TY - JOUR
T1 - Detection and Stability of SARS-CoV-2 in Three Self-Collected Specimen Types
T2 - Flocked Midturbinate Swab (MTS) in Viral Transport Media, Foam MTS, and Saliva
AU - Veguilla, Vic
AU - Fowlkes, Ashley L.
AU - Bissonnette, Adam
AU - Beitel, Shawn
AU - Gaglani, Manjusha
AU - Porucznik, Christina A.
AU - Stockwell, Melissa S.
AU - Tyner, Harmony L.
AU - Naleway, Allison L.
AU - Yoon, Sarang K.
AU - Caban-Martinez, Alberto J.
AU - Wesley, Meredith G.
AU - Duque, Jazmin
AU - Jeddy, Zuha
AU - Stanford, Joseph B.
AU - Daugherty, Michael
AU - Dixon, Ashton
AU - Burgess, Jefferey L.
AU - Odean, Marilyn
AU - Groom, Holly C.
AU - Phillips, Andrew L.
AU - Schaefer-Solle, Natasha
AU - Mistry, Peenaz
AU - Rolfes, Melissa A.
AU - Thompson, Mark
AU - Dawood, Fatimah S.
AU - Meece, Jennifer
N1 - Funding Information:
We acknowledge the families that participated in the C-HEaRT, RECOVER, and AZ HEROES cohorts; Kim Altunkaynak, Parker Malek, Hannah Michelle Brower, Utsav Kattel, Lauren E. W. Olsho, Laura J. Edwards, Danielle R. Hunt, Tyler C. Morrill, Brandon P. Poe, Brian Sokol, John Thacker, Tana Brummer, Andrea Bronaugh, James Carr, Hala Deeb, Sauma Doka, Claire Douglas, Kate Durocher, Tara Earl, Jini Etolue, Deanna Fleary, Isaiah Gerber, Kimberly Groover, Louise Hadden, Jenna Harder, Ed Hock, Keya Jacoby, Ryan Klein, Lindsay LeClair, Nancy McGarry, Steve Pickett, Khaila Prather, David Pulaski, Rajbansi Raorane, Alfredo Rodriguez-Nogues, Meghan Shea, Chao Zhou, and Meghan Herring, all from Abt Associates; Michael E. Smith, Kempapura Murthy, Spencer Rose, Nicole Calhoun, Eric Hoffman, Martha Zayed, Joel Blais, Jason Ettlinger, Angela Kennedy, Natalie Settele, Rupande Patel, Elisa Priest, Jennifer Thomas, Madhava Beeram, and Alejandro Arroliga, all from Baylor Scott & White Health; Lauren Grant, Julie Mayo Lamberte, Young M. Yoo, Josephine Mak, Monica Dickerson, Eduardo Azziz-Baumgartner, Melissa L. Arvay, Preeta Kutty, and Alicia M. Fry, all from Centers for Disease Control and Prevention; Priyam Thind, Maria Castro, Franklin Sosa, Chelsea Wynn, Laura Staeheli, Angela Cameron, and Ogooluwa Fayemiwo, all from Columbia University Irving Medical Center; Yolanda Prado, Daniel Sapp, Mi Lee, Chris Eddy, Matt Hornbrook, Donna Eubanks, Danielle Millay, Dorothy Kurdyla, Kristin Bialobok, Ambrosia Bass, Kristi Bays, Kimberly Berame, Cathleen Bourdoin, Carlea Buslach, Jennifer Gluth, Kenni Graham, Tarika Holness, Enedina Luis, Abreeanah Magdaleno, DeShaun Martin, Joyce Smith-McGee, Martha Perley, Sam Peterson, Aaron Piepert, Krystil Phillips, Joanna Price, Sperry Robinson, Katrina Schell, Emily Schield, Natosha Shirley, Anna Shivinsky, Britta Torgrimson-Ojerio, Brooke Wainwright, and Shawn Westaway, all from Kaiser Permanente Northwest; Angela Hunt, Jessica Lundgren, Karley Respet, Jennifer Viergutz, and Daniel Stafki, all from St. Luke’s Regional Health Care System; Karen Lutrick, Patrick Rivers, Katherine