scholarly journals Self-Collected Samples to Detect SARS-CoV-2: Direct Comparison of Saliva, Tongue Swab, Nasal Swab, Chewed Cotton Pads and Gargle Lavage

2021 ◽  
Vol 10 (24) ◽  
pp. 5751
Author(s):  
Niko Kohmer ◽  
Lisa Eckermann ◽  
Boris Böddinghaus ◽  
Udo Götsch ◽  
Annemarie Berger ◽  
...  
Keyword(s):  
Nasal Swab ◽  
Clinical Symptoms ◽  
Tap Water ◽  
Diagnostic Sensitivity ◽  
Lower Sensitivity ◽  
Limited Data ◽  
Sample Collection ◽  
Rt Pcr ◽  
Nasal Swabs ◽  
Different Types

Testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by RT-PCR is a vital public health tool in the pandemic. Self-collected samples are increasingly used as an alternative to nasopharyngeal swabs. Several studies suggested that they are sufficiently sensitive to be a useful alternative. However, there are limited data directly comparing several different types of self-collected materials to determine which material is preferable. A total of 102 predominantly symptomatic adults with a confirmed SARS-CoV-2 infection self-collected native saliva, a tongue swab, a mid-turbinate nasal swab, saliva obtained by chewing a cotton pad and gargle lavage, within 48 h of initial diagnosis. Sample collection was unsupervised. Both native saliva and gargling with tap water had high diagnostic sensitivity of 92.8% and 89.1%, respectively. Nasal swabs had a sensitivity of 85.1%, which was not significantly inferior to saliva (p = 0.092), but 16.6% of participants reported they had difficult in self-collection of this sample. A tongue swab and saliva obtained by chewing a cotton pad had a significantly lower sensitivity of 74.2% and 70.2%, respectively. Diagnostic sensitivity was not related to the presence of clinical symptoms or to age. When comparing self-collected specimens from different material, saliva, gargle lavage or mid-turbinate nasal swabs may be considered for most symptomatic patients. However, complementary experiments are required to verify that differences in performance observed among the five sampling modes were not attributed to collection impairment.

scholarly journals Evaluation of sample collection and transport strategies to enhance yield, accessibility, and biosafety of COVID-19 RT-PCR testing

2021 ◽  
Author(s):  
Padmapriya Banada ◽  
David Elson ◽  
Naranjargal Daivaa ◽  
Claire Park ◽  
Samuel Desind ◽  
...  
Keyword(s):  
Sampling Methods ◽  
Diagnostic Yield ◽  
Sampling Strategy ◽  
Sample Collection ◽  
Rt Pcr ◽  
Viral Inactivation ◽  
Viral Transport ◽  
Nasal Swabs ◽  
Polymerase Chain ◽  
Transport Buffer

ABSTRACTSensitive, accessible, and biosafe sampling methods for COVID-19 reverse-transcriptase polymerase chain reaction (RT-PCR) assays are needed for frequent and widespread testing. We systematically evaluated diagnostic yield across different sample collection and transport workflows, including the incorporation of a viral inactivation buffer. We prospectively collected nasal swabs, oral swabs, and saliva, from 52 COVID-19 RT-PCR-confirmed patients, and nasopharyngeal (NP) swabs from 37 patients. Nasal and oral swabs were placed in both viral transport media (VTM) and eNAT™, a sterilizing transport buffer, prior to testing with the Xpert Xpress SARS-CoV-2 (Xpert) test. The sensitivity of each sampling strategy was compared using a composite positive standard. Overall, swab specimens collected in eNAT showed superior sensitivity compared to swabs in VTM (70% vs 57%, P=0.0022). Direct saliva 90.5%, (95% CI: 82%, 95%), followed by NP swabs in VTM and saliva in eNAT, was significantly more sensitive than nasal swabs in VTM (50%, P<0.001) or eNAT (67.8%, P=0.0012) and oral swabs in VTM (50%, P<0.0001) or eNAT (56%, P<0.0001). Saliva and use of eNAT buffer each increased detection of SARS-CoV-2 with the Xpert test; however, no single sample matrix identified all positive cases.

scholarly journals SARS-CoV-2 detection in setting of viral swab scarcity: are MRSA swabs and viral swabs equivalent?

