Gargle lavage & saliva: Feasible & cheaper alternatives to nasal & throat swabs for diagnosis of COVID-19
Background & objectives: In the present scenario, the most common sample for diagnosis of COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) is nasal and throat swab (NTS). Other sampling options such as gargle lavage have found limited application in clinical use mostly becaus...
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| Veröffentlicht in: | Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2021-05, Vol.153 (5), p.665-670 |
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| container_title | Indian journal of medical research (New Delhi, India : 1994) |
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| creator | Gupta, Ankesh Mittal, Ankit Dhakad, Shivram Brijwal, Megha Soneja, Manish Srigyan, Deepankar Xess, Ashit Kumar, Arvind Ray, Animesh Meena, Ved Garg, Rohit Singh, Komal Desai, Devashish Chowdhury, Mohit Chowdhury, Souradeep Sharma, Kunal Narayan, Ananthu Krishnan, G Naik, Shivdas Dar, Lalit Pandey, Ravindra Pandey, Shivam Sinha, Sanjeev Wig, Naveet |
| description | Background & objectives: In the present scenario, the most common sample for diagnosis of COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) is nasal and throat swab (NTS). Other sampling options such as gargle lavage have found limited application in clinical use mostly because of unavailability of an appropriate gargling liquid. This study was conducted to assess the stability of SARS-CoV-2 RNA in normal saline at 4°C that can serve as a gargling liquid as well as a transport medium. The study also looked at the agreement between NTS and gargle lavage/saliva for the detection of SARS-CoV-2.
Methods: In 29 consecutive real-time RT-PCR (rRT-PCR) positive COVID-19 patients, paired NTS, gargle and saliva samples were taken. Samples were processed by rRT-PCR for the detection of SARS-CoV-2 RNA. To assess the SARS-CoV-2 RNA stability in normal saline, gargle lavage specimens were divided into two aliquots; one subset of the specimen was run within 4-6 h along with the routine samples (NTS and saliva) and the other subset was stored at 4°C and processed after 24-30 h. Agreement between cycle threshold (Ct) values from both the runs was compared using Bland-Altman (BA) analysis.
Results: The positivity rates of rRT-PCR in NTS, saliva and gargle lavage samples were 82.7 (24/29), 79.3 (23/29) and 86.2 per cent (25/29), respectively. BA plot showed a good agreement between the Ct values of fresh and stored gargle samples, stipulating that there were no significant differences in the approximate viral load levels between the fresh and stored gargle lavage samples (bias: E gene −0.64, N gene −0.51, ORF gene −0.19).
Interpretation & conclusions: Our study results show stability of SARS-CoV-2 RNA in the gargle samples collected using normal saline up to 24-30 h. Gargle lavage and saliva specimen collection are cost-effective and acceptable methods of sampling for the detection of SARS-CoV-2 RNA by rRT-PCR. These simplified, inexpensive and acceptable methods of specimen collection would reduce the cost and workload on healthcare workers for sample collection. |
| doi_str_mv | 10.4103/ijmr.IJMR_4209_20 |
| format | Article |
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Methods: In 29 consecutive real-time RT-PCR (rRT-PCR) positive COVID-19 patients, paired NTS, gargle and saliva samples were taken. Samples were processed by rRT-PCR for the detection of SARS-CoV-2 RNA. To assess the SARS-CoV-2 RNA stability in normal saline, gargle lavage specimens were divided into two aliquots; one subset of the specimen was run within 4-6 h along with the routine samples (NTS and saliva) and the other subset was stored at 4°C and processed after 24-30 h. Agreement between cycle threshold (Ct) values from both the runs was compared using Bland-Altman (BA) analysis.
Results: The positivity rates of rRT-PCR in NTS, saliva and gargle lavage samples were 82.7 (24/29), 79.3 (23/29) and 86.2 per cent (25/29), respectively. BA plot showed a good agreement between the Ct values of fresh and stored gargle samples, stipulating that there were no significant differences in the approximate viral load levels between the fresh and stored gargle lavage samples (bias: E gene −0.64, N gene −0.51, ORF gene −0.19).
