Calvet, Guilherme; Ogrzewalska, Maria; Tassinari, Wagner; Guaraldo, Lusiele; Resende, Paola; Fuller, Trevon; Penetra, Stephanie; Borges, Michele; Pina-Costa, Anielle; Martins, Ezequias; +12 more... Moraes, Isabella; Santos, Heloisa; Damasceno, Luana; Medeiros-Filho, Fernando; Espindola, Otavio; Mota, Fernando; Nacife, Valéria; Pauvolid-Corrêa, Alex; Whitworth, Jimmy; Smith, Chris; Siqueira, Marilda; Brasil, Patrícia; (2023) Accuracy of saliva for SARS-CoV-2 detection in outpatients and their household contacts during the circulation of the Omicron variant of concern. BMC infectious diseases, 23 (1). 295-. ISSN 1471-2334 DOI: https://doi.org/10.1186/s12879-023-08271-3
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Abstract
BACKGROUND: While nasopharyngeal (NP) swabs are considered the gold standard for severe acute respiratory coronavirus 2 (SARS-CoV-2) real-time reverse transcriptase-polymerase chain reaction (RT-PCR) detection, several studies have shown that saliva is an alternative specimen for COVID-19 diagnosis and screening. METHODS: To analyze the utility of saliva for the diagnosis of COVID-19 during the circulation of the Omicron variant, participants were enrolled in an ongoing cohort designed to assess the natural history of SARS-CoV-2 infection in adults and children. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa coefficient were calculated to assess diagnostic performance. RESULTS: Overall, 818 samples were collected from 365 outpatients from January 3 to February 2, 2022. The median age was 32.8 years (range: 3-94 years). RT-PCR for SARS-CoV-2 was confirmed in 97/121 symptomatic patients (80.2%) and 62/244 (25.4%) asymptomatic patients. Substantial agreement between saliva and combined nasopharyngeal/oropharyngeal samples was observed with a Cohen's kappa value of 0.74 [95% confidence interval (CI): 0.67-0.81]. Sensitivity was 77% (95% CI: 70.9-82.2), specificity 95% (95% CI: 91.9-97), PPV 89.8% (95% CI: 83.1-94.4), NPV 87.9% (95% CI: 83.6-91.5), and accuracy 88.5% (95% CI: 85.0-91.4). Sensitivity was higher among samples collected from symptomatic children aged three years and older and adolescents [84% (95% CI: 70.5-92)] with a Cohen's kappa value of 0.63 (95% CI: 0.35-0.91). CONCLUSIONS: Saliva is a reliable fluid for detecting SARS-CoV-2, especially in symptomatic children and adolescents during the circulation of the Omicron variant.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023) Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Elements ID | 203011 |
Official URL | http://dx.doi.org/10.1186/s12879-023-08271-3 |
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