RESUMO
Health care workers (HCWs) are at high risk for SARS-CoV-2. In addition, pre-symptomatic or asymptomatic transmission accounts for around half of the cases. Saliva testing is an option to detect SARS-CoV-2 infection. To determine the performance of saliva samples for screening, HCWs were tested for SARS-CoV-2 by RT-PCR. Those with a positive result in saliva were tested by nasopharyngeal swabbing for viral RNA detection and blood collection to search for the presence of specific antibodies. In September-October 2020, 100 HCWs were enrolled and followed up. Six subjects (6%) tested positive in saliva. Of them, 5/6 were positive in a subsequent nasopharyngeal swab and 4/6 developed signs and symptoms compatible with COVID-19. Among the latter, 3 seroconverted while asymptomatic HCWs remained seronegative. Saliva screening was helpful for identifying SARS-CoV-2 infection in HCWs. This screening permitted rapid personnel isolation avoiding further transmission of the virus in the hospital setting.
Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/diagnóstico , Saliva , Pessoal de Saúde , NasofaringeRESUMO
Current diagnostic standards involve severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection in nasopharyngeal swabs (NPS), but saliva is an attractive and noninvasive option for diagnosis. The objectives were to determine the performance of saliva in comparison with NPS for detecting SARS-CoV-2 and to compare the optimized home brew reverse-transcription polymerase chain reaction (RT-PCR) with a commercial RT-PCR. Paired NPS and saliva specimens were prospectively collected and tested by RT-PCR from patients presenting at an emergency room with signs and symptoms compatible with coronavirus disease-2019. A total of 348 samples from 174 patients were tested by RT-PCR assays. Among 174 patients with symptoms, 63 (36%) were SARS-CoV-2 positive in NPS using the optimized home-brew PCR. Of these 63 patients, 61 (98%) were also positive in saliva. An additional positive SARS-CoV-2 saliva was detected in a patient with pneumonia. Kappa Cohen's coefficient agreement between NPS and saliva was 0.96 (95% confidence interval [CI], 0.90-0.99). Median Ct values in NPS versus saliva were 18.88 (interquartile range [IQR], 15.60-23.58; range, 11.97-38.10) versus 26.10 (IQR, 22.75-30.06; range, 13.78-39.22), respectively (p < .0001). The optimized home-brew RT-PCR demonstrated higher analytical and clinical sensitivity compared with the commercial RT-PCR assay. A high sensitivity (98%) and agreement (kappa 0.96) in saliva samples compared to NPS was demonstrated when using an optimized home-brew PCR even when the viral load in saliva was lower than in NPS. This noninvasive sample is easy to collect, requires less consumable and avoids discomfort to patients. Importantly, self-collection of saliva can diminish exposure to healthcare personnel.
Assuntos
COVID-19/diagnóstico , COVID-19/virologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , SARS-CoV-2/isolamento & purificação , Saliva/virologia , Manejo de Espécimes/métodos , Adulto , Idoso , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.
El objetivo de este trabajo fue evaluar los factores explicativos de la respuesta inmune humoral en adultos mayores de establecimientos de estancia prolongada de Buenos Aires, Argentina, hasta 180 días post vacunación. Se utilizó un diseño de cohorte abierta, prospectiva, multicéntrica, con voluntarios que recibieron dos dosis de vacunas Sputnik V, Sinopharm o AZD1222. Se analizaron muestras de plasma en los tiempos 0, 21 días post primera dosis, 21 días post segunda dosis, 120 y 180 días post primera dosis. Se ajustaron modelos lineales marginales y aditivos generalizados mixtos para evaluar el comportamiento de la concentración de anticuerpos IgG anti-Spike en el tiempo según grupo de exposición (naïve/no-naïve) y vacuna. Las covariables analizadas fueron: ocurrencia de brote de COVID-19 en establecimientos de estancia prolongada y comorbilidades. Se incluyeron en el análisis 773 participantes con una mediana de edad de 83 años (RIQ: 76-89). Al final del estudio, los niveles de anticuerpos del grupo naïve: Sinopharm fueron significativamente menores que el resto de los grupos (p < 0,05); los del no-naïve: Sinopharm resultaron similares a los naïve que recibieron AZD1222 (p = 0,945) o Sputnik V (p = 1). Los participantes expuestos a brotes en establecimientos de estancia prolongada presentaron niveles de anticuerpos significativamente mayores, independientemente del grupo de exposición y la vacuna (p < 0,001). Concluimos que la exposición previa a COVID-19, el tipo de vacuna y la pertenencia a un establecimiento de estancia prolongada con antecedente de brote son factores a considerar frente a futuros eventos epidémicos con dinámicas de transmisión y mecanismos inmunológicos similares al COVID-19, en poblaciones similares a la analizada en este trabajo.