Interpretation & conclusions: Our study results show stability of SARS-CoV-2 RNA in the gargle samples collected using normal saline up to 24-30 h. Gargle lavage and saliva specimen collection are cost-effective and acceptable methods of sampling for the detection of SARS-CoV-2 RNA by rRT-PCR. These simplified, inexpensive and acceptable methods of specimen collection would reduce the cost and workload on healthcare workers for sample collection.</description><identifier>ISSN: 0971-5916</identifier><identifier>EISSN: 0975-9174</identifier><identifier>DOI: 10.4103/ijmr.IJMR_4209_20</identifier><identifier>PMID: 34414924</identifier><language>eng</language><publisher>New Delhi: Wolters Kluwer India Pvt. Ltd</publisher><subject>Coronaviruses ; COVID-19 ; Lavage ; Methods ; Original ; Salivary diagnostics ; Severe acute respiratory syndrome coronavirus 2</subject><ispartof>Indian journal of medical research (New Delhi, India : 1994), 2021-05, Vol.153 (5), p.665-670</ispartof><rights>COPYRIGHT 2021 Medknow Publications and Media Pvt. Ltd.</rights><rights>2021. This article is published under (http://creativecommons.org/licenses/by-nc-sa/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright: © 2021 Indian Journal of Medical Research 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c552e-ff5df4f2782b436b3928401b5816684d8234c2f0374f4024b5b34690571ec4963</citedby><cites>FETCH-LOGICAL-c552e-ff5df4f2782b436b3928401b5816684d8234c2f0374f4024b5b34690571ec4963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555589/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555589/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids></links><search><creatorcontrib>Gupta, Ankesh</creatorcontrib><creatorcontrib>Mittal, Ankit</creatorcontrib><creatorcontrib>Dhakad, Shivram</creatorcontrib><creatorcontrib>Brijwal, Megha</creatorcontrib><creatorcontrib>Soneja, Manish</creatorcontrib><creatorcontrib>Srigyan, Deepankar</creatorcontrib><creatorcontrib>Xess, Ashit</creatorcontrib><creatorcontrib>Kumar, Arvind</creatorcontrib><creatorcontrib>Ray, Animesh</creatorcontrib><creatorcontrib>Meena, Ved</creatorcontrib><creatorcontrib>Garg, Rohit</creatorcontrib><creatorcontrib>Singh, Komal</creatorcontrib><creatorcontrib>Desai, Devashish</creatorcontrib><creatorcontrib>Chowdhury, Mohit</creatorcontrib><creatorcontrib>Chowdhury, Souradeep</creatorcontrib><creatorcontrib>Sharma, Kunal</creatorcontrib><creatorcontrib>Narayan, Ananthu</creatorcontrib><creatorcontrib>Krishnan, G</creatorcontrib><creatorcontrib>Naik, Shivdas</creatorcontrib><creatorcontrib>Dar, Lalit</creatorcontrib><creatorcontrib>Pandey, Ravindra</creatorcontrib><creatorcontrib>Pandey, Shivam</creatorcontrib><creatorcontrib>Sinha, Sanjeev</creatorcontrib><creatorcontrib>Wig, Naveet</creatorcontrib><title>Gargle lavage & saliva: Feasible & cheaper alternatives to nasal & throat swabs for diagnosis of COVID-19</title><title>Indian journal of medical research (New Delhi, India : 1994)</title><description>Background & objectives: In the present scenario, the most common sample for diagnosis of COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) is nasal and throat swab (NTS). Other sampling options such as gargle lavage have found limited application in clinical use mostly because of unavailability of an appropriate gargling liquid. This study was conducted to assess the stability of SARS-CoV-2 RNA in normal saline at 4°C that can serve as a gargling liquid as well as a transport medium. The study also looked at the agreement between NTS and gargle lavage/saliva for the detection of SARS-CoV-2.
