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J Clin Virol . Natural spring water gargle and direct RT-PCR for the diagnosis of COVID-19 (COVID-SPRING study)

tetano

Editor, Senior Moderator
J Clin Virol


. 2021 Oct 2;144:104995.
doi: 10.1016/j.jcv.2021.104995. Online ahead of print.
Natural spring water gargle and direct RT-PCR for the diagnosis of COVID-19 (COVID-SPRING study)


Jeannot Dumaresq[SUP] 1 [/SUP], François Coutlée[SUP] 2 [/SUP], Philippe J Dufresne[SUP] 3 [/SUP], Jean Longtin[SUP] 4 [/SUP], Judith Fafard[SUP] 5 [/SUP], Julie Bestman-Smith[SUP] 4 [/SUP], Marco Bergevin[SUP] 6 [/SUP], Emilie Vallières[SUP] 7 [/SUP], Marc Desforges[SUP] 8 [/SUP], Annie-Claude Labbé[SUP] 9 [/SUP]



Affiliations

Abstract

Background: Nasopharyngeal swab has long been considered the specimen of choice for the diagnosis of respiratory viral infections, including SARS-CoV-2 infection, but it suffers from several drawbacks: its discomfort limits screening acceptability, and it is vulnerable to shortages in both specialized materials and trained healthcare workers in the context of a pandemic.
Methods: We prospectively compared natural spring water gargle to combined oro-nasopharyngeal swab (ONPS) for the diagnosis of coronavirus disease 2019 (COVID-19) in paired clinical specimens (1005 ONPS and 1005 gargles) collected from 987 unique early symptomatic as well as asymptomatic individuals from the community.
Results: Using a direct RT-PCR method with the Allplex™ 2019-nCoV Assay (Seegene), the clinical sensitivity of the gargle was 95.3% (95% confidence interval [CI], 90.2 - 98.3%), similar to the sensitivity of the ONPS (93.8%; 95% CI, 88.2 - 97.3%), despite significantly lower viral RNA concentration in gargles, as reflected by higher cycle threshold values. No single specimen type detected all COVID-19 cases. SARS-CoV-2 RNA was stable in gargles at room temperature for at least 7 days.
Conclusion: The simplicity of this sampling method coupled with the accessibility of spring water are clear advantages in a pandemic situation where testing frequency, turnaround time and shortage of consumables and trained staff are critical elements.

Keywords: COVID-19; Diagnosis; Gargle; PCR; SARS-CoV-2; Saliva.
 
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