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SARS-CoV-2 detection by rRT-PCR on self-collected anterior nares swabs or saliva compared with clinician-collected nasopharyngeal swabs--Denver and Atlanta, August--November, 2020

Marx, G. E.; Smith-Jeffcoat, S. E.; Biggerstaff, B. J.; Koh, M.; Nawrocki, C. C.; Travanty, E. A.; Totten, S. E.; Scott, T.; Chavez-Van De Hey, J.; Carlson, J. J.; Wendel, K. A.; Burakoff, A. W.; Hoffman, A.; Rebolledo, P. A.; Schechter, M. C.; Wang, Y. F.; Moore, B. L.; Atallah, H. Y.; Sexton, D. J.; Hartloge, C.; Paulick, A.; Miller, H. K.; Sleweon, S.; Rosetti, R.; Shragai, T.; O'Laughlin, K.; Stewart, R. J.; da Silva, J.; Biedron, C.; CDPHE COVID-19 Laboratory Response Team, ; CDC COVID-19 Response GA-10 Team, ; CDC COVID-19 Response Lab Task Force, ; Thomas, J. D.; Kirking, H. L.; Tate

2021-02-19 infectious diseases
10.1101/2021.02.16.21251521 medRxiv
Show abstract

Nasopharyngeal swabs (NPS) collected by trained healthcare professionals are the preferred specimen for SARS-CoV-2 testing. Self-collected specimens might decrease patient discomfort, conserve healthcare resources, and be preferred by patients. During August - November 2020, 1,806 adults undergoing SARS-CoV-2 testing in Denver, Colorado and Atlanta, Georgia, provided self-collected anterior nares swabs (ANS) and saliva specimens before NPS collection. Compared to NPS, sensitivity for SARS-CoV-2 detection by rRT-PCR appeared higher for saliva than for ANS (85% versus 80% in Denver; 67% versus 58% in Atlanta) and higher among participants reporting current symptoms (94% and 87% in Denver; 72% and 62% in Atlanta, for saliva and ANS, respectively) than among those reporting no symptoms (29% and 50% in Denver; 50% and 44% in Atlanta, for saliva and ANS, respectively). Compared to ANS, saliva was more challenging to collect and process. Self-collected saliva and ANS are less sensitive than NPS for SARS-CoV-2 detection; however, they offer practical advantages and might be most useful for currently symptomatic patients.

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