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Quick and affordable saliva-based COVID-19 test developed by Yale scientists receives FDA Emergency Use Authorization

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  • Quick and affordable saliva-based COVID-19 test developed by Yale scientists receives FDA Emergency Use Authorization

    August 15, 2020

    By Michael Greenwood

    A saliva-based laboratory diagnostic test developed by researchers at the Yale School of Public Health to determine whether someone is infected with the novel coronavirus has been granted an emergency use authorization by the U.S. Food and Drug Administration (FDA).

    The method, called SalivaDirect, is being further validated as a test for asymptomatic individuals through a program that tests players and staff from the National Basketball Association (NBA). SalivaDirect is simpler, less expensive, and less invasive than the traditional method for such testing, known as nasopharyngeal (NP) swabbing. Results so far have found that SalivaDirect is highly sensitive and yields similar outcomes as NP swabbing.

    With the FDA’s emergency use authorization, the testing method is immediately available to other diagnostic laboratories that want to start using the new test, which can be scaled up quickly for use across the nation — and, perhaps, beyond — in the coming weeks, the researchers said. A key component of SalivaDirect, they note, is that the method has been validated with reagents and instruments from multiple vendors. This flexibility enables continued testing if some vendors encounter supply chain issues, as experienced early in the pandemic.

    ... “Wide-spread testing is critical for our control efforts. We simplified the test so that it only costs a couple of dollars for reagents, and we expect that labs will only charge about $10 per sample. If cheap alternatives like SalivaDirect can be implemented across the country, we may finally get a handle on this pandemic, even before a vaccine,” said Grubaugh.

    One of the team’s goals was to eliminate the expensive saliva collection tubes that other companies use to preserve the virus for detection.

    ... “Using SalivaDirect, our lab can double our testing capacity,” said Professor Chen Liu, chair of Yale Pathology, who oversaw the clinical validation of the study.

    “Dr. Liu and Yale Pathology Laboratory were instrumental in our application. We look forward to continuing to partner with them,” said Grubaugh.

    Liu will start offering SalivaDirect as a testing option in their CLIA-certified clinical laboratory in the coming days.

    The YSPH-developed test, called SalivaDirect, has been used as part of an NBA testing program and will now be available to more diagnostic laboratories.







  • #2
    SalivaDirect: Simple and sensitive molecular diagnostic test for SARS-CoV-2 surveillance

    doi: https://doi.org/10.1101/2020.08.03.20167791

    Current bottlenecks for improving accessibility and scalability of SARS-CoV-2 testing include diagnostic assay costs, complexity, and supply chain shortages. To resolve these issues, we developed SalivaDirect. The critical component of our approach is to use saliva instead of respiratory swabs, which enables non-invasive frequent sampling and reduces the need for trained healthcare professionals during collection. Furthermore, we simplified our diagnostic test by ([1][1]) not requiring nucleic acid preservatives at sample collection, ([2][2]) replacing nucleic acid extraction with a simple proteinase K and heat treatment step, and ([3][3]) testing specimens with a dualplex quantitative reverse transcription PCR (RT-qPCR) assay. We validated SalivaDirect with reagents and instruments from multiple vendors to minimize the risk for supply chain issues. Regardless of our tested combination of reagents and instruments from different vendors, we found that SalivaDirect is highly sensitive with a limit of detection of 6-12 SARS-CoV-2 copies/µL. When comparing paired nasopharyngeal swabs and saliva specimens using the authorized ThermoFisher Scientific TaqPath COVID-19 combo kit and our SalivaDirect protocol, we found high agreement in testing outcomes (>94%). Being flexible and inexpensive ($1.29-$4.37/sample), SalivaDirect is a viable and accessible option to help alleviate SARS-CoV-2 testing demands. We submitted SalivaDirect as a laboratory developed test to the US Food and Drug Administration for Emergency Use Authorization on July 14th, 2020, and current details can be found on our website ([covidtrackerct.com/about-salivadirect/][4]). One sentence summary SalivaDirect is an extraction-free, dualplex RT-qPCR laboratory developed test validated with reagents and instruments from multiple vendors and submitted for FDA Emergency Use Authorization. ### Competing Interest Statement ALW has received research funding through grants from Pfizer to Yale and has received consulting fees for participation in advisory boards for Pfizer. The other authors declare no competing interests. ### Funding Statement This study was funded by a clinical research agreement with the National Basketball Association and the National Basketball Players Association (NDG), the Huffman Family Donor Advised Fund (NDG), Fast Grant funding support from the Emergent Ventures at the Mercatus Center, George Mason University (NDG), the Yale Institute for Global Health (NDG), and the Beatrice Kleinberg Neuwirth Fund (AIK). CBFV is supported by NWO Rubicon 019.181EN.004. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Institutional Review Board of the Yale Human Research Protection Program (FWA00002571, Protocol IDs. 2000027690 & 0409027018) All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data are included in this article, the supplementary files, and the Source Data. [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: http://covidtrackerct.com/about-salivadirect/

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    • #3
      This test still seems to need a lab with RT qPCR and the staff to operate them. Samples still need to be taken to a lab, tested and returned all of which takes time and cost money. It may help a bit in that it skips the first part of the normal process but what is really needed is a test that can be self administered, is fairly fool proof, returns a result in minutes and is cheap. It needs to work like a home pregnancy test, but cheaper if possible. This test is still using the same PCR machines as the existing system, as far as I can see, so does not free up much PCR capacity.

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