2020 ◽  
Author(s):  
Daniel G. Federman ◽  
Shaili Gupta ◽  
Gary Stack ◽  
Sheldon M. Campbell ◽  
David R. Peaper ◽  
...  
Keyword(s):  
Nasal Swab ◽  
High Rate ◽  
Test Results ◽  
Sample Collection ◽  
Transport Medium ◽  
Viral Transport ◽  
Global Pandemic ◽  
Viral Transport Medium ◽  
Nasal Swabs ◽  
Viral Media

AbstractBackgroundThe global pandemic of Severe Acute Respiratory Syndrome-Related Coronavirus 2 (SARS-CoV2) has resulted in unprecedented challenges for healthcare systems. One barrier to widespread testing has been a paucity of traditional respiratory viral swab collection kits relative to the demand. Whether other sample collection kits, such as widely available MRSA nasal swabs can be used to detect SARS-CoV-2 is unknown.MethodsWe compared simultaneous nasal MRSA swabs (COPAN ESwabs ® 480C flocked nasal swab in 1mL of liquid Amies medium) and virals wabs (BD H192(07) flexible mini-tip flocked nasopharyngeal swabs in 3mL Universal Transport Medium) for SARS-CoV-2 PCR testing using Simplexa COVID-19 Direct assay on patients over a 4-day period. When the results were discordant, the viral swab sample was run again on the Cepheid Xpert Xpress ® SARS-CoV-2 assay.ResultsOf the 81 included samples, there were 19 positives and 62 negatives in viral media and 18 positives and 63 negative in the MRSA swabs. Amongst all included samples, there was concordance between the COPAN ESwabs ® 480C and the viral swabs in 78 (96.3%).ConclusionWe found a high rate of concordance in test results between COPAN ESwabs ® 480C in Amies solution and BD H192(07) nasopharyngeal swabs in in 3 mL of Universal Viral Transport medium viral media. Clinicians and laboratories should feel better informed and assured using COPAN ESwabs ® 480C to help in the diagnosis of COVID-19.

scholarly journals A prospective diagnostic evaluation of accuracy of self-taken and healthcare worker-taken swabs for rapid COVID-19 testing

2021 ◽  
Author(s):  
Helen R. Savage ◽  
Lorna Finch ◽  
Richard Body ◽  
Rachel L. Watkins ◽  
Gail Hayward ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Diagnostic Tests ◽  
Nasal Swab ◽  
Rapid Diagnostic Tests ◽  
Absolute Difference ◽  
Accuracy Evaluation ◽  
List Type ◽  
Rt Pcr ◽  
Predictive Values ◽  
Nasal Swabs

AbstractObjectivesTo compare self-taken and healthcare worker (HCW)-taken throat/nasal swabs to perform rapid diagnostic tests (RDT) for SARS-CoV-2, and how these compare to RT-PCR. We hypothesised that self-taken samples are non-inferior for use with RDTs and in clinical and research settings could have substantial individual and public health benefit.DesignA prospective diagnostic accuracy evaluation as part of the ‘Facilitating Accelerated Clinical Evaluation of Novel Diagnostic Tests for COVID -19 (FALCON C-19), workstream C (undifferentiated community testing)’.SettingNHS Test and Trace drive-through community PCR testing site (Liverpool, UK). ParticipantsEligible participants 18 years or older with symptoms of COVID-19. 250 participants recruited; one withdrew before analysis.SamplingSelf-administered throat/nasal swab for the Covios® RDT, a trained HCW taken throat/nasal sample for PCR and HCW comparison throat/nasal swab for RDT.Main outcome measuresSensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated; comparisons between self-taken and HCW-taken samples used McNemar’s test.ResultsSeventy-five participants (75/249, 30.1%) were positive by RT-PCR. RDTs with self-taken swabs had a sensitivity of 90.5% (67/74, 95% CI: 83.9-97.2), compared to 78.4% (58/74, 95% CI: 69.0-87.8) for HCW-taken swabs (absolute difference 12.2%, 95% CI: 4.7-19.6, p=0.003). Specificity for self-taken swabs was 99.4% (173/174, 95% CI: 98.3-100.0), versus 98.9% (172/174, 95% CI: 97.3-100.0) for HCW-taken swabs (absolute difference 0.6%, 95% CI: 0.5-1.7, p=0.317). The PPV of self-taken RDTs (98.5%, 67/68, 95% CI: 95.7-100.0) and HCW-taken RDTs (96.7%, 58/60, 95% CI 92.1-100.0) were not significantly different (p=0.262). However, the NPV of self-taken swab RDTs was significantly higher (96.1%, 173/180, 95% CI: 93.2-98.9) than HCW-taken RDTs (91.5%, 172/188, 95% CI 87.5-95.5, p=0.003).ConclusionSelf-taken swabs for COVID-19 testing offer substantial individual benefits in terms of convenience, accuracy, and reduced risk of transmitting infection. Our results demonstrate that self-taken throat/nasal samples can be used by lay individuals as part of rapid testing programmes for symptomatic adults.Trial RegistrationIRAS ID:28422, clinical trial ID: NCT04408170SummaryWhat is already known on this topic?Rapid diagnostic tests (RDTs)for SARS-CoV-2 Ag are a cheaper point-of-care alternative to RT-PCR for diagnosing COVID-19 disease.The accuracy of tests can vary dependent on sampling technique, test processing and reading of results.What this study adds?Self-taken throat-nasal swabs for RDTs can be used by symptomatic adults to give reliable results to diagnose SARS-CoV-2.Self-sampling can be implemented with little training and no assistance.

