Lab Med Qual Assur.  2022 Jun;44(2):82-87. 10.15263/jlmqa.2022.44.2.82.

Evaluation of SARS-CoV-2 Molecular Test Using Saliva and Anterior Nasal Swab Samples Compared with Conventional Nasopharyngeal Swab Samples

  • 1Departments of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 2Departments of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 3Department of Internal Medicine, Gyeonggi-do Medical Center Paju Hospital, Paju, Korea


As the global pandemic of severe acute respiratory syndrome coronavirus-2 continues, so does the need for molecular tests with simple, painless, and easy sample collection. We aimed to investigate the potential use of saliva and anterior nasal swab samples as a noninvasive and selfcollectable specimen for the molecular diagnosis of coronavirus disease 2019 (COVID-19).
We prospectively collected the saliva, anterior nasal swab, and conventional nasopharyngeal swab samples at the same time of patients hospitalized in a public hospital from March 2021 to September 2021. Patients were assessed for symptoms, and real-time polymerase chain reaction (RT-PCR) was performed on the samples. The results and cyclethresholds (Ct) of the three sample types were compared.
Three types of samples per patient were collected, and a total of 135 samples were collected. The mean age of the patients was 39.5 years (range, 9–71 years). The positive rates were 82.2% for nasopharyngeal swab samples, 35.6% for anterior nasal swab samples, and 55.6% for saliva samples. No significant differences in the Ct values between samples (P =0.256) were observed when comparing only the sets which were positive in all three sample types. Using nasopharyngeal swab RT-PCR as the reference standard, the sensitivity and specificity of the combined saliva and anterior nasal swab RT-PCR were 70.3% and 62.5%, respectively.
Saliva and anterior nasal swab samples could not be used as alternative samples for COVID-19 diagnosis. Further studies with a larger number of patients are needed in the future.


SARS-CoV-2; COVID-19; Real-time polymerase chain reaction; Nasopharyngeal swab; Saliva; Anterior nasal swab
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