Spit or swab? The diagnostic accuracy of saliva-based testing as a SARS-CoV-2 surveillance tool
- Author:
Raymundo Lo, Farrah Kristine Santiago
1
;
Grig Misiona
1
;
Melani Sionzon
1
;
Danielle Anne Gonong
1
;
Jill Jaime
1
;
Jan Roman Ayco
1
;
Aquiles Joseph Lira
1
;
Erik Francis Rarugal
1
;
Jon Carlo Crisostomo
1
;
Manuel Bautista
1
;
Kenneth Chrysostom Ibarra
1
;
Eunice Jane Ciriaco
1
;
Arielle Trish Zamora
1
;
Kimberly Abundo
1
;
Emmylou Tarnate
1
;
Jonathan Nario
1
;
an Joseph Hernandez
1
;
Kathleen Mae Montes
1
;
Anabella Recio
1
Author Information
- Publication Type:Journal Article
- Keywords: qRT-PCR; Rapid antigen test; Pooling
- MeSH: SARS-CoV-2; COVID-19
- From: Philippine Journal of Pathology 2022;7(2):13-22
- CountryPhilippines
- Language:English
-
Abstract:
Background:Nasopharyngeal swab/oropharyngeal swab (NPS/OPS) qRT-PCR is the gold standard for detecting SARS-CoV-2. However, it has its own limitations including cost and invasiveness. As an alternative, individual qRT-PCR testing of saliva samples was validated and shown to be comparable in sensitivity and specificity with NP-OP qRT-PCR. To further maximize its utility, the researchers wish to explore antigen and pooled testing methods.
Objective:The study aimed to evaluate the diagnostic accuracy of detecting SARS-CoV-2 infection using saliva-based pooled qRT-PCR and rapid antigen test compared with individual saliva qRT-PCR.
Methodology:In this retrospective cross-sectional study, saliva specimen from individuals aged 18 years old and above from the outpatient specimen collection station at the Philippine Children’s Medical Center were tested individually using qRT-PCR (Mag-bind RNA Extraction Kit/MACURA, Allsheng Extraction Machine, Sansure PCR kit, and MA-600 Sansure Biotech). Non-probability convenience sampling was utilized. Based on the individual results, pools of five (5) individual specimens, which includes one (1) positive sample were tested with qRT-PCR for sensitivity. DNK-2150-1S Dynamiker SARS-CoV-2 Ag Rapid Test (Dynamiker Biotechnology Co., Ltd., Tianjin, China) was also used to test individual saliva specimens. . Out of 196 individual saliva specimens, 73 were detected to have SARS-COV-2 by qRT-PCR, while the remaining 123 were negative. Compared with the individual saliva qRT-PCR, rapid antigen tests done showed sensitivity of 46.58% (95% CI 35.13%, 58.02%), specificity of 86.18% (95% CI 80.08%, 92.28%), positive and negative predictive value of 66.67% (95% CI 53.71%, 79.60%) and 73.10% (95% CI 65.89%, 80.32%) respectively. Based on the results of individual saliva-based qRT-PCR, 62 pools were tested and showed sensitivity of 98.39% (95% CI 91.34%, 99.96%).
Conclusion and Recommendation:Pooled saliva-based testing for SARS-CoV-2 is comparable with individual saliva-based rapid antigen testing. The use of rapid antigen testing is less sensitive and less specific compared with qRT-PCR consistent with prior reports. Additional studies are recommended to determine optimal conditions for testing. - Full text:21 pjp.pdf