scholarly journals Diagnostic accuracy of a novel SARS-CoV-2 antigen-detecting rapid diagnostic test from standardized self-collected anterior nasal swabs

2021 ◽  
Author(s):  
Bilgin Osmanodja ◽  
Klemens Budde ◽  
Daniel Zickler ◽  
Marcel G. Naik ◽  
Jörg Hofmann ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Point Of Care ◽  
High Viral Load ◽  
Ease Of Use ◽  
Healthcare Personnel ◽  
Sample Collection ◽  
Rt Pcr ◽  
Self Testing ◽  
Nasal Swabs ◽  
Potential Benefits

AbstractBackgroundAntigen-detecting rapid diagnostic tests (Ag-RDT) for SARS-CoV-2 offer new opportunities for the quick and laboratory-independent identification of infected individuals for control of the SARS-CoV-2 pandemic. Despite the potential benefits, nasopharyngeal sample collection is frequently perceived as uncomfortable by patients and requires trained healthcare personnel with protective equipment. Therefore, anterior nasal self-sampling is increasingly recognized as a valuable alternative.MethodsWe performed a prospective, single-center, point of care validation of an Ag-RDT using a polypropylene absorbent collector for standardized self-collected anterior nasal swabs. Real-Time Polymerase Chain Reaction (RT-PCR) from combined oropharyngeal/nasopharyngeal swabs served as a comparator. Primary endpoint was sensitivity of the standardized Ag-RDT in symptomatic patients with medium or high viral concentration (≥ 1 million RNA copies on RT-PCR for SARS-CoV-2).ResultsBetween February 12 and March 22, 2021, 388 participants were enrolled. After exclusion of 9 patients for which no PCR result could be obtained, the novel Ag-RDT was evaluated based on 379 participants, of which 273 were symptomatic and 106 asymptomatic. In 61 samples from symptomatic patients with medium or high viral load (≥ 1 million RNA copies), the sensitivity of the standardized Ag-RDT was 96.7% (59/61; 95%CI: 88.7-99.6%) for the primary endpoint. In total, 62 positive Ag-RDT results were detected out of 70 RT-PCR positive individuals, yielding an overall sensitivity of 88.6% (95%CI: 78.7-94.9%). Specificity was 99.7% (95%CI: 98.2-100%) in 309 RT-PCR negative individuals.ConclusionHere, we present a validation of a novel Ag-RDT with a standardized sampling process for anterior nasal self-collection, which meets WHO criteria of ≥80% sensitivity and ≥97% specificity. Although less sensitive than RT-PCR, this assay could be beneficial due to its rapid results, ease of use, and suitability for standardized self-testing.(Funded by Drägerwerk AG & Co. KGaA, Lübeck, Germany; ClinicalTrials.gov number NCT04698993)

scholarly journals Sampling site for SARS-CoV-2 RT-PCR—An intrapatient four-site comparison from Tampere, Finland

