Open AccessDiagnostic accuracy and acceptability of molecular diagnosis of COVID-19 on saliva samples relative to nasopharyngeal swabs in tropical hospital and extra-hospital contexts: The COVISAL study
Author(s) -
Mathieu Nacher,
Mayka Mergeay-Fabre,
Denis Blanchet,
Orelie Benois,
Tristan Pozl,
Pauline Mesphoule,
Vincent Sainte-Rose,
Véronique Vialette,
Bruno Toulet,
Aurélie Moua,
Mona Saout,
Stéphane Simon,
Ma Guidarelli,
Muriel Galindo,
Barbara Biche,
William Faurous,
Laurie Chaizemartin,
Aniza Fahrasmane,
Devi Rochemont,
Fatou Diop,
Moussa Niang,
Jean Marc Pujo,
Nicolas Vignier,
Dominique Dotou,
Astrid Vabret,
Magalie Demar
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0257169
Subject(s) - saliva , medicine , asymptomatic , covid-19 , prospective cohort study , gastroenterology , disease , infectious disease (medical specialty)
A prospective study was conducted among different intra and extra-hospital populations of French Guiana to evaluate the performance of saliva testing compared to nasopharyngeal swabs. Persons aged 3 years and older with mild symptoms suggestive of COVID-19 and asymptomatic persons with a testing indication were prospectively enrolled. Nasopharyngeal and salivary samples were stored at 4°C before analysis. Both samples were analyzed with the same Real-time PCR amplification of E gene, N gene, and RdRp gene. Between July 22th and October 28th, 1159 persons were included, of which 1028 were analyzed. When only considering as positives those with 2 target genes with Ct values <35, the sensitivity of RT-PCR on saliva samples was 100% relative to nasopharyngeal samples. Specificity positive and negative predictive values were above 90%. Across a variety of cultures and socioeconomic conditions, saliva tests were generally much preferred to nasopharyngeal tests and persons seemed largely confident that they could self-sample. For positive patients defined as those with the amplification of 2 specific target genes with Ct values below 35, the sensitivity and specificity of RT-PCR on saliva samples was similar to nasopharyngeal samples despite the broad range of challenging circumstances in a tropical environment.