Diagnostic Accuracy of Saliva for SARS-CoV-2 Detection in State-sponsored Quarantine in Thailand

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Somrak Sirikhetkon Manash Shrestha Pilailuk Akkapaiboon Okada Kriengkrai Prasert Poolsap Phonsingh Suthee Intharachat Anek Mungomklang

Abstract

The aim of this study was to assess the diagnostic accuracy of saliva for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes among people in state-sponsored quarantine in Thailand. A cohort of 233 Thais in state-sponsored quarantine in Bangkok was enrolled into the study. Baseline demographic characteristics, presence of underlying diseases, and symptoms related to COVID-19 were collected on day 1 of the quarantine. Saliva specimens and nasopharyngeal (NP) swabs collected on day 7 at the quarantine premises were tested for SARS-CoV-2 RNA by real-time reverse transcription polymerase chain reaction. Overall, the viral RNA was detected in 32 (13.7%) NP swab samples, but only in 12 (5.2%) of the saliva samples. No person had NP negative but saliva positive result. Among the SARS-CoV-2 infected cases, nearly 20% had COVID-19-like illness and around 80% were asymptomatic. Sensitivity and specificity of saliva specimen were found to be 37.5% (95% confidence interval (CI)=21.1-56.3%) and 100% (95% CI=98.2-100%), respectively compared to the NP swab specimens. The area under the receiver operating characteristic curve was found to be 0.7 (95% CI=0.6-0.8). Our findings indicate that despite no false-positives, a high false-negative rate can occur with saliva specimen due to its low sensitivity, which limits its application in ruling out SARS-CoV-2 infection in quarantine settings.


Keywords:  nasopharyngeal swab, saliva, SARS-CoV-2, state quarantine, Thailand


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SIRIKHETKON, Somrak et al. Diagnostic Accuracy of Saliva for SARS-CoV-2 Detection in State-sponsored Quarantine in Thailand. OSIR Journal, [S.l.], v. 14, n. 1, mar. 2021. ISSN 2651-1061. Available at: <http://osirjournal.net/index.php/osir/article/view/246>. Date accessed: 20 apr. 2021.
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