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260184
Author(s):  
Dominik Kerimov ◽  
Pekka Tamminen ◽  
Hanna Viskari ◽  
Lauri Lehtimäki ◽  
Janne Aittoniemi
Keyword(s):  
Informed Consent ◽  
Study Design ◽  
Nasal Swab ◽  
Sampling Site ◽  
Threshold Values ◽  
Rt Pcr ◽  
Cycle Threshold ◽  
Significant Difference ◽  
Nasal Swabs ◽  
Written Informed Consent

Background SARS-CoV-2 diagnosis relies on the performance of nasopharyngeal swabs. Alternative sample sites have been assessed but the heterogeneity of the studies have made comparing different sites difficult. Objectives Our aim was to compare the performance of four different sampling sites for SARS-CoV-2 samples with nasopharynx being the benchmark. Study design COVID-19 positive patients were recruited prospectively, and samples were collected and analysed for SARS-CoV-2 with RT-PCR from all four anatomical sites in 43 patients, who provided written informed consent. Results All anterior nasal and saliva samples were positive, while two oropharyngeal samples were negative. There was no significant difference in the cycle threshold values of nasopharyngeal and anterior nasal samples while saliva and oropharynx had higher cycle threshold values. Conclusions Anterior nasal swab performs as good as nasopharynx swab with saliva also finding all the positives but with higher cycle threshold values. Thus, we can conclude that anterior nasal swabs can be used for SARS-CoV-2 detection instead of nasopharyngeal swabs if the situation would require so.

scholarly journals Sensitive detection and quantification of SARS-CoV-2 in saliva

2020 ◽  
Author(s):  
Mustafa Fatih Abasiyanik ◽  
Blake Flood ◽  
Jing Lin ◽  
Sefika Ozcan ◽  
Sherin J Rouhani ◽  
...  
Keyword(s):  
Nasal Swab ◽  
Digital Pcr ◽  
Rt Pcr ◽  
Community Screening ◽  
Viral Loads ◽  
Reverse Transcription Pcr ◽  
Testing Facility ◽  
Wide Range ◽  
Nasal Swabs ◽  
Higher Sensitivity

AbstractSaliva has significant advantages as a test medium for detection of SARS-CoV-2 infection in patients, such as ease of collection, minimal requirement of supplies and trained personnel, and safety. Comprehensive validation in a large cohort of prospectively collected specimens with unknown SARS-CoV-2 status should be performed to evaluate the potential and limitations of saliva-based testing. We developed a saliva-based testing pipeline for detection of SARS-CoV-2 nucleic acids using real-time reverse transcription PCR (RT-PCR) and droplet digital PCR (ddPCR) readouts, and measured samples from 137 outpatients tested at a curbside testing facility and 29 inpatients hospitalized for COVID-19. These measurements were compared to the nasal swab results for each patient performed by a certified microbiology laboratory. We found that our saliva testing positively detects 100% (RT-PCR) and 93.75% (ddPCR) of curbside patients that were identified as SARS-CoV-2 positive by the Emergency Use Authorization (EUA) certified nasal swab testing assay. Quantification of viral loads by ddPCR revealed an extremely wide range, with 1 million-fold difference between individual patients. Our results demonstrate for both community screening and hospital settings that saliva testing reliability is on par with that of the nasal swabs in detecting infected cases, and has potential for higher sensitivity when combined with ddPCR in detecting low-abundance viral loads that evade traditional testing methods.

scholarly journals Sensitive detection and quantification of SARS-CoV-2 in saliva

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mustafa Fatih Abasiyanik ◽  
Blake Flood ◽  
Jing Lin ◽  
Sefika Ozcan ◽  
Sherin J. Rouhani ◽  
...  
Keyword(s):  
Nasal Swab ◽  
Digital Pcr ◽  
Rt Pcr ◽  
Community Screening ◽  
Viral Loads ◽  
Reverse Transcription Pcr ◽  
Testing Facility ◽  
Wide Range ◽  
Nasal Swabs ◽  
Higher Sensitivity

