Manuscript alternative specimens for SARS-CoV-2 detection (4).pdf (853.84 kB)
Alternative clinical specimens for the detection of SARS-CoV-2: A rapid review
journal contributionposted on 2022-09-02, 16:23 authored by Laura Comber, Kieran A. Walsh, Karen Jordan, Kirsty K. O'Brien, Barbara ClyneBarbara Clyne, Conor Teljeur, Linda Drummond, Paul G. Carty, Cillian F. De Gascun, Susan SmithSusan Smith, Patricia Harrington, Mairin Ryan, Michelle O’Neill
The collection of nasopharyngeal swabs to test for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an invasive technique with implications for patients and clinicians. Alternative clinical specimens from the upper respiratory tract may offer benefits in terms of collection, comfort and infection risk. The objective of this review was to synthesise the evidence for detection of SARS-CoV-2 ribonucleic acid (RNA) using reverse transcription polymerase chain reaction (RT-PCR) tested saliva or nasal specimens compared with RT-PCR tested nasopharyngeal specimens. Searches were conducted in PubMed, Embase, Europe PMC and NHS evidence from December 2019 to 20 July 2020. Eighteen studies were identified; 12 for saliva, four for nasal and two included both specimen types. For saliva-based studies, the proportion of saliva samples testing positive relative to all positive samples in each study ranged from 82.9% to 100%; detection in nasopharyngeal specimens ranged from 76.7% to 100%; positive agreement between specimens for overall detection ranged from 65.4% to 100%. For nasal-based studies, the proportion of nasal swabs testing positive relative to all positive samples in each study ranged from 81.9% to 100%; detection in nasopharyngeal specimens ranged from 70% to 100%; positive agreement between specimens for overall detection ranged from 62.3% to 100%. The results indicate an inconsistency in the detection of SARS-CoV-2 RNA in the specimen types included, often with neither the index nor the reference of interest detecting all known cases. Depending on the test environment, these clinical specimens may offer a viable alternative to standard. However, at present the evidence is limited, of variable quality, and relatively inconsistent.
Health Research Board, Grant/Award Number:HRB‐CICER‐2016‐1871
Comments"This is the peer reviewed version of the following article: Comber L, Walsh KA, Jordan K, O'Brien KK, Clyne B, Teljeur C, Drummond L, Carty PG, De Gascun CF, Smith SM, Harrington P, Ryan M, O'Neill M. Alternative clinical specimens for the detection of SARS-CoV-2: A rapid review. Rev Med Virol. 2020;31(4):e2185. , which has been published in final form at https://doi.org/10.1002/rmv.2185 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited."
Published CitationComber L, et al. Alternative clinical specimens for the detection of SARS-CoV-2: A rapid review. Rev Med Virol. 2020;31(4):e2185.
Publication Date22 October 2020
- General Practice
- Population Health and Health Services
PublisherJohn Wiley & Sons, Inc.
- Accepted Version (Postprint)