Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study.
<h4>Background</h4>The SARS-CoV-2 pandemic has caused an unprecedented strain on healthcare systems worldwide, including the United Kingdom National Health Service (NHS). We conducted an observational cohort study of SARS-CoV-2 infection in frontline healthcare workers (HCW) working in a...
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280908&type=printable |
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| author | Naomi F Walker Rachel L Byrne Ashleigh Howard Elissavet Nikolaou Madlen Farrar Sharon Glynn Katerina S Cheliotis Ana I Cubas Atienzar Kelly Davies Jesús Reiné Zalina Rashid-Gardner Esther L German Carla Solórzano Tess Blandamer Lisa Hitchins Christopher Myerscough Bradford D Gessner Elizabeth Begier Andrea M Collins Mike Beadsworth Stacy Todd Helen Hill Catherine F Houlihan Eleni Nastouli Emily R Adams Elena Mitsi Daniela M Ferreira SAFER investigators |
| author_facet | Naomi F Walker Rachel L Byrne Ashleigh Howard Elissavet Nikolaou Madlen Farrar Sharon Glynn Katerina S Cheliotis Ana I Cubas Atienzar Kelly Davies Jesús Reiné Zalina Rashid-Gardner Esther L German Carla Solórzano Tess Blandamer Lisa Hitchins Christopher Myerscough Bradford D Gessner Elizabeth Begier Andrea M Collins Mike Beadsworth Stacy Todd Helen Hill Catherine F Houlihan Eleni Nastouli Emily R Adams Elena Mitsi Daniela M Ferreira SAFER investigators |
| author_sort | Naomi F Walker |
| collection | DOAJ |
| description | <h4>Background</h4>The SARS-CoV-2 pandemic has caused an unprecedented strain on healthcare systems worldwide, including the United Kingdom National Health Service (NHS). We conducted an observational cohort study of SARS-CoV-2 infection in frontline healthcare workers (HCW) working in an acute NHS Trust during the first wave of the pandemic, to answer emerging questions surrounding SARS-CoV-2 infection, diagnosis, transmission and control.<h4>Methods</h4>Using self-collected weekly saliva and twice weekly combined oropharyngeal/nasopharyngeal (OP/NP) samples, in addition to self-assessed symptom profiles and isolation behaviours, we retrospectively compared SARS-CoV-2 detection by RT-qPCR of saliva and OP/NP samples. We report the association with contemporaneous symptoms and isolation behaviour.<h4>Results</h4>Over a 12-week period from 30th March 2020, 40·0% (n = 34/85, 95% confidence interval 31·3-51·8%) HCW had evidence of SARS-CoV-2 infection by surveillance OP/NP swab and/or saliva sample. Symptoms were reported by 47·1% (n = 40) and self-isolation by 25·9% (n = 22) participants. Only 44.1% (n = 15/34) participants with SARS-CoV-2 infection reported any symptoms within 14 days of a positive result and only 29·4% (n = 10/34) reported self-isolation periods. Overall agreement between paired saliva and OP/NP swabs was 93·4% (n = 211/226 pairs) but rates of positive concordance were low. In paired samples with at least one positive result, 35·0% (n = 7/20) were positive exclusively by OP/NP swab, 40·0% (n = 8/20) exclusively by saliva and in only 25·0% (n = 5/20) were the OP/NP and saliva result both positive.<h4>Conclusions</h4>HCW are a potential source of SARS-CoV-2 transmission in hospitals and symptom screening will identify the minority of infections. Without routine asymptomatic SARS-CoV-2 screening, it is likely that HCW with SARS-CoV-2 infection would continue to attend work. Saliva, in addition to OP/NP swab testing, facilitated ascertainment of symptomatic and asymptomatic SARS-CoV-2 infections. Combined saliva and OP/NP swab sampling would improve detection of SARS-CoV-2 for surveillance and is recommended for a high sensitivity strategy. |
| format | Article |