AbstractSaliva has significant advantages as a test medium for detection of SARS-CoV-2 infection in patients, such as ease of collection, minimal requirement of supplies and trained personnel, and safety. Comprehensive validation in a large cohort of prospectively collected specimens with unknown SARS-CoV-2 status should be performed to evaluate the potential and limitations of saliva-based testing. We developed a saliva-based testing pipeline for detection of SARS-CoV-2 nucleic acids using real-time reverse transcription PCR (RT-PCR) and droplet digital PCR (ddPCR) readouts, and measured samples from 137 outpatients tested at a curbside testing facility and 29 inpatients hospitalized for COVID-19. These measurements were compared to the nasal swab results for each patient performed by a certified microbiology laboratory. We found that our saliva testing positively detects 100% (RT-PCR) and 93.75% (ddPCR) of curbside patients that were identified as SARS-CoV-2 positive by the Emergency Use Authorization (EUA) certified nasal swab testing assay. Quantification of viral loads by ddPCR revealed an extremely wide range, with 1 million-fold difference between individual patients. Our results demonstrate for both community screening and hospital settings that saliva testing reliability is on par with that of the nasal swabs in detecting infected cases, and has potential for higher sensitivity when combined with ddPCR in detecting low-abundance viral loads that evade traditional testing methods.

scholarly journals Usability of an At-Home Anterior Nares SARS-CoV-2 RT-PCR Sample Collection Kit: Human Factors Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Laura E Strong ◽  
Irene Middendorf ◽  
Michelle Turner ◽  
David K Edwards V ◽  
Varun Sama ◽  
...  
Keyword(s):  
Health Care ◽  
Human Factors ◽  
Nasal Swab ◽  
Medical Laboratory ◽  
Written Feedback ◽  
Swab Sample ◽  
Sample Collection ◽  
Rt Pcr ◽  
Nasal Swab Sample ◽  
At Home

BACKGROUND Readily available testing for SARS-CoV-2 is necessary to mitigate COVID-19 disease outbreaks. At-home collection kits, in which samples are self-collected without requiring a laboratory or clinic visit and sent to an external laboratory for testing, can provide convenient testing to those with barriers to access. They can prevent unnecessary exposure between patient and clinical staff, increase access for patients with disabilities or remote workers, and decrease burdens on health care resources, such as provider time and personal protective equipment. Exact Sciences developed an at-home collection kit for samples to be tested to detect SARS-CoV-2 that includes an Instructions for Use (IFU) document, which guides people without prior experience on collecting a nasal swab sample. Demonstrating successful sample collection and usability is critical to ensure that these samples meet the same high-quality sample collection standards as samples collected in clinics. OBJECTIVE The aim of this study was to determine the usability of a SARS-CoV-2 at-home nasal swab sample collection kit. METHODS A human factors usability study was conducted with 30 subjects without prior medical, laboratory, or health care training and without COVID-19 sample self-collection experience. Subjects were observed while they followed the IFU for the at-home sample collection portion of the SARS-CoV-2 test in a setting that simulated a home environment. IFU usability was further evaluated by requiring the subjects to complete a survey, answer comprehension questions, provide written feedback, and respond to questions from the observer about problems during use. RESULTS All 30 subjects successfully completed the sample collection process, and all 30 samples were determined by reverse transcription–polymerase chain reaction (RT-PCR) testing to meet quality standards for SARS-CoV-2 testing. The subjects’ written feedback and comments revealed several recommendations to improve the IFU. CONCLUSIONS The study demonstrated the overall usability of an at-home SARS-CoV-2 collection kit. Various feedback mechanisms provided opportunities to improve the wording and graphics for some critical tasks, including placing the label correctly on the tube. A modified IFU was prepared based on study outcomes.

scholarly journals Accuracy of a Novel SARS-CoV-2 Antigen-Detecting Rapid Diagnostic Test from Standardized Self-Collected Anterior Nasal Swabs

2021 ◽  
Vol 10 (10) ◽  
pp. 2099
Author(s):  
Bilgin Osmanodja ◽  
Klemens Budde ◽  
Daniel Zickler ◽  
Marcel G. Naik ◽  
Jörg Hofmann ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Point Of Care ◽  
World Health Organisation ◽  
Ease Of Use ◽  
Alternative Methods ◽  
World Health ◽  
Healthcare Personnel ◽  
Sample Collection ◽  
Rt Pcr ◽  
Nasal Swabs