D. Ellingson, Xiaoxiao Sun, Joe K. Gerald, Janko Nikolich-Žugich, Genesis Barron, Dimaye Calvo, Esteban Cardona, Adam Carl, Andrea Carmona, Alissa Coleman, Zoe Baccam, Emily Cooksey, Stacy Delgado, Kiara Earley, Natalie Giroux, Sofia Grijalva, Allan Guidos, Brad Haeckel, Adrianna Hernandez, James Hollister, Theresa Hopkins, Christina Hughey, Rezwana Islam, Krystal Jovel, Olivia Kavanagh, Jonathan Leyva, Sally Littau, Amelia Lobos, James Lopez, Veronica Lugo, Jeremy Makar, Taylor Maldonado, Enrique Marquez, Allyson Munoz, Assumpta Nsengiyunva, Joel Parker, Jonathan Perez Leyva, Alexa Roy, Saskia Smidt, Isabella Terrazas, Tahlia Thompson, Heena Timsina, Erica Vanover, Graham Wegner, Mandie White, April Yingst, Kenneth Komatsu, Elizabeth Kim, and Karla Ledezma, all from University of Arizona; Carlos Silvera, Cynthia Beaver, Roger Noriega, Alexandrea Cruz, Damena Gallimore-Wilson, Rachel Reyes, Christian Rojas, Catalina Gonzalez, Addison Testoff, Alex Stewart, Kemi Ogunsina, Aimee Green, Johanna Garibaldi, Nathaly Suarez, Olga Carrera, and Hannah Kling, all from University of Miami; Emily Hacker, Halle Lee, Jacob Anderson, Katrhyn Graham, Matthew Bruner, Rachel Brown, Jenna Praggastis, Marcus Stucki, Arlyne Arteaga, Riley Campbell, Madeleine Smith, Adriele Fugal, Maya Wheeler, Gretchen Maughan, Allana Soriano, Nikki Gallacher, Anika Dsouza, Lauren Anderson, Jenna Vo, Trevor Stubbs, Iman Ibrahim, Tristen Forbes, Taryn Hunt-Smith, Ryder Jordin, Michael Langston, Timina Powaukee, Daniel Dawson, Kathy Tran, Fiona Tsang, Hannah Whiting, Emilee Eden, Braydon Black, Christina Pick, Madison Tallman, Chapman Cox, Derrick Wong, Camie Schaefer, Kurt T. Hegmann, Jeanmarie Mayer, and Joseph Stanford, all from University of Utah; Allen Bateman, Erik Reisdorf, Kyley Guenther, and Erika Hanson, all from Wisconsin State Laboratory of Hygiene; and the REDCap (Research Electronic Data Capture) data platform. The authors have no conflicts of interest to declare. This work was supported by the CDC through contract no. 75D30120C08150 to Abt Associates, Inc., contract 75D30120R68013 to the Marshfield Clinic Research Institute, and contract 75D30120C08379 to the University of Arizona. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Any references to specific commercial products are for identification purposes only and do not constitute an endorsement by CDC. The CDC funded this study. CDC-affiliated authors were involved in study design, data collection, analysis and interpretation, report writing, and the decision to submit the paper for publication. The corresponding authors had full access to all data used in the analysis and had final responsibility for the decision to submit for publication.
Funding Information:
This work was supported by the CDC through contract no. 75D30120C08150 to Abt Associates, Inc., contract 75D30120R68013 to the Marshfield Clinic Research Institute, and contract 75D30120C08379 to the University of Arizona.
