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Hempel EM, Bharmal A, Li G, Minhas A, Manan R, Doull K, Hamilton L, Cheung B, Chan M, Gunadasa K, Chow R, Lee T, Tsang F, Krajden M, Mooder K, Kassan T, Prystajecky N, Jassem A, Hoang LMN. Prospective, clinical comparison of self-collected throat-bilateral nares swabs and saline gargle compared to health care provider collected nasopharyngeal swabs among symptomatic outpatients with potential SARS-CoV-2 infection. J Assoc Med Microbiol Infect Dis Can 2024; 8:283-298. [PMID: 38250616 PMCID: PMC10797771 DOI: 10.3138/jammi-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/27/2023] [Accepted: 06/15/2023] [Indexed: 01/23/2024]
Abstract
Background In British Columbia (BC), self-collected saline gargle (SG) is the only alternative to health care provider (HCP)-collected nasopharyngeal (NP) swabs to detect SARS-CoV-2 in an outpatient setting by polymerase chain reaction (PCR). However, some individuals cannot perform a SG. Our study aimed to assess combined throat-bilateral nares (TN) swabbing as a swab-based alternative. Methods Symptomatic individuals greater than 12 years of age seeking a COVID-19 PCR test at one of two COVID-19 collection centres in Metro Vancouver were asked to participate in this study. Participants provided a HCP-collected NP sample and a self-collected SG and TN sample for PCR testing, which were either HCP observed or unobserved. Results Three-hundred and eleven individuals underwent all three collections. Compared against HCP-NP, SG was 99% sensitive and 98% specific (kappa 0.97) and TN was 99% sensitive and 99% specific (kappa 0.98). Using the final clinical test interpretation as the reference standard, NP was 98% sensitive and 100% specific (kappa 0.98), and both SG and TN were 99% sensitive and 100% specific (both kappa 0.99). Mean cycle threshold values for each viral target were higher in SG specimens compared to the other sample types; however, this did not significantly impact the clinical performance, because the positivity rates were similar. The clinical performance of all specimen types was comparable within the first 7 days of symptom onset, regardless of the observation method. SG self-collections were rated the most acceptable, followed by TN. Conclusions TN provides another less invasive self-collection modality for symptomatic outpatient SARS-CoV-2 PCR testing.
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Affiliation(s)
- Eric M Hempel
- Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Aamir Bharmal
- British Columbia Centre for Disease Control Public Health Response, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Guiyun Li
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Aileen Minhas
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Ramndip Manan
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Kathy Doull
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Lynsey Hamilton
- British Columbia Centre for Disease Control Knowledge Translation, Vancouver, British Columbia, Canada
| | - Branco Cheung
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Michael Chan
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Kingsley Gunadasa
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Ron Chow
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Tracy Lee
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Frankie Tsang
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karen Mooder
- Provincial Health Services Authority, Vancouver, British Columbia, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Trushna Kassan
- Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Natalie Prystajecky
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Agatha Jassem
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda MN Hoang
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Xu P, Chen J, Qian C, Yu W. Pre-enriched saline gargle samples for detection of SARS-CoV-2. Biosci Trends 2023; 17:81-84. [PMID: 36653152 DOI: 10.5582/bst.2022.01530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
A self‑collected gargle sample, which avoids discomfort and largely reduces the dependency on medical resources, is emerging for detection of SARS‑CoV‑2. However, the incomplete usage of starting materials for both routine oropharyngeal swabs (OPS)/nasopharyngeal swabs (NPS) and saline gargle (SG) samples implies sensitivity can be further improved. Presented here is a bead‑based strategy for pre‑enrichment of SG samples, and results revealed that it acquired about 20 times the starting materials obtained from OPS samples for downstream detection of SARS‑CoV‑2. The sensitivity and specificity of this pre‑enrichment strategy were validated in 100 paired pre‑enriched saline gargle (PenSG) and OPS samples and 89 PenSG samples from healthy volunteers. In addition to detection of SARS‑CoV‑2, this pre‑enrichment strategy may also be implemented in more clinical settings to optimize detection of other diseases.
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Affiliation(s)
- Peng Xu
- Laboratory of RNA Epigenetics, Institutes of Biomedical Sciences & Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, Shanghai, China.,Research and Development Department, Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai, China
| | - Jing Chen
- Research and Development Department, Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai, China
| | - Chengchen Qian
- Research and Development Department, Shanghai Epiprobe Biotechnology Co., Ltd, Shanghai, China
| | - Wenqiang Yu
- Laboratory of RNA Epigenetics, Institutes of Biomedical Sciences & Shanghai Public Health Clinical Center, Shanghai Medical College, Fudan University, Shanghai, China
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Qiao K, Tao X, Liu H, Zheng M, Asakawa T, Lu H. Verification of the efficiency of saline gargle sampling for detection of the Omicron variant of SARS-CoV-2, a pilot study. Biosci Trends 2022; 16:451-454. [PMID: 36504073 DOI: 10.5582/bst.2022.01498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A saline gargle (SG) has proven to be an efficient method of sampling to detect SARS-CoV-2. The aim of this pilot study was to verify the efficiency of SG sampling in detecting the Omicron variant of SARS-CoV-2. Subjects were a total of 68 patients with COVID-19 (Omicron variant), and 167 pairs of samples were collected. A conventional oropharyngeal swab (OPS) was obtained and SG sampling was performed immediately afterward; both were subjected to RT-qPCR. A subgroup analysis of symptomatic and asymptomatic patients was performed. Results revealed no significant differences in the distribution of patients and cycle threshold (CT) values between the SG and OPS in overall data and data on days 1-3, 4-7, and 8-14. The subgroup analysis revealed no significant differences between the SG and OPS results in symptomatic patients. In asymptomatic patients, the CT values for the SG were significantly lower than those for the OPS, implying that SG sampling had better sensitivity in the context of the Omicron variant. These data indicate that the SG had satisfactory efficiency (vs. the OPS). An SG is a simple and less invasive method of sampling that is suited to mass, frequent, and repeated sampling to detect SARS-CoV-2.
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Affiliation(s)
- Kun Qiao
- Department of Thoracic Surgery, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Xiaoting Tao
- Department of Thoracic Surgery, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Houming Liu
- Clinical Laboratory, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Mingbin Zheng
- Institute of Neurology, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Tetsuya Asakawa
- Institute of Neurology, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Hongzhou Lu
- Institute of Neurology, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China.,Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Third People's Hospital of Shenzhen, Shenzhen, China
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