Methods: In 29 consecutive real-time RT-PCR (rRT-PCR) positive COVID-19 patients, paired NTS, gargle and saliva samples were taken. Samples were processed by rRT-PCR for the detection of SARS-CoV-2 RNA. To assess the SARS-CoV-2 RNA stability in normal saline, gargle lavage specimens were divided into two aliquots; one subset of the specimen was run within 4-6 h along with the routine samples (NTS and saliva) and the other subset was stored at 4°C and processed after 24-30 h. Agreement between cycle threshold (Ct) values from both the runs was compared using Bland-Altman (BA) analysis.
Results: The positivity rates of rRT-PCR in NTS, saliva and gargle lavage samples were 82.7 (24/29), 79.3 (23/29) and 86.2 per cent (25/29), respectively. BA plot showed a good agreement between the Ct values of fresh and stored gargle samples, stipulating that there were no significant differences in the approximate viral load levels between the fresh and stored gargle lavage samples (bias: E gene −0.64, N gene −0.51, ORF gene −0.19).
Interpretation & conclusions: Our study results show stability of SARS-CoV-2 RNA in the gargle samples collected using normal saline up to 24-30 h. Gargle lavage and saliva specimen collection are cost-effective and acceptable methods of sampling for the detection of SARS-CoV-2 RNA by rRT-PCR. These simplified, inexpensive and acceptable methods of specimen collection would reduce the cost and workload on healthcare workers for sample collection.</description><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Lavage</subject><subject>Methods</subject><subject>Original</subject><subject>Salivary diagnostics</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><issn>0971-5916</issn><issn>0975-9174</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1Uk1v1DAUjBCIlsIP4GYJCXHJYju2E3NAqhZaFhVVQoC4PTmJnfXWG2_tZFf993VI-SgC-2DrvZmx3niy7DnBC0Zw8dputmGx-vjpMzCKJVD8IDvGsuS5JCV7-ONOci6JOMqexLjBmEhaysfZUcEYYZKy48yeq9A5jZzaq06jlygqZ_fqDTrTKtraTaVmrdVOB6TcoEOvBrvXEQ0e9SqBU39YB68GFA-qjsj4gFqrut5HG5E3aHn5bfUuJ_Jp9sgoF_Wzu_Mk-3r2_svyQ35xeb5anl7kDedU58bw1jBDy4rWrBB1IWnFMKl5RYSoWFvRgjXU4KJkhmHKal4XTEjMS6IbJkVxkr2ddXdjvdVto_shKAe7YLcq3IBXFu53eruGzu-h4mlVMgm8uhMI_nrUcYCtjY12TvXajxEoFwWjrCIkQV_8Bd34MVnkJlQpk8OU8N-oTjkNtjc-vdtMonAq0pwlkZgm1OIfqLRbvbWN77WxqX6PQGZCE3yMQZtfMxIMUz5gygf8mY_E-T5zDn76zHjlxoMOkNy46v3h_0QQgsMcFZijAnNQ4GdOiluzCMnL</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Gupta, Ankesh</creator><creator>Mittal, Ankit</creator><creator>Dhakad, Shivram</creator><creator>Brijwal, Megha</creator><creator>Soneja, Manish</creator><creator>Srigyan, Deepankar</creator><creator>Xess, Ashit</creator><creator>Kumar, Arvind</creator><creator>Ray, Animesh</creator><creator>Meena, Ved</creator><creator>Garg, Rohit</creator><creator>Singh, Komal</creator><creator>Desai, Devashish</creator><creator>Chowdhury, Mohit</creator><creator>Chowdhury, Souradeep</creator><creator>Sharma, Kunal</creator><creator>Narayan, Ananthu</creator><creator>Krishnan, G</creator><creator>Naik, Shivdas</creator><creator>Dar, Lalit</creator><creator>Pandey, Ravindra</creator><creator>Pandey, Shivam</creator><creator>Sinha, Sanjeev</creator><creator>Wig, Naveet</creator><general>Wolters Kluwer India Pvt. 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Lalit</au><au>Pandey, Ravindra</au><au>Pandey, Shivam</au><au>Sinha, Sanjeev</au><au>Wig, Naveet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gargle lavage & saliva: Feasible & cheaper alternatives to nasal & throat swabs for diagnosis of COVID-19</atitle><jtitle>Indian journal of medical research (New Delhi, India : 1994)</jtitle><date>2021-05-01</date><risdate>2021</risdate><volume>153</volume><issue>5</issue><spage>665</spage><epage>670</epage><pages>665-670</pages><issn>0971-5916</issn><eissn>0975-9174</eissn><abstract>Background & objectives: In the present scenario, the most common sample for diagnosis of COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) is nasal and throat swab (NTS). Other sampling options such as gargle lavage have found limited application in clinical use mostly because of unavailability of an appropriate gargling liquid. This study was conducted to assess the stability of SARS-CoV-2 RNA in normal saline at 4°C that can serve as a gargling liquid as well as a transport medium. The study also looked at the agreement between NTS and gargle lavage/saliva for the detection of SARS-CoV-2.