Este estudo teve como objetivo avaliar os fatores explicativos da resposta imune humoral em idosos em instituições de longa permanência em Buenos Aires, Argentina, até 180 dias após a vacinação. Foi realizado um estudo de coorte aberto, prospectivo e multicêntrico, com voluntários que receberam duas doses das vacinas Sputnik V, Sinopharm ou AZD1222. As amostras de plasma foram analisadas nos tempos 0, 21 dias após a primeira dose, 21 dias após a segunda dose, 120 e 180 dias após a primeira dose. Os modelos lineares marginais e os aditivos generalizados mistos foram ajustados para determinar o comportamento da concentração de anticorpos IgG anti-Spike ao longo do tempo de acordo com o grupo de exposição (naïve/no-naïve) e vacina. As covariáveis analisadas foram ocorrência de pico de COVID-19 nas instituições de longa permanência e comorbidades. Foram incluídos 773 participantes, com média de idade de 83 anos (IIQ: 76-89). Os resultados apontaram níveis de anticorpos do grupo naïve: Sinopharm significativamente mais baixos do que os outros grupos (p < 0,05); e as variáveis do grupo no-naïve: Sinopharm foram semelhantes à do grupo naïve que recebeu AZD1222 (p = 0,945) ou Sputnik V (p = 1). Os participantes expostos a picos nas instituições de longa permanência apresentaram níveis de anticorpos significativamente maiores, independentemente do grupo de exposição e da vacina (p < 0,001). Conclui-se que a exposição prévia à COVID-19, tipo de vacina e adesão a uma instituição de longa permanência com histórico de pico são fatores a serem considerados em futuros eventos epidêmicos com dinâmica de transmissão e mecanismos imunológicos semelhantes à COVID-19, em populações semelhantes à analisada neste trabalho.
Assuntos
Anticorpos Antivirais , Vacinas contra COVID-19 , COVID-19 , Imunidade Humoral , SARS-CoV-2 , Humanos , COVID-19/imunologia , COVID-19/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Feminino , Masculino , Estudos Prospectivos , SARS-CoV-2/imunologia , Argentina/epidemiologia , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Anticorpos Antivirais/sangue , Imunoglobulina G/sangue , Assistência de Longa Duração , Glicoproteína da Espícula de Coronavírus/imunologiaRESUMO
Asymptomatic infections with SARS-CoV-2 are associated with viral transmission and have a key role in the propagation of the pandemic. Understanding viral shedding during asymptomatic infections is critical. Unfortunately, data on asymptomatic SARS-CoV-2 infection in children is extremely limited. To determine the presence of viral viable shedding, we prospectively followed two healthy children of a family where both parents developed mild COVID-19 (April 2021). SARS-CoV-2 detection was made by RT-PCR and virus isolation by cell culture from saliva samples. Positive samples were sequenced to identify variants of SARS-CoV-2. Serum samples were evaluated to determine the presence of antibodies using a single enzyme-linked immunosorbent assay (ELISA, COVIDAR IgG). Both children were SARS-CoV-2 positive and asymptomatic. In addition, the virus grew in cell culture from saliva samples. Furthermore, one child showed viable SARS-CoV-2 for at least 17 days after the onset symptoms from his father. The recommended isolation period for asymptomatic contacts during the acquisition of data had been established for 10 days; however, this child remained with viable virus beyond that period. The positive samples from both children were consistent with B.1.1.28.1 lineage (Gamma). In both asymptomatic children, anti-Spike IgG was detected. Asymptomatic children may represent a source of infection that should not be underestimated during this pandemic.
Las infecciones asintomáticas por SARS-CoV-2 están asociadas a la transmisión viral y tienen un papel clave en la propagación de la pandemia. Comprender la excreción viral durante las infecciones asintomáticas es fundamental. Desafortunadamente, los datos sobre la infección asintomática por SARS-CoV-2 en niños son extremadamente limitados. Para determinar la presencia de excreción de virus viable, se siguió prospectivamente a dos niños sanos de una familia en la que ambos padres desarrollaron COVID-19 leve (abril 2021). La detección de SARS-CoV-2 se realizó por RT-PCR y el aislamiento del virus por cultivo celular a partir de muestras de saliva. Las muestras positivas se secuenciaron para identificar variantes de SARS-CoV-2. En las muestras de suero se determinó la presencia de anticuerpos utilizando un ensayo de ELISA (COVIDAR IgG). Ambos niños fueron positivos para SARS-CoV-2 y asintomáticos. Además, el virus creció en cultivos celulares a partir de muestras de saliva. Uno de los niños mantuvo SARS-CoV-2 viables durante al menos 17 días después de la aparición de los síntomas de su padre. El período de aislamiento recomendado para contactos asintomáticos durante la adquisición de datos se había establecido en 10 días, sin embargo, este niño permaneció con virus viable más allá de ese período. Las muestras positivas de estos niños correspondieron al linaje B.1.1.28.1 (Gamma). En ambos niños asintomáticos se detectó anticuerpos IgG anti-Spike. Concluimos que los niños asintomáticos pueden representar una fuente de infección que no debe subestimarse durante esta pandemia.
