcock, Charles S. Eby, Neil W. Anderson, Bijal A. Parikh, Carey Ann D. Burnham

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Saliva has garnered great interest as an alternative specimen type for molecular detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data are limited on the relative performance of different molecular methods using saliva specimens and the relative sensitivity of saliva to nasopharyngeal (NP) swabs. Methods: To address the gap in knowledge, we enrolled symptomatic healthcare personnel (n = 250) from Barnes-Jewish Hospital/Washington University Medical Center and patients presenting to the Emergency Department with clinical symptoms compatible with coronavirus disease 2019 (COVID-19; n = 292). We collected paired saliva specimens and NP swabs. The Lyra SARS-CoV-2 assay (Quidel) was evaluated on paired saliva and NP samples. Subsequently we compared the Simplexa COVID-19 Direct Kit (Diasorin) and a modified SalivaDirect (Yale) assay on a subset of positive and negative saliva specimens. Results: The positive percent agreement (PPA) between saliva and NP samples using the Lyra SARS-CoV-2 assay was 63.2%. Saliva samples had higher SARS-CoV-2 cycle threshold values compared to NP swabs (P < 0.0001). We found a 76.47% (26/34) PPA for Simplexa COVID-19 Direct Kit on saliva and a 67.6% (23/34) PPA for SalivaDirect compared to NP swab results. Conclusion: These data demonstrate molecular assays have variability in performance for detection of SARS-CoV-2 in saliva.

Original languageEnglish
Pages (from-to)727-736
Number of pages10
JournalThe journal of applied laboratory medicine
Volume7
Issue number3
DOIs
StatePublished - May 1 2022

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