The ongoing coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of nasopharyngeal swabs (NPS) and viral transport media, necessitating the search for alternate diagnostic specimens, such as saliva. We directly compared matched saliva and NPS specimens from symptomatic patients suspected of having COVID-19. An enhanced saliva specimen (i.e., strong sniff, elicited cough, and collection of saliva/secretions) was collected without transport medium prior to collection of NPS from 224 patients with symptoms deemed consistent with COVID-19. Both specimens were tested with the CDC 2019 nCoV real-time RT-PCR diagnostic panel (4 February 2020 version), with the NPS result used as the reference standard. For the 216 patients included in the final analysis, there was 100% positive agreement (38/38 positive specimens) and 99.4% negative agreement (177/178 negative specimens). The one discrepant specimen had the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) confirmed in the saliva specimen using an alternate FDA EUA assay. The overall mean difference in cycle threshold (C_T) values for the positive NPS and saliva specimens was −3.61 (95% confidence interval [CI], −5.78 to −1.44; P = 0.002). An enhanced saliva specimen performed as well as NPS for the qualitative detection of SARS-CoV-2 in symptomatic patients, although the overall mean viral load in saliva was lower.

中文翻译：

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对有症状患​​者中SARS-CoV-2检测的增强唾液与鼻咽拭子的直接比较。

正在进行的2019年冠状病毒病（COVID-19）大流行导致鼻咽拭子（NPS）和病毒运输介质短缺，因此需要寻找其他诊断标本，例如唾液。我们直接比较了疑似患有COVID-19的有症状患者的匹配唾液和NPS标本。在从224例症状被认为与COVID-19一致的患者中收集NPS之前，在没有转运介质的情况下收集了增强的唾液标本（即，强烈的鼻息，引起的咳嗽和唾液/分泌物的收集）。两个样本均使用CDC 2019 nCoV实时RT-PCR诊断面板（2020年2月4日版）进行了测试，并将NPS结果用作参考标准。对于最终分析中包括的216名患者，有100％的阳性一致性（38/38阳性标本）和99％。阴性一致性为4％（177/178个阴性样本）。使用另一种FDA EUA分析法，在唾液标本中证实了一个差异标本存在严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）。周期阈值的总体平均差（阳性NPS和唾液样本的C _T）值为-3.61（95％置信区间[CI]，-5.78至-1.44；P = 0.002）。尽管症状患者的总体平均病毒载量较低，但增强的唾液标本和NPS可以对有症状的患者进行SARS-CoV-2的定性检测。