Assuntos
COVID-19 , SARS-CoV-2 , Criança , Humanos , Infecções Assintomáticas , Anticorpos Antivirais , Imunoglobulina GRESUMO
The COVID-19 pandemic has particularly affected older adults residing in nursing homes, resulting in high rates of hospitalisation and death. Here, we evaluated the longitudinal humoral response and neutralising capacity in plasma samples of volunteers vaccinated with different platforms (Sputnik V, BBIBP-CorV, and AZD1222). A cohort of 851 participants, mean age 83 (60-103 years), from the province of Buenos Aires, Argentina were included. Sequential plasma samples were taken at different time points after vaccination. After completing the vaccination schedule, infection-naïve volunteers who received either Sputnik V or AZD1222 exhibited significantly higher specific anti-Spike IgG titers than those who received BBIBP-CorV. Strong correlation between anti-Spike IgG titers and neutralising activity levels was evidenced at all times studied (rho=0.7 a 0.9). Previous exposure to SARS-CoV-2 and age <80 years were both associated with higher specific antibody levels. No differences in neutralising capacity were observed for the infection-naïve participants in either gender or age group. Similar to anti-Spike IgG titers, neutralising capacity decreased 3 to 9-fold at 6 months after initial vaccination for all platforms. Neutralising capacity against Omicron was between 10-58 fold lower compared to ancestral B.1 for all vaccine platforms at 21 days post dose 2 and 180 days post dose 1. This work provides evidence about the humoral response and neutralising capacity elicited by vaccination of a vulnerable elderly population. This data could be useful for pandemic management in defining public health policies, highlighting the need to apply reinforcements after a complete vaccination schedule.
Assuntos
COVID-19 , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , ChAdOx1 nCoV-19 , Humanos , Imunoglobulina G , Pandemias , SARS-CoV-2 , VacinaçãoRESUMO
Recent studies have shown a temporal increase in the neutralizing antibody potency and breadth to SARS-CoV-2 variants in coronavirus disease 2019 (COVID-19) convalescent individuals. Here, we examined longitudinal antibody responses and viral neutralizing capacity to the B.1 lineage virus (Wuhan related), to variants of concern (VOC; Alpha, Beta, Gamma, and Delta), and to a local variant of interest (VOI; Lambda) in volunteers receiving the Sputnik V vaccine in Argentina. Longitudinal serum samples (N = 536) collected from 118 volunteers obtained between January and October 2021 were used. The analysis indicates that while anti-spike IgG levels significantly wane over time, the neutralizing capacity for the Wuhan-related lineages of SARS-CoV-2 and VOC is maintained within 6 months of vaccination. In addition, an improved antibody cross-neutralizing ability for circulating variants of concern (Beta and Gamma) was observed over time postvaccination. The viral variants that displayed higher escape to neutralizing antibodies with respect to the original virus (Beta and Gamma variants) were the ones showing the largest increase in susceptibility to neutralization over time after vaccination. Our observations indicate that serum neutralizing antibodies are maintained for at least 6 months and show a reduction of VOC escape to neutralizing antibodies over time after vaccination. IMPORTANCE Vaccines have been produced in record time for SARS-CoV-2, offering the possibility of halting the global pandemic. However, inequalities in vaccine accessibility in different regions of the world create a need to increase international cooperation. Sputnik V is a recombinant adenovirus-based vaccine that has been widely used in Argentina and other developing countries, but limited information is available about its elicited immune responses. Here, we examined longitudinal antibody levels and viral neutralizing capacity elicited by Sputnik V vaccination. Using a cohort of 118 volunteers, we found that while anti-spike antibodies wane over time, the neutralizing capacity to viral variants of concern and local variants of interest is maintained within 4 months of vaccination. In addition, we observed an increased cross-neutralization activity over time for the Beta and Gamma variants. This study provides valuable information about the immune response generated by a vaccine platform used in many parts of the world.
