2021 · Journal of clinical microbiology · open access
Self-Collected Saline Gargle Samples as an Alternative to Health Care Worker-Collected Nasopharyngeal Swabs for COVID-19 Diagnosis in Outpatients
Goldfarb et al.
The finding, in our words
Self-collected saline gargle samples detected SARS-CoV-2 with 98 per cent sensitivity compared with nasopharyngeal swabs, outperforming saliva at 79 per cent, and viral RNA remained stable for two days at room temperature. Gargle samples also received the highest acceptability scores among participants aged 4 to 71 years, supporting their use as a swab-independent alternative for outpatient and paediatric COVID-19 diagnosis.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Self-collected saliva without additives showed comparable diagnostic performance to nasopharyngeal swabs for SARS-CoV-2 detection, with 87.6% sensitivity and 99.6% specificity. The sample remained stable for 72 hours and was deemed acceptable by both patients and staff, supporting its use in decentralised, patient-centric screening programmes.
In 1580 paired samples from children aged 3–17 years, saliva self-collection detected SARS-CoV-2 with 84.6% sensitivity compared with nasopharyngeal swabs, and identified eight infections missed by swabs alone. This less invasive approach offers a feasible alternative for decentralised diagnosis of COVID-19 in paediatric populations.
Salivary glucocorticoid concentrations were comparable across Salivette Cortisol, passive drool and SalivaBio collection methods, and remained stable for 72 hours at room temperature and 4 degrees Celsius with no significant degradation after repeated freeze-thaw cycles. In children under six years, the SaliPac pacifier swab was well tolerated and collected sufficient saliva for steroid analysis in under four minutes.
Saliva self-collected by children within minutes of eating showed reduced SARS-CoV-2 detection for over half of foods tested, but a 20-minute waiting period restored accurate results in nearly all cases. This provides evidence that fasting is unnecessary for decentralised viral testing, offering a practical protocol for home collection.
Saliva shows promise as a patient-friendly alternative to nasopharyngeal swabs for COVID-19 diagnosis, particularly for decentralised testing, though variability in collection and processing methods affects sensitivity. Standardising protocols could improve reliability and support wider use in decentralised diagnostics.