An optimal clinical specimen for accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) by minimizing the usage of consumables and reduce hazard exposure to healthcare workers is an urgent priority. The diagnostic performance of SARS‐CoV‐2 detection between healthcare worker‐collected nasopharyngeal and oropharyngeal (NP + OP) swabs and patient performed self‐collected random saliva was assessed. Paired NP + OP swabs and random saliva were collected and processed within 48 h of specimen collection from two cohort studies which recruited 562 asymptomatic adult candidates. Real‐time reverse‐transcription polymerase chain reaction targeting Open reading frame 1a (ORF1a) and nucleocapsid (N) genes was performed and the results were compared. Overall, 65 of 562 (28.1%) candidates tested positive for COVID‐19 based on random saliva, NP + OP swabs, or both testing techniques. The detection rate of SARS‐CoV‐2 was higher in random saliva compared to NP + OP testing (92.3%; 60/65 vs. 73.8%; 48/65; p < .05). The estimated sensitivity and specificity of random saliva were higher than NP + OP swabs (95.0; 99.9 vs. 72.2; 99.4). The C_t values of ORF1a and N genes were significantly lower in random saliva compared to NP + OP swabs specimens. Our findings demonstrate that random saliva is an alternative diagnostic specimen for the detection of SARS‐CoV‐2. Self‐collected random oropharyngeal saliva is a valuable specimen that provides accurate SARS‐CoV‐2 surveillance testing of a community.

中文翻译：

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使用随机口咽唾液进行 COVID-19 筛查测试

当务之急是通过最大限度地减少消耗品的使用并减少医护人员的危险暴露来准确检测严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的最佳临床样本。评估了医护人员采集的鼻咽和口咽 (NP + OP) 拭子与患者自行采集的随机唾液之间 SARS-CoV-2 检测的诊断性能。两项队列研究招募了 562 名无症状成人候选人，在样本采集后 48 小时内收集并处理配对的 NP + OP 拭子和随机唾液。对开放阅读框1a（ORF1a）和核衣壳（N）基因进行实时逆转录聚合酶链反应并比较结果。总体而言，根据随机唾液、NP + OP 拭子或两种检测技术，562 名候选人中有 65 名 (28.1%) 的 COVID-19 检测结果呈阳性。与 NP + OP 检测相比，随机唾液中 SARS-CoV-2 的检出率更高（92.3%；60/65 vs. 73.8%；48/65；p  < .05）。随机唾液的估计敏感性和特异性高于 NP + OP 拭子（95.0；99.9 vs. 72.2；99.4）。_{与 NP + OP} 拭子样本相比，随机唾液中 ORF1a 和 N 基因的Ct值显着较低。我们的研究结果表明，随机唾液是检测 SARS-CoV-2 的替代诊断样本。自行采集的随机口咽唾液是一种有价值的样本，可以为社区提供准确的 SARS-CoV-2 监测测试。