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SARS-CoV-2 Detection in saliva samples are more sensitive and consistent

Yale University Research Study Proof Point- Saliva More Sensitive for COVID-19 Detection Than Naso-Swabs

The test, developed by a Rutgers lab, could be a safer and faster alternative.

Researchers are working around the clock, innovating ways to improve the COVID-19 testing process. Recently, a group of researchers from Yale University presented findings that suggest that one improvement could be made right at the beginning of the testing process—in the choice of the sample to be tested. Although the current gold standard is to use samples collected from nasopharyngeal swabs (NPS), the group found that using saliva for SARS-CoV-2 detection is more sensitive and consistent than using a nasopharyngeal swab. They assert that saliva should be considered as a reliable sample type to improve COVID-19 testing.

The work is published as a preprint in MedRxiv. The title of the preprint (a paper that has not yet gone through the peer review process) is “Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs.”

Currently available SARS-CoV-2 detection tests suffer from multiple challenges including low sensitivity and reliance on swabs. In addition, swab collection requires close contact between the healthcare worker performing the collection and the patient, which poses a health risk to healthcare workers. Using saliva for COVID-19 testing has several advantages when compared to collection of nasopharyngeal swabs. Saliva collection does not require specialized swabs or tubes, is far less uncomfortable for the patient, and may even be done independently by the patient–potentially alleviating the current overwhelming demand for healthcare workers. Indeed, in this study, the saliva samples were self-collected by the patient. The process is described as, “upon waking, patients were asked to avoid food, water, and brushing of teeth until the sample was collected. Patients were asked to repeatedly spit into a sterile urine cup until roughly a third full of liquid (excluding bubbles), before securely closing it.”

Spectrum Solutions COVA-19 Testing Kits

© Spectrum Solutions™ Bloomberg News/George Frey

The test, developed by a Rutgers lab, could be a safer and faster alternative.

Researchers are working around the clock, innovating ways to improve the COVID-19 testing process. Recently, a group of researchers from Yale University presented findings that suggest that one improvement could be made right at the beginning of the testing process—in the choice of the sample to be tested. Although the current gold standard is to use samples collected from nasopharyngeal swabs (NPS), the group found that using saliva for SARS-CoV-2 detection is more sensitive and consistent than using a nasopharyngeal swab. They assert that saliva should be considered as a reliable sample type to improve COVID-19 testing.

The work is published as a preprint in MedRxiv. The title of the preprint (a paper that has not yet gone through the peer review process) is “Saliva is more sensitive for SARS-CoV-2 detection in COVID-19 patients than nasopharyngeal swabs.”

Currently available SARS-CoV-2 detection tests suffer from multiple challenges including low sensitivity and reliance on swabs. In addition, swab collection requires close contact between the healthcare worker performing the collection and the patient, which poses a health risk to healthcare workers. Using saliva for COVID-19 testing has several advantages when compared to collection of nasopharyngeal swabs. Saliva collection does not require specialized swabs or tubes, is far less uncomfortable for the patient, and may even be done independently by the patient–potentially alleviating the current overwhelming demand for healthcare workers. Indeed, in this study, the saliva samples were self-collected by the patient. The process is described as, “upon waking, patients were asked to avoid food, water, and brushing of teeth until the sample was collected. Patients were asked to repeatedly spit into a sterile urine cup until roughly a third full of liquid (excluding bubbles), before securely closing it.”

Spectrum Solutions COVA-19 Testing Kits

© Spectrum Solutions™ Bloomberg News/George Frey

Saliva is a better diagnostic sample for COVID-19 testing

The researchers evaluated SARS-CoV-2 detection in paired nasopharyngeal swabs and saliva samples collected from COVID-19 inpatients and asymptomatic healthcare workers at moderate-to-high risk of COVID-19 exposure. They collected clinical samples from 44 COVID-19 inpatient study participants—all of whom had serious illness—and 98 health care workers. After testing for the presence of the SARS-CoV-2 virus, the findings suggest that saliva samples provided greater detection, sensitivity, and consistency throughout the course of infection than the nasopharyngeal swabs.

This is a “super useful new study,” tweeted Akiko Iwasaki, PhD, professor at the Yale School of Medicine, showing that “saliva is a better diagnostic sample for COVID-19 testing than nasopharyngeal swabs.”

When the authors compared SARS-CoV-2 detection from patient-matched nasopharyngeal and saliva samples, they found that “saliva yielded greater detection sensitivity and consistency throughout the course of infection.” In addition, there was less variability in self-sample collection of saliva. 

The experiment also detected SARS-CoV-2 from the saliva of two asymptomatic healthcare workers who tested negative from their nasopharyngeal swabs. This finding, tweeted Anne Wyllie, PhD, associate research scientist in epidemiology at Yale School of Medicine and lead author on the study, “suggests that saliva could be a viable alternative for identifying mild or subclinical infections.”

With further validation, Wyllie asserts, “widespread use of saliva sampling could be transformative for public health efforts.”

