Study Shows COVID-19 Saliva Samples Yield Test Results as Accurate as Nasal Swabs

July 14, 2022

Rockville, Md.—A paper Abt Global coauthored shows that COVID-19 specimen-collection methods other than traditional nasal swabs are accurate in detecting SARS-CoV-2 infections. SARS-CoV-2 is the virus that causes COVID-19 illness. A variety of options for testing is critical because of global supply shortages faced during a public health emergency such as a pandemic.

Abt Global, which collects data on COVID-19 transmission and vaccine effectiveness for the Centers for Disease Control and Prevention (CDC), explored several approaches. The normal protocol, the gold standard for testing for this type of virus, was to use traditional, soft-tipped nasal swabs. Study participants placed them in tubes with liquid and sent them in for analysis. The other methods Abt tested were saliva put in cups and foam-tipped swabs put in empty tubes.

Participants with at least one COVID-19 symptom from three CDC-sponsored studies provided specimens for all three collection methods. The results, which were published in Microbiology Spectrum, showed that saliva and foam-tipped swabs provided the sensitivity and specificity (true positives and true negatives) required. The analysis showed 97 percent positive results for soft-tipped swabs, 99 percent for saliva, and 89 percent for foam-tipped swabs.

“This paper shows there are alternatives to the most commonly used swab test for COVID-19 testing,“ says Jazmin Duque, the Abt lead for the Coronavirus Household Evaluation and Respiratory Testing (C-HEaRT) study. “This allows us to address supply shortages in the setting of a public health emergency.”

The saliva option is particularly attractive for children. “They have fun drooling into a funnel,” Duque says. “It’s a more appealing option than sticking a swab up their noses.”

The specimens came from 1,900 participants in three studies: C-HEaRT, the Abt-led Research on the Epidemiology of SARS-CoV-2 in Essential Response personnel, and the University of Arizona’s Arizona Healthcare, Emergency Response, and Other Essential Workers Surveillance study. They produced more than 4,000 specimens. The paper’s merger of data from three studies shows the value of carrying out different studies using similar protocols.

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