| id | doaj-art-2f8d87f300ff42ec98b0540f44bdb8b9 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-2f8d87f300ff42ec98b0540f44bdb8b92025-08-20T02:23:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e028090810.1371/journal.pone.0280908Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study.Naomi F WalkerRachel L ByrneAshleigh HowardElissavet NikolaouMadlen FarrarSharon GlynnKaterina S CheliotisAna I Cubas AtienzarKelly DaviesJesús ReinéZalina Rashid-GardnerEsther L GermanCarla SolórzanoTess BlandamerLisa HitchinsChristopher MyerscoughBradford D GessnerElizabeth BegierAndrea M CollinsMike BeadsworthStacy ToddHelen HillCatherine F HoulihanEleni NastouliEmily R AdamsElena MitsiDaniela M FerreiraSAFER investigators<h4>Background</h4>The SARS-CoV-2 pandemic has caused an unprecedented strain on healthcare systems worldwide, including the United Kingdom National Health Service (NHS). We conducted an observational cohort study of SARS-CoV-2 infection in frontline healthcare workers (HCW) working in an acute NHS Trust during the first wave of the pandemic, to answer emerging questions surrounding SARS-CoV-2 infection, diagnosis, transmission and control.<h4>Methods</h4>Using self-collected weekly saliva and twice weekly combined oropharyngeal/nasopharyngeal (OP/NP) samples, in addition to self-assessed symptom profiles and isolation behaviours, we retrospectively compared SARS-CoV-2 detection by RT-qPCR of saliva and OP/NP samples. We report the association with contemporaneous symptoms and isolation behaviour.<h4>Results</h4>Over a 12-week period from 30th March 2020, 40·0% (n = 34/85, 95% confidence interval 31·3-51·8%) HCW had evidence of SARS-CoV-2 infection by surveillance OP/NP swab and/or saliva sample. Symptoms were reported by 47·1% (n = 40) and self-isolation by 25·9% (n = 22) participants. Only 44.1% (n = 15/34) participants with SARS-CoV-2 infection reported any symptoms within 14 days of a positive result and only 29·4% (n = 10/34) reported self-isolation periods. Overall agreement between paired saliva and OP/NP swabs was 93·4% (n = 211/226 pairs) but rates of positive concordance were low. In paired samples with at least one positive result, 35·0% (n = 7/20) were positive exclusively by OP/NP swab, 40·0% (n = 8/20) exclusively by saliva and in only 25·0% (n = 5/20) were the OP/NP and saliva result both positive.<h4>Conclusions</h4>HCW are a potential source of SARS-CoV-2 transmission in hospitals and symptom screening will identify the minority of infections. Without routine asymptomatic SARS-CoV-2 screening, it is likely that HCW with SARS-CoV-2 infection would continue to attend work. Saliva, in addition to OP/NP swab testing, facilitated ascertainment of symptomatic and asymptomatic SARS-CoV-2 infections. Combined saliva and OP/NP swab sampling would improve detection of SARS-CoV-2 for surveillance and is recommended for a high sensitivity strategy.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280908&type=printable |
| spellingShingle | Naomi F Walker Rachel L Byrne Ashleigh Howard Elissavet Nikolaou Madlen Farrar Sharon Glynn Katerina S Cheliotis Ana I Cubas Atienzar Kelly Davies Jesús Reiné Zalina Rashid-Gardner Esther L German Carla Solórzano Tess Blandamer Lisa Hitchins Christopher Myerscough Bradford D Gessner Elizabeth Begier Andrea M Collins Mike Beadsworth Stacy Todd Helen Hill Catherine F Houlihan Eleni Nastouli Emily R Adams Elena Mitsi Daniela M Ferreira SAFER investigators Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study. PLoS ONE |
| title | Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study. |
| title_full | Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study. |
| title_fullStr | Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study. |
| title_full_unstemmed | Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study. |
| title_short | Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: An observational cohort study. |
| title_sort | detection of sars cov 2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers an observational cohort study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280908&type=printable |
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