Methods: In 29 consecutive real-time RT-PCR (rRT-PCR) positive COVID-19 patients, paired NTS, gargle and saliva samples were taken. Samples were processed by rRT-PCR for the detection of SARS-CoV-2 RNA. To assess the SARS-CoV-2 RNA stability in normal saline, gargle lavage specimens were divided into two aliquots; one subset of the specimen was run within 4-6 h along with the routine samples (NTS and saliva) and the other subset was stored at 4°C and processed after 24-30 h. Agreement between cycle threshold (Ct) values from both the runs was compared using Bland-Altman (BA) analysis.
Results: The positivity rates of rRT-PCR in NTS, saliva and gargle lavage samples were 82.7 (24/29), 79.3 (23/29) and 86.2 per cent (25/29), respectively. BA plot showed a good agreement between the Ct values of fresh and stored gargle samples, stipulating that there were no significant differences in the approximate viral load levels between the fresh and stored gargle lavage samples (bias: E gene −0.64, N gene −0.51, ORF gene −0.19).
Interpretation & conclusions: Our study results show stability of SARS-CoV-2 RNA in the gargle samples collected using normal saline up to 24-30 h. Gargle lavage and saliva specimen collection are cost-effective and acceptable methods of sampling for the detection of SARS-CoV-2 RNA by rRT-PCR. These simplified, inexpensive and acceptable methods of specimen collection would reduce the cost and workload on healthcare workers for sample collection.</abstract><cop>New Delhi</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>34414924</pmid><doi>10.4103/ijmr.IJMR_4209_20</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0971-5916 |
| ispartof | Indian journal of medical research (New Delhi, India : 1994), 2021-05, Vol.153 (5), p.665-670 |
| issn | 0971-5916 0975-9174 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8555589 |
| source | Medknow Open Access Medical Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; PubMed Central |
| subjects | Coronaviruses COVID-19 Lavage Methods Original Salivary diagnostics Severe acute respiratory syndrome coronavirus 2 |
| title | Gargle lavage & saliva: Feasible & cheaper alternatives to nasal & throat swabs for diagnosis of COVID-19 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T06%3A31%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Gargle%20lavage%20&%20saliva:%20Feasible%20&%20cheaper%20alternatives%20to%20nasal%20&%20throat%20swabs%20for%20diagnosis%20of%20COVID-19&rft.jtitle=Indian%20journal%20of%20medical%20research%20(New%20Delhi,%20India%20:%201994)&rft.au=Gupta,%20Ankesh&rft.date=2021-05-01&rft.volume=153&rft.issue=5&rft.spage=665&rft.epage=670&rft.pages=665-670&rft.issn=0971-5916&rft.eissn=0975-9174&rft_id=info:doi/10.4103/ijmr.IJMR_4209_20&rft_dat=%3Cgale_pubme%3EA678271902%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2579924215&rft_id=info:pmid/34414924&rft_galeid=A678271902&rfr_iscdi=true |