A group of researchers from Melbourne, Australia, published similar findings last week in a paper, “Saliva as a non-invasive specimen for detection of SARS-CoV-2,” published in the Journal of Clinical Microbiology as a Letter to the Editor.

This study used samples taken between March 25 and April 1. During that time, 622 patients were tested for COVID-19 at the Royal Melbourne Hospital through the screening clinic. All patients had nasopharyngeal swab samples, and 522/622 (83.9%) patients also provided saliva.

Spectrum Solutions COVID-19 SDNA-1000 Saliva Collection Testing Kit

© Spectrum Solutions™ COVID-19 SDNA-1000 Saliva Collection Testing Kit | Bloomberg News/George Frey

The researchers evaluated SARS-CoV-2 detection in paired nasopharyngeal swabs and saliva samples collected from COVID-19 inpatients and asymptomatic healthcare workers at moderate-to-high risk of COVID-19 exposure. They collected clinical samples from 44 COVID-19 inpatient study participants—all of whom had serious illness—and 98 health care workers. After testing for the presence of the SARS-CoV-2 virus, the findings suggest that saliva samples provided greater detection, sensitivity, and consistency throughout the course of infection than the nasopharyngeal swabs.

This is a “super useful new study,” tweeted Akiko Iwasaki, PhD, professor at the Yale School of Medicine, showing that “saliva is a better diagnostic sample for COVID-19 testing than nasopharyngeal swabs.”

When the authors compared SARS-CoV-2 detection from patient-matched nasopharyngeal and saliva samples, they found that “saliva yielded greater detection sensitivity and consistency throughout the course of infection.” In addition, there was less variability in self-sample collection of saliva. 

The experiment also detected SARS-CoV-2 from the saliva of two asymptomatic healthcare workers who tested negative from their nasopharyngeal swabs. This finding, tweeted Anne Wyllie, PhD, associate research scientist in epidemiology at Yale School of Medicine and lead author on the study, “suggests that saliva could be a viable alternative for identifying mild or subclinical infections.”

With further validation, Wyllie asserts, “widespread use of saliva sampling could be transformative for public health efforts.”

A group of researchers from Melbourne, Australia, published similar findings last week in a paper, “Saliva as a non-invasive specimen for detection of SARS-CoV-2,” published in the Journal of Clinical Microbiology as a Letter to the Editor.

This study used samples taken between March 25 and April 1. During that time, 622 patients were tested for COVID-19 at the Royal Melbourne Hospital through the screening clinic. All patients had nasopharyngeal swab samples, and 522/622 (83.9%) patients also provided saliva.

Spectrum Solutions COVID-19 SDNA-1000 Saliva Collection Testing Kit

© Spectrum Solutions™ COVID-19 SDNA-1000 Saliva Collection Testing Kit | Bloomberg News/George Frey

Saliva could be a viable alternative for identifying mild or subclinical infections

Of the 622 people, 39 (6.3%) patients tested positive using standard RT-PCR tests on nasopharyngeal samples. Out of the 39 COVID-19 positive patients, SARS-CoV-2 was also detected in the saliva of 33 of them. As a control, the group also tested saliva specimens from 50 patients with PCR-negative swabs. SARS-CoV-2 was detected in 1 of the 50 samples.

Although the sensitivity of saliva as a diagnostic specimen was less than nasopharyngeal swabs in this study, the authors write that “saliva testing may be a suitable alternative first-line screening test in several environments, including low resource settings, with NPS reserved for patients with an ongoing high clinical index of suspicion. These findings are highly relevant in the face of shortages of both swabs and personal protective equipment in many settings.”

Indeed, saliva-based tests are moving into the COVID-19 testing arena as a saliva SARS-CoV-2 detection assay has already gained authorization through the U.S. Food and Drug Administration emergency use authorization. The test is from the Rutgers Clinical Genomics Laboratory.

The recent findings from both the Yale and Melbourne researchers amplify the call for immediate validation and implementation of saliva sampling for SARS-CoV-2.

Spectrum Solutions Saliva Collection Kit COVID-19 Testing

© Spectrum Solutions™ | Photo Credit: Leslie Titus Bryant

Of the 622 people, 39 (6.3%) patients tested positive using standard RT-PCR tests on nasopharyngeal samples. Out of the 39 COVID-19 positive patients, SARS-CoV-2 was also detected in the saliva of 33 of them. As a control, the group also tested saliva specimens from 50 patients with PCR-negative swabs. SARS-CoV-2 was detected in 1 of the 50 samples.

Although the sensitivity of saliva as a diagnostic specimen was less than nasopharyngeal swabs in this study, the authors write that “saliva testing may be a suitable alternative first-line screening test in several environments, including low resource settings, with NPS reserved for patients with an ongoing high clinical index of suspicion. These findings are highly relevant in the face of shortages of both swabs and personal protective equipment in many settings.”

Indeed, saliva-based tests are moving into the COVID-19 testing arena as a saliva SARS-CoV-2 detection assay has already gained authorization through the U.S. Food and Drug Administration emergency use authorization. The test is from the Rutgers Clinical Genomics Laboratory.

