{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:19:15Z","timestamp":1787239155372,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:00:00Z","timestamp":1605571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Widely available and easily accessible testing for COVID-19 is a cornerstone of pandemic containment strategies. Nasopharyngeal swabs (NPS) are the currently accepted standard for sample collection but are limited by their need for collection devices and sampling by trained healthcare professionals. The aim of this study was to compare the performance of saliva to NPS in an outpatient setting. This was a prospective study conducted at three centers, which compared the performance of saliva and NPS samples collected at the time of assessment center visit. Samples were tested by real-time reverse transcription polymerase chain reaction and sensitivity and overall agreement determined between saliva and NPS. Clinical data was abstracted by chart review for select study participants. Of the 432 paired samples, 46 were positive for SARS-CoV-2, with seven discordant observed between the two sample types (four individuals testing positive only by NPS and three by saliva only). The observed agreement was 98.4% (kappa coefficient 0.91) and a composite reference standard demonstrated sensitivity of 0.91 and 0.93 for saliva and NPS samples, respectively. On average, the Ct values obtained from saliva as compared to NPS were higher by 2.76. This study demonstrates that saliva performs comparably to NPS for the detection of SARS-CoV-2. Saliva was simple to collect, did not require transport media, and could be tested with equipment readily available at most laboratories. The use of saliva as an acceptable alternative to NPS could support the use of widespread surveillance testing for SARS-CoV-2.<\/jats:p>","DOI":"10.3390\/v12111314","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T07:23:28Z","timestamp":1605597808000},"page":"1314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Detection of SARS-CoV-2 from Saliva as Compared to Nasopharyngeal Swabs in Outpatients"],"prefix":"10.3390","volume":"12","author":[{"given":"Christopher","family":"Kandel","sequence":"first","affiliation":[{"name":"Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"McCready","sequence":"additional","affiliation":[{"name":"Department of Medicine, Michael Garron Hospital, Toronto, ON M4C 3E7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Serbanescu","sequence":"additional","affiliation":[{"name":"Dynacare Laboratory, Brampton, ON L6T 5M3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Racher","sequence":"additional","affiliation":[{"name":"Dynacare Laboratory, Brampton, ON L6T 5M3, Canada"},{"name":"Department of Laboratory Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Desaulnier","sequence":"additional","affiliation":[{"name":"Dynacare Laboratory, Brampton, ON L6T 5M3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Powis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Michael Garron Hospital, Toronto, ON M4C 3E7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Vojdani","sequence":"additional","affiliation":[{"name":"Department of Medicine, Michael Garron Hospital, Toronto, ON M4C 3E7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Finlay","sequence":"additional","affiliation":[{"name":"Department of Medicine, Michael Garron Hospital, Toronto, ON M4C 3E7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-385X","authenticated-orcid":false,"given":"Elena","family":"Sheldrake","sequence":"additional","affiliation":[{"name":"Shared Hospital Laboratory, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie","family":"Vermeiren","sequence":"additional","affiliation":[{"name":"Shared Hospital Laboratory, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6388-9842","authenticated-orcid":false,"given":"Kevin","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Shared Hospital Laboratory, Toronto, ON M4N 3M5, Canada"},{"name":"North York General Hospital, Toronto, ON M2K 1E1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"McGeer","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kozak","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Shared Hospital Laboratory, Toronto, ON M4N 3M5, Canada"},{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Goneau","sequence":"additional","affiliation":[{"name":"Dynacare Laboratory, Brampton, ON L6T 5M3, Canada"},{"name":"Department of Laboratory Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,17]]},"reference":[{"key":"ref_1","first-page":"e7708","article-title":"A Review of Salivary Diagnostics and Its Potential Implication in Detection of Covid-19","volume":"12","author":"Santosh","year":"2020","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3343\/alm.2020.40.5.351","article-title":"Guidelines for Laboratory Diagnosis of Coronavirus Disease 2019 (COVID-19) in Korea","volume":"40","author":"Hong","year":"2020","journal-title":"Ann. 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