Equivalence of Saliva RT-qPCR Testing to Nasal-throat/Nasopharyngeal Swab Testing in the General Practitioner’s Setting to Detect SARS-CoV-2

Author(s): Ilse Jonckheere, Liesbeth Faes, Yarah Overmeire, An De Vleeschauwer, Laura Vanden Daele, Nathalie Van Bruaene, Ilse Vandecandelaere, Britt Merlaen, Joannes van Cann, Jo Vandesompele

Study design: Saliva has been proposed as valid alternative for nasopharyngeal swab for RT-qPCR detection of SARS-CoV-2. The sensitivity is generally equivalent, and it comes with much less discomfort for the patient. While there is an overall good performance in the literature for adults, there is much less information on the use of saliva in children or in the general practitioner’s setting.

Methods: We tested a novel commercially available saliva collection kit with a virus inactivating and RNA stabilizing buffer (InActiv Blue®) in matched saliva and swab samples from 245 individuals, including 216 children, collected by general practitioners.

Results: Blind RT-qPCR testing of the saliva samples confirmed all 23 positives identified by swab testing (100% concordance), irrespective of age, presence of symptoms, or high-risk status. One child’s saliva sample was found low positive while negative on the nasopharyngeal swab, resulting in an overall relative sensitivity of RT-qPCR saliva testing of 104.3%.

Conclusion: Saliva collected in InActiv Blue® can be a valid alternative for SARS-CoV-2 RT-qPCR testing in the general practitioner’s setting, including children.

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