The recent findings from both the Yale and Melbourne researchers amplify the call for immediate validation and implementation of saliva sampling for SARS-CoV-2.

Spectrum Solutions Saliva Collection Kit COVID-19 Testing

© Spectrum Solutions™ | Photo Credit: Leslie Titus Bryant

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Noninvasive
Saliva Diagnostics

This changes everything

Health is a dynamic state of well-being. Healthcare providers and researchers have long believed that changes in our saliva record our ongoing state-of-health story. Interestingly, saliva acts as a wide resource of genomic information useful for identifying and monitoring in real-time a disease as well as its state of progression. Saliva analysis looks at the cellular level, the biologically active compounds, making it a true representative of what is clinically relevant.

Spectrum’s technically-superior saliva collection systems have not only been engineered to lead the saliva collection industry in molecular diagnostics and clinical research applications but deliver the safest, most robust biomaterial for the earliest detection and diagnosis of disease and infection.

  • Saliva provides the earliest path to critical detection and diagnosis
  • Saliva contains the entire library of proteins, hormones, antibodies, and other molecular compounds measured in routine blood tests
  • First EUA authorized saliva collection device for COVID-19 testing & authorized device for direct-to-patient at-home sample self-collection
  • Used in supervised & unsupervised sample collection LDT workflows of symptomatic & asymptomatic users
  • Pain-free, non-invasive, & safe – ideal for those needing frequent & repeat testing
  • In-device live virus inactivation at ambient temps (COVID-19 EUA validated data)
  • Eliminates hooded containment of samples arriving at the testing lab
  • No temperature-controlled storage or transport of collected saliva samples
  • Single device for DNA & viral RNA applications
  • Safest collection approach & most robust biomaterial for detecting COVID-19
  • Delivers 99.998% highest levels of testing accuracy & sensitivity
  • Formulation identifies infections at its earliest stage from as few as 200 copies/ml (lateral flow rapid tests need 10,000-20,000 copies/ml)
  • A single preserved saliva sample provides opportunity for multiple tests
  • Over two weeks of post-collection stability with no degradation in sample efficacy
  • System maintains critical bio-sample consistency
  • Mass-testing scalability & easy device integration using validated and supported processes
  • Mitigates any risk of infection throughout the testing process
  • Pinpoint life-cycle stage of active viral infection
  • Eliminates UN3373 shipping designation with clearance from USPS, FedEx, & UPS
  • Delivers the highest levels of testing accuracy using qualified extraction chemistries
Questions, Let’s Connect!

Noninvasive
Saliva Diagnostics

This changes everything

Health is a dynamic state of well-being. Healthcare providers and researchers have long believed that changes in our saliva record our ongoing state-of-health story. Interestingly, saliva acts as a wide resource of genomic information useful for identifying and monitoring in real-time a disease as well as its state of progression. Saliva analysis looks at the cellular level, the biologically active compounds, making it a true representative of what is clinically relevant.

Spectrum’s technically-superior saliva collection systems have not only been engineered to lead the saliva collection industry in molecular diagnostics and clinical research applications but deliver the safest, most robust biomaterial for the earliest detection and diagnosis of disease and infection.

  • Saliva provides the earliest path to critical detection and diagnosis
  • Saliva contains the entire library of proteins, hormones, antibodies, and other molecular compounds measured in routine blood tests
  • First EUA authorized saliva collection device for COVID-19 testing & authorized device for direct-to-patient at-home sample self-collection
  • Used in supervised & unsupervised sample collection LDT workflows of symptomatic & asymptomatic users
  • Pain-free, non-invasive, & safe – ideal for those needing frequent & repeat testing
  • In-device live virus inactivation at ambient temps (COVID-19 EUA validated data)
  • Eliminates hooded containment of samples arriving at the testing lab
  • No temperature-controlled storage or transport of collected saliva samples
  • Single device for DNA & viral RNA applications
  • Safest collection approach & most robust biomaterial for detecting COVID-19
  • Delivers 99.998% highest levels of testing accuracy & sensitivity
  • Formulation identifies infections at its earliest stage from as few as 200 copies/ml (lateral flow rapid tests need 10,000-20,000 copies/ml)
  • A single preserved saliva sample provides opportunity for multiple tests
  • Over two weeks of post-collection stability with no degradation in sample efficacy
  • System maintains critical bio-sample consistency
  • Mass-testing scalability & easy device integration using validated and supported processes
  • Mitigates any risk of infection throughout the testing process
  • Pinpoint life-cycle stage of active viral infection
  • Eliminates UN3373 shipping designation with clearance from USPS, FedEx, & UPS
  • Delivers the highest levels of testing accuracy using qualified extraction chemistries
Questions, Let’s Connect!

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Anywhere from customized testing solutions to new medical science product innovations–we’re here to help.

Outside-of-the-Box Thinking, Inside-of-the-Box Innovation

Anywhere from customized testing solutions to new medical science product innovations–we’re here to help.