Publisher Copyright:
© 2022 American Society for Microbiology. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - Respiratory specimen collection materials shortages hampers severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. We compared specimen alternatives and evaluated SARS-CoV-2 RNA stability under simulated shipping conditions. We compared concordance of RT-PCR detection of SARS-CoV-2 from flocked midturbinate swabs (MTS) in viral transport media (VTM), foam MTS without VTM, and saliva. Specimens were collected between August 2020 and April 2021 from three prospective cohorts. We compared RT-PCR cycle quantification (Cq) for Spike (S), Nucleocapsid (N), and the Open Reading Frame 1ab (ORF) genes for flocked MTS and saliva specimens tested before and after exposure to a range of storage temperatures (4–30°C) and times (2, 3, and 7 days). Of 1,900 illnesses with $2 specimen types tested, 335 (18%) had SARS-CoV-2 detected in $1 specimen; 304 (91%) were concordant across specimen types. Among illnesses with SARS-CoV-2 detection, 97% (95% confidence interval [CI]: 94–98%) were positive on flocked MTS, 99% (95% CI: 97–100%) on saliva, and 89% (95% CI: 84–93%) on foam MTS. SARS-CoV-2 RNA was detected in flocked MTS and saliva stored up to 30°C for 7 days. All specimen types provided highly concordant SARS-CoV-2 results. These findings support a range of viable options for specimen types, collection, and transport methods that may facilitate SARS-CoV-2 testing during supply and personnel shortages. IMPORTANCE Findings from this analysis indicate that (1) self-collection of flocked and foam MTS and saliva samples is feasible in both adults and children, (2) foam MTS with VTM and saliva are both viable and reasonable alternatives to traditional flocked MTS in VTM for SARS-CoV-2 detection, and (3) these sample types may be stored and transported at ambient temperatures for up to 7 days without compromising sample quality. These findings support methods of sample collection for SARS-CoV-2 detection that may facilitate widespread community testing in the setting of supply and personnel shortages during the current pandemic.
AB - Respiratory specimen collection materials shortages hampers severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. We compared specimen alternatives and evaluated SARS-CoV-2 RNA stability under simulated shipping conditions. We compared concordance of RT-PCR detection of SARS-CoV-2 from flocked midturbinate swabs (MTS) in viral transport media (VTM), foam MTS without VTM, and saliva. Specimens were collected between August 2020 and April 2021 from three prospective cohorts. We compared RT-PCR cycle quantification (Cq) for Spike (S), Nucleocapsid (N), and the Open Reading Frame 1ab (ORF) genes for flocked MTS and saliva specimens tested before and after exposure to a range of storage temperatures (4–30°C) and times (2, 3, and 7 days). Of 1,900 illnesses with $2 specimen types tested, 335 (18%) had SARS-CoV-2 detected in $1 specimen; 304 (91%) were concordant across specimen types. Among illnesses with SARS-CoV-2 detection, 97% (95% confidence interval [CI]: 94–98%) were positive on flocked MTS, 99% (95% CI: 97–100%) on saliva, and 89% (95% CI: 84–93%) on foam MTS. SARS-CoV-2 RNA was detected in flocked MTS and saliva stored up to 30°C for 7 days. All specimen types provided highly concordant SARS-CoV-2 results. These findings support a range of viable options for specimen types, collection, and transport methods that may facilitate SARS-CoV-2 testing during supply and personnel shortages. IMPORTANCE Findings from this analysis indicate that (1) self-collection of flocked and foam MTS and saliva samples is feasible in both adults and children, (2) foam MTS with VTM and saliva are both viable and reasonable alternatives to traditional flocked MTS in VTM for SARS-CoV-2 detection, and (3) these sample types may be stored and transported at ambient temperatures for up to 7 days without compromising sample quality. These findings support methods of sample collection for SARS-CoV-2 detection that may facilitate widespread community testing in the setting of supply and personnel shortages during the current pandemic.
KW - COVID-19
KW - RT-PCR
KW - SARS-CoV-2
KW - respiratory specimens
KW - sensitivity
UR - http://www.scopus.com/inward/record.url?scp=85133214620&partnerID=8YFLogxK
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U2 - 10.1128/spectrum.01033-22
DO - 10.1128/spectrum.01033-22
M3 - Article
C2 - 35665629
AN - SCOPUS:85133214620
SN - 2165-0497
VL - 10
JO - Microbiology Spectrum
JF - Microbiology Spectrum
IS - 3
ER -