{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:44:56Z","timestamp":1773290696544,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["COVID190107"],"award-info":[{"award-number":["COVID190107"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005407","name":"Food and Health Bureau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Self-collected specimens have been advocated to avoid infectious exposure to healthcare workers. Self-induced sputum in those with a productive cough and saliva in those without a productive cough have been proposed, but sensitivity remains uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a prospective study in 2 regional hospitals in Hong Kong.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We prospectively examined 563 serial samples collected during the virus shedding periods of 50 patients: 150 deep throat saliva (DTS), 309 pooled-nasopharyngeal (NP) and throat swabs, and 104 sputum. Deep throat saliva had the lowest overall reverse-transcriptase polymerase chain reaction (RT-PCR)-positive rate (68.7% vs 89.4% [sputum] and 80.9% [pooled NP and throat swabs]) and the lowest viral ribonucleic acid (RNA) concentration (mean log copy\/mL 3.54 vs 5.03 [sputum] and 4.63 [pooled NP and throat swabs]). Analyses with respect to time from symptom onset and severity also revealed similar results. Virus yields of DTS correlated with that of sputum (Pearson correlation index 0.76; 95% confidence interval, 0.62\u20130.86). We estimated that the overall false-negative rate of DTS could be as high as 31.3% and increased 2.7 times among patients without sputum.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Deep throat saliva produced the lowest viral RNA concentration and RT-PCR-positive rate compared with conventional respiratory specimens in all phases of illness. Self-collected sputum should be the choice for patients with sputum.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaa487","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T11:14:29Z","timestamp":1596194069000},"page":"1612-1619","source":"Crossref","is-referenced-by-count":35,"title":["Prospective Study Comparing Deep Throat Saliva With Other Respiratory Tract Specimens in the Diagnosis of Novel Coronavirus Disease 2019"],"prefix":"10.1093","volume":"222","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-5944","authenticated-orcid":false,"given":"Christopher K C","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (SAR), China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zigui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (SAR), China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-2967","authenticated-orcid":false,"given":"Grace","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lowell","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin C S","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita W Y","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (SAR), China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene Y K","family":"Tso","sequence":"additional","affiliation":[{"name":"United Christian Hospital, Hospital Authority, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kitty S C","family":"Fung","sequence":"additional","affiliation":[{"name":"United Christian Hospital, Hospital Authority, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siu T","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry K C","family":"Wong","sequence":"additional","affiliation":[{"name":"United Christian Hospital, Hospital Authority, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siaw S","family":"Boon","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (SAR), China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S C","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul K S","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region (SAR), China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,1]]},"reference":[{"key":"2020101307145688900_CIT0001","first-page":"w20225","article-title":"COVID-19 epidemic in Switzerland: on the importance of testing, contact tracing and isolation","volume":"150","author":"Salath\u00e9","year":"2020","journal-title":"Swiss Med Wkly"},{"key":"2020101307145688900_CIT0002","author":"World Health Organization."},{"key":"2020101307145688900_CIT0003","author":"Center of Disease Control and Prevention"},{"key":"2020101307145688900_CIT0004","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med"},{"key":"2020101307145688900_CIT0005","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1093\/cid\/ciaa377","article-title":"Gargle lavage as a safe and sensitive alternative to swab samples to diagnose COVID-19: a case report in Japan","volume":"71","author":"Saito","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2020101307145688900_CIT0006","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jviromet.2017.06.010","article-title":"Comparison of gargle samples and throat swab samples for the detection of respiratory pathogens","volume":"248","author":"Bennett","year":"2017","journal-title":"J Virol Methods"},{"key":"2020101307145688900_CIT0007","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.cmi.2018.06.009","article-title":"Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study","volume":"25","author":"To","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"2020101307145688900_CIT0008","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciaa797","article-title":"Posterior