Comparison of Saliva and Midturbinate Swabs for Detection of SARS-CoV-2

  1. Jianyu Lai
  2. Jennifer German
  3. Filbert Hong
  4. S.-H. Sheldon Tai
  5. Kathleen M. McPhaul
  6. Donald K. Milton
  7. for the University of Maryland StopCOVID Research Group for the University of Maryland StopCOVID Research Group, Oluwasanmi Oladapo Adenaiye, Barbara Albert, P. Jacob Bueno de Mesquita, Yi Esparza, Aaron Kassman, Michael Lutchenkov, Dewansh Rastogi, Maria Schanz, Isabel Sierra Maldonado, Aditya Srikakulapu, Delwin Suraj, Faith Touré, Rhonda Washington-Lewis, Somayeh Youssefi, Stuart Weston, Matthew Frieman, Mara Cai, Ashok Agrawala

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Abstract

The findings of this manuscript are increasingly important with new variants that appear to have shorter incubation periods emerging, which may be more prone to detection in saliva before detection in nasal swabs. Therefore, there is an urgent need to provide the science to support the use of a detection method that is highly sensitive and widely acceptable to the public to improve screening rates and early detection.

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  1. Version published to 10.1128/spectrum.00128-22
  2. ScreenIT

    SciScore for 10.1101/2021.12.01.21267147: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethics statement: This study was approved by the University of Maryland Institutional Review Board and the Human Research Protection Office of the Department of the Navy.
    Consent: Electronically signed informed consent was obtained from all participants and questionnaire data were collected and stored with REDCap [18].
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All the analyses were carried out using RStudio and R (version 4.0.4) [17].
    RStudio
    suggested: (RStudio, RRID:SCR_000432)
    Electronically signed informed consent was obtained from all participants and questionnaire data were collected and stored with REDCap [18].
    REDCap
    suggested: (REDCap, RRID:SCR_003445)

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The current study has several limitations. The contacts enrolled in this study who eventually tested positive for SARS-CoV-2 developed mild, and in some cases, transient infections. Some of these mild (low viral titer) infections would not have been detected by less frequent testing protocols and may not have posed a risk for onward transmission. The sample size of those who tested positive is relatively small. Only one asymptomatic case was identified in our study so we could not compare the sensitivity of the two types of samples among asymptomatic COVID-19 cases. The evidence for using saliva to detect asymptomatic cases was mixed in previous studies [2,10] and further studies are needed to clarify this issue. In conclusion, the use of saliva is preferable for testing pre-symptomatic populations. It is more acceptable to people, which reduces barrier to testing. It is also more cost effective for individuals to collect their own saliva rather than using highly trained professionals to collect NPS and/or MTS. Finally, self-collected saliva samples eliminate the exposure to aerosols produced by sneezing, coughing and gagging of patients undergoing NPS/MTS.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.12.01.21267147 on medRxiv