Validation of Saliva as the Clinical Specimen Type for a University-Wide COVID-19 Surveillance Program

At the beginning of the COVID-19 pandemic, the Georgia Institute of Technology made the decision to keep the university doors open for on-campus attendance. To manage COVID-19 infection rates, internal resources were applied to develop and implement a mass asymptomatic surveillance program. The obje...

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Bibliographic Details
Published in:	Viruses Vol. 16; no. 9; p. 1494
Main Authors:	Farrell, Michael L, Bryksin, Anton V, Ryan, Emily, Lin, Jessica, Djeddar, Naima, Khunteev, German, Holton, Benjamin, Paca, Miles, Speller, Nicholas, Merrill, James T, Ross, Ted M, Hogan, Robert J, Gibson, Greg, García, Andrés J, Shannon, Michael P
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 21-09-2024 MDPI
Subjects:	Asymptomatic Automation College students Contact tracing COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 diagnostic tests COVID-19 Testing - methods Evaluation Georgia - epidemiology Health aspects Health surveillance Homogenization Humans Infections Methods nasopharyngeal swap Nasopharynx - virology Public health RNA Saliva Saliva - virology Salivary diagnostics SARS-CoV-2 SARS-CoV-2 - isolation & purification Sentinel health events Severe acute respiratory syndrome coronavirus 2 Specimen Handling - methods Student health services surveillance Universities Validation studies Volunteers Georgia United States United States > US COVID-19 saliva SARS-CoV-2 surveillance RNA nasopharyngeal swap
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Summary:	At the beginning of the COVID-19 pandemic, the Georgia Institute of Technology made the decision to keep the university doors open for on-campus attendance. To manage COVID-19 infection rates, internal resources were applied to develop and implement a mass asymptomatic surveillance program. The objective was to identify infections early for proper follow-on verification testing, contact tracing, and quarantine/isolation as needed. Program success depended on frequent and voluntary sample collection from over 40,000 students, faculty, and staff personnel. At that time, the nasopharyngeal (NP) swab, not saliva, was the main accepted sample type for COVID-19 testing. However, due to collection discomfort and the inability to be self-collected, the NP swab was not feasible for voluntary and frequent self-collection. Therefore, saliva was selected as the clinical sample type and validated. A saliva collection kit and a sample processing and analysis workflow were developed. The results of a clinical sample-type comparison study between co-collected and matched NP swabs and saliva samples showed 96.7% positive agreement and 100% negative agreement. During the Fall 2020 and Spring 2021 semesters, 319,988 samples were collected and tested. The program resulted in maintaining a low overall mean positivity rate of 0.78% and 0.54% for the Fall 2020 and Spring 2021 semesters, respectively. For this high-throughput asymptomatic COVID-19 screening application, saliva was an exceptionally good sample type.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 These authors contributed equally to this work.
ISSN:	1999-4915 1999-4915
DOI:	10.3390/v16091494