oropharyngeal saliva for the detection of SARS-CoV-2","author":"Wong","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2020101307145688900_CIT0009","doi-asserted-by":"crossref","first-page":"e0004100","DOI":"10.1371\/journal.pntd.0004100","article-title":"Value of routine dengue diagnostic tests in urine and saliva specimens","volume":"9","author":"Andries","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"2020101307145688900_CIT0010","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1002\/jmv.1890410207","article-title":"Demonstration of hepatitis C virus genome in saliva and urine of patients with type C hepatitis: usefulness of the single round polymerase chain reaction method for detection of the HCV genome","volume":"41","author":"Numata","year":"1993","journal-title":"J Med Virol"},{"key":"2020101307145688900_CIT0011","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.1016\/j.jcv.2013.08.017","article-title":"Comparison of HIV oral fluid and plasma antibody results during early infection in a longitudinal Nigerian cohort","volume":"58","author":"Luo","year":"2013","journal-title":"J Clin Virol"},{"key":"2020101307145688900_CIT0012","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.3201\/eid1007.031113","article-title":"Detection of SARS associated coronavirus in throat wash and saliva in early diagnosis","volume":"10","author":"Wang","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"2020101307145688900_CIT0013","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S1473-3099(20)30196-1","article-title":"Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study","volume":"20","author":"To","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2020101307145688900_CIT0014","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMp2015897","article-title":"False negative tests for SARS-CoV-2 infection \u2014 challenges and implications","author":"Woloshin","year":"2020","journal-title":"N Engl J Med"},{"key":"2020101307145688900_CIT0015","author":"Centre for Health Protection, Hong Kong SAR."},{"key":"2020101307145688900_CIT0016","author":"Centers for Disease Control and Prevention"},{"key":"2020101307145688900_CIT0017","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jinf.2020.04.014","article-title":"Viral dynamics of SARS-CoV-2 across a spectrum of disease severity in COVID-19","volume":"81","author":"Lui","year":"2020","journal-title":"J Infect"},{"key":"2020101307145688900_CIT0018","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.ajic.2020.04.010","article-title":"COVID-19 drive through testing: an effective strategy for conserving personal protective equipment","volume":"48","author":"Ton","year":"2020","journal-title":"Am J Infect Control"},{"key":"2020101307145688900_CIT0019","first-page":"100111","article-title":"Testing on the move: South Korea\u2019s rapid response to the COVID-19 pandemic","volume":"5","author":"Lee","year":"2020","journal-title":"Transp Res Interdiscip Perspect"},{"key":"2020101307145688900_CIT0020","author":"The Hong Kong SAR Government"},{"key":"2020101307145688900_CIT0021","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1093\/cid\/ciaa149","article-title":"Consistent detection of 2019 novel coronavirus in saliva","volume":"71","author":"To","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2020101307145688900_CIT0022","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1080\/22221751.2020.1775133","article-title":"Evaluating the use of posterior oropharyngeal saliva in a point-of-care assay for the detection of SARS-CoV-2","volume":"9","author":"Chen","year":"2020","journal-title":"Emerg Microbes Infect"},{"key":"2020101307145688900_CIT0023","doi-asserted-by":"crossref","DOI":"10.1016\/j.cmi.2020.05.001","article-title":"Saliva sample as a non-invasive specimen for the diagnosis of coronavirus disease 2019: a cross sectional study","author":"Pasomsub","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"2020101307145688900_CIT0024","doi-asserted-by":"crossref","DOI":"10.1002\/jmv.26258","article-title":"Deep throat saliva as an alternative diagnostic specimen type for the detection of SARS-CoV-2","author":"Leung","year":"2020","journal-title":"J Med Virol"},{"key":"2020101307145688900_CIT0025","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.jinf.2020.04.005","article-title":"Saliva is a reliable tool to detect SARS-CoV-2","volume":"81","author":"Azzi","year":"2020","journal-title":"J Infect"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiaa487\/33721176\/jiaa487.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/222\/10\/1612\/33872690\/jiaa487.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/222\/10\/1612\/33872690\/jiaa487.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T11:21:32Z","timestamp":1602588092000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/222\/10\/1612\/5879767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,1]]},"references-count":25,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,8,1]]},"published-print":{"date-parts":[[2020,10,13]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiaa487","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11,15]]},"published":{"date-parts":[[2020,8,1]]}}}