Background Antigen-detecting rapid diagnostic tests (Ag-RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) offer new opportunities for the quick and laboratory-independent identification of infected individuals for control of the SARS-CoV-2 pandemic. Despite the potential benefits, nasopharyngeal sample collection is frequently perceived as uncomfortable by patients and requires trained healthcare personnel with protective equipment. Therefore, anterior nasal self-sampling is increasingly recognized as a valuable alternative. Methods We performed a prospective, single-center, point of care validation of an Ag-RDT using a polypropylene absorbent collector for standardized self-collected anterior nasal swabs. Real-time polymerase chain reaction (RT-PCR) from combined oropharyngeal/nasopharyngeal swabs served as a comparator. Primary endpoint was sensitivity of the standardized Ag-RDT in symptomatic patients with medium or high viral concentration (≥1 million RNA copies on RT-PCR for SARS-CoV-2). Results Between 12 February and 22 March 2021, 388 participants were enrolled. After exclusion of 9 patients for which no PCR result could be obtained, the novel Ag-RDT was evaluated based on 379 participants, of whom 273 were symptomatic and 106 asymptomatic. In 61 samples from symptomatic patients with medium or high viral load (≥1 million RNA copies), the sensitivity of the standardized Ag-RDT was 96.7% (59/61; 95% confidence interval (CI): 88.7–99.6%) for the primary endpoint. In total, 62 positive Ag-RDT results were detected out of 70 RT-PCR positive individuals, yielding an overall sensitivity of 88.6% (95% CI: 78.7–94.9%). Specificity was 99.7% (95% CI: 98.2–100%) in 309 RT-PCR negative individuals. Conclusions Here, we present a validation of a novel Ag-RDT with a standardized sampling process for anterior nasal self-collection, which meets World Health Organisation (WHO) criteria of ≥80% sensitivity and ≥97% specificity. Although less sensitive than RT-PCR, this assay could be beneficial due to its rapid results, ease of use, and suitability for standardized self-testing.

scholarly journals Detection of Coronavirus in Simultaneously Collected Tear and Throat Swab Samples from the Patients with 2019- new Coronavirus Infection Disease: A Single Center Cross-sectional Study

2020 ◽  
Author(s):  
Ying Yan ◽  
Bo Zeng ◽  
Zhang Zhang ◽  
Cheng Hu ◽  
Ming Yan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Throat Swab ◽  
Case Series ◽  
Threshold Value ◽  
Time Interval ◽  
Sample Collection ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Case Series Study ◽  
Infection Disease

Abstract Objecive: This study aimed to evaluate whether the coronavirus can be detected in the tears in the eyes of 2019- novel coronavirus (2019-nCoV) infected patients and compa re the detection consistency of two simultaneously collected samples, from the tears and throat swabs, of these patients.Methods: A total of 35 diagnosis confirmed patients with 2019-nCoV infection disease,from January 26 to February 19, 2020, at central theater Wuhan general hospital of PLA, were included in this cross-sectional case series study. The diagnosis was confirmed by both clinical and laboratory ways. Throat samples from all enrolled patients were collected with sampling swab, and simultaneously ,tear samples were collected w ith sampling swab from 9 patients (No.1-9) and with Schirmer's strip from the remaining patients (No.10-35) (bilateral eyes for all patients). Sample collecting and testing were performed in three separate time points: first from patients No.1-9,second from p atients No.10-29,and third from patients No.30-35. Reverse-transcriptase-polymerase-chai n-reaction (RT-PCR) assay was performed by the same technician(Researcher Zhang), who was blind to the patients profile, within 4 hours after each collection.Results: Among enrolled patients, 29 (No.1-29) had mild or moderate clinical symptoms and 6 (No.30-35) had severe symptoms. The mean time interval from the sample collection day to diagnosis confirmation day was 9.71±6.50 days (ranged from 3 to 29 days). None of the patients had conjunctivitis. Nineteen out of 35 (54.3%) throat samples presented positive Rt-PCR results. Three (no.13,21,31) out of 35 (8.6%) tear samples presented positive RT-PCR results. Two(no.21, 31) of these three patients were throat swab positive and one (No. 13) was negative. The consistency analysis indicated that tears and throat samples showed poor consistency ( Kappa=-0.009, P=0.9 ).The cycle threshold value (Ct-value) of tears samples collected by sampling swab was significantly higher than that by Schirmer's strip(t=2.288, P=0.03).Conclusion: In spite of the low 2019-nCoV positive detection rate of tear samples from 2019-nCoV infected patients, we cannot fully rule out the transmission by ocular surface. Whether tear testing can be used as an aid in judging of 2019-nCoV infection need further investigation.Authors Ying Yan and Bo Zeng contributed equally to this study

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