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High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children

Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
Division of Infectious Diseases and Hospital Hygiene, Spital Limmattal, 8952 Schlieren, Switzerland
Division of Medicine, Spital Limmattal, 8952 Schlieren, Switzerland
Division of Infectious Diseases, Hospital Hygiene and Occupational Medicine, Stadtspital Triemli, 8063 Zurich, Switzerland
Emergency Department, University Hospital Zurich, 8091 Zurich, Switzerland
Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
Authors to whom correspondence should be addressed.
Shared contribution.
Academic Editor: Sofia Costa-de-Oliveira
Microorganisms 2021, 9(3), 642;
Received: 3 March 2021 / Revised: 15 March 2021 / Accepted: 16 March 2021 / Published: 19 March 2021
(This article belongs to the Section Medical Microbiology)
Rising demands for repetitive SARS-CoV-2 screens and mass testing necessitate additional test strategies. Saliva may serve as an alternative to nasopharyngeal swab (NPS) as its collection is simple, non-invasive and amenable for mass- and home testing, but its rigorous validation, particularly in children, is missing. We conducted a large-scale head-to-head comparison of SARS-CoV-2 detection by RT-PCR in saliva and NPS of 1270 adults and children reporting to outpatient test centers and an emergency unit. In total, 273 individuals were tested positive for SARS-CoV-2 in either NPS or saliva. SARS-CoV-2 RT-PCR results in the two specimens showed a high agreement (overall percent agreement = 97.8%). Despite lower viral loads in the saliva of both adults and children, detection of SARS-CoV-2 in saliva fared well compared to NPS (positive percent agreement = 92.5%). Importantly, in children, SARS-CoV-2 infections were more often detected in saliva than NPS (positive predictive value = 84.8%), underlining that NPS sampling in children can be challenging. The comprehensive parallel analysis reported here establishes saliva as a generally reliable specimen for the detection of SARS-CoV-2, with particular advantages for testing children, that is readily applicable to increase and facilitate repetitive and mass testing in adults and children. View Full-Text
Keywords: SARS-CoV-2; PCR; children; saliva SARS-CoV-2; PCR; children; saliva
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MDPI and ACS Style

Huber, M.; Schreiber, P.W.; Scheier, T.; Audigé, A.; Buonomano, R.; Rudiger, A.; Braun, D.L.; Eich, G.; Keller, D.I.; Hasse, B.; Böni, J.; Berger, C.; Günthard, H.F.; Manrique, A.; Trkola, A. High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children. Microorganisms 2021, 9, 642.

AMA Style

Huber M, Schreiber PW, Scheier T, Audigé A, Buonomano R, Rudiger A, Braun DL, Eich G, Keller DI, Hasse B, Böni J, Berger C, Günthard HF, Manrique A, Trkola A. High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children. Microorganisms. 2021; 9(3):642.

Chicago/Turabian Style

Huber, Michael, Peter W. Schreiber, Thomas Scheier, Annette Audigé, Roberto Buonomano, Alain Rudiger, Dominique L. Braun, Gerhard Eich, Dagmar I. Keller, Barbara Hasse, Jürg Böni, Christoph Berger, Huldrych F. Günthard, Amapola Manrique, and Alexandra Trkola. 2021. "High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children" Microorganisms 9, no. 3: 642.

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