Superior effectiveness and acceptability of saliva samples for the detection of SARS-CoV-2 in China

Saliva-based nucleic acid amplification tests (NAATs) have demonstrated satisfactory diagnostic performance and acceptability for case detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in many countries. In response to problems of poor sampling quality, low sensitivity, and high demand for medical personnel regarding the current SARS-CoV-2 oropharyngeal swab sampling used in China, we aimed to evaluate the diagnostic performance and acceptability of saliva-based NAATs in China. The results showed that the overall sensitivities for saliva specimens and oropharyngeal swabs were 93.3 % and 85.0 %, respectively. The results of an acceptability survey showed that the scores for saliva, oropharyngeal, and nasopharyngeal samples were 9.46 ± 1.69, 8.11 ± 2.42, and 4.58 ± 3.82 out of 10, respectively, with significant differences among the three groups (P < 0.05). With higher sensitivity, comparable specificity, and strong public preference, saliva-based NAATs represent a convenient and effective method for detecting SARS-CoV-2 in future epidemics.