2021 · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · open access
A Comparison of Less Invasive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Diagnostic Specimens in Nursing Home Residents-Arkansas, June-August 2020
Gable et al.
The finding, in our words
In 17 nursing home residents, anterior nasal swabs detected SARS-CoV-2 most often in the first ten days after diagnosis, while saliva and oropharyngeal swabs remained PCR-positive longer (up to 48 days). Only nasal and oropharyngeal specimens yielded replication-competent virus, suggesting saliva's prolonged positivity represents residual RNA, which matters for decentralised testing because using saliva could lead to unnecessary isolation if PCR detection occurs after active viral shedding has ceased.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
The study found that self-collected dried saliva on FishburneTabs achieved 92% accuracy for viral RNA detection compared to standard liquid saliva samples. This method supports decentralised testing by enabling reliable sample storage and transport for upper respiratory infections.
This review establishes that microsampling across blood, saliva, urine and stool matrices offers validated workflows and regulatory recognition for human biomonitoring comparable to conventional methods. It finds that these decentralised approaches enhance participant acceptability and enable screening in remote or low-resource settings.
The COVID-19 pandemic accelerated adoption of decentralised testing and self-collected saliva specimens, but revealed challenges with variable diagnostic accuracy and lack of internationally standardised processing protocols. Stricter regulatory oversight and robust diagnostic stewardship are needed to balance broad access with clinical performance.
This review summarises how incorporating saliva and urine into home-based point-of-care systems expands diagnostic accessibility for dengue virus, aligning with the WHO REASSURED framework for affordable and rapid testing.
Oral sponge saliva RT-PCR achieved 95% sensitivity and 95% specificity compared with nasopharyngeal swabs in 3,488 symptomatic and asymptomatic adults, while buccal swab performance varied with infection history and symptoms. The rapid antigen test showed 66.9% sensitivity overall, increasing to 97% in high viral load samples. Oral sponge collection permits self-sampling without laboratory pre-analytical steps, offering a robust method for decentralised SARS-CoV-2 screening.