Assuntos
Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus , Humanos , Anticorpos Neutralizantes , Anticorpos Antivirais , COVID-19/prevenção & controle , Estudos Longitudinais , Glicoproteína da Espícula de Coronavírus/imunologia , Vacinação , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/uso terapêuticoRESUMO
Heterologous vaccination against coronavirus disease 2019 (COVID-19) provides a rational strategy to rapidly increase vaccination coverage in many regions of the world. Although data regarding messenger RNA (mRNA) and ChAdOx1 vaccine combinations are available, there is limited information about the combination of these platforms with other vaccines widely used in developing countries, such as BBIBP-CorV and Sputnik V. Here, we assess the immunogenicity and reactogenicity of 15 vaccine combinations in 1,314 participants. We evaluate immunoglobulin G (IgG) anti-spike response and virus neutralizing titers and observe that a number of heterologous vaccine combinations are equivalent or superior to homologous schemes. For all cohorts in this study, the highest antibody response is induced by mRNA-1273 as the second dose. No serious adverse events are detected in any of the schedules analyzed. Our observations provide rational support for the use of different vaccine combinations to achieve wide vaccine coverage in the shortest possible time.
Assuntos
COVID-19 , Vacinas Virais , Vacina de mRNA-1273 contra 2019-nCoV , Anticorpos Antivirais , COVID-19/prevenção & controle , Humanos , Imunização , RNA Mensageiro/genética , SARS-CoV-2 , VacinaçãoRESUMO
Resumen: El objetivo de este trabajo fue evaluar los factores explicativos de la respuesta inmune humoral en adultos mayores de establecimientos de estancia prolongada de Buenos Aires, Argentina, hasta 180 días post vacunación. Se utilizó un diseño de cohorte abierta, prospectiva, multicéntrica, con voluntarios que recibieron dos dosis de vacunas Sputnik V, Sinopharm o AZD1222. Se analizaron muestras de plasma en los tiempos 0, 21 días post primera dosis, 21 días post segunda dosis, 120 y 180 días post primera dosis. Se ajustaron modelos lineales marginales y aditivos generalizados mixtos para evaluar el comportamiento de la concentración de anticuerpos IgG anti-Spike en el tiempo según grupo de exposición (naïve/no-naïve) y vacuna. Las covariables analizadas fueron: ocurrencia de brote de COVID-19 en establecimientos de estancia prolongada y comorbilidades. Se incluyeron en el análisis 773 participantes con una mediana de edad de 83 años (RIQ: 76-89). Al final del estudio, los niveles de anticuerpos del grupo naïve: Sinopharm fueron significativamente menores que el resto de los grupos (p < 0,05); los del no-naïve: Sinopharm resultaron similares a los naïve que recibieron AZD1222 (p = 0,945) o Sputnik V (p = 1). Los participantes expuestos a brotes en establecimientos de estancia prolongada presentaron niveles de anticuerpos significativamente mayores, independientemente del grupo de exposición y la vacuna (p < 0,001). Concluimos que la exposición previa a COVID-19, el tipo de vacuna y la pertenencia a un establecimiento de estancia prolongada con antecedente de brote son factores a considerar frente a futuros eventos epidémicos con dinámicas de transmisión y mecanismos inmunológicos similares al COVID-19, en poblaciones similares a la analizada en este trabajo.
Abstract: This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.
Resumo: Este estudo teve como objetivo avaliar os fatores explicativos da resposta imune humoral em idosos em instituições de longa permanência em Buenos Aires, Argentina, até 180 dias após a vacinação. Foi realizado um estudo de coorte aberto, prospectivo e multicêntrico, com voluntários que receberam duas doses das vacinas Sputnik V, Sinopharm ou AZD1222. As amostras de plasma foram analisadas nos tempos 0, 21 dias após a primeira dose, 21 dias após a segunda dose, 120 e 180 dias após a primeira dose. Os modelos lineares marginais e os aditivos generalizados mistos foram ajustados para determinar o comportamento da concentração de anticorpos IgG anti-Spike ao longo do tempo de acordo com o grupo de exposição (naïve/no-naïve) e vacina. As covariáveis analisadas foram ocorrência de pico de COVID-19 nas instituições de longa permanência e comorbidades. Foram incluídos 773 participantes, com média de idade de 83 anos (IIQ: 76-89). Os resultados apontaram níveis de anticorpos do grupo naïve: Sinopharm significativamente mais baixos do que os outros grupos (p < 0,05); e as variáveis do grupo no-naïve: Sinopharm foram semelhantes à do grupo naïve que recebeu AZD1222 (p = 0,945) ou Sputnik V (p = 1). Os participantes expostos a picos nas instituições de longa permanência apresentaram níveis de anticorpos significativamente maiores, independentemente do grupo de exposição e da vacina (p < 0,001). Conclui-se que a exposição prévia à COVID-19, tipo de vacina e adesão a uma instituição de longa permanência com histórico de pico são fatores a serem considerados em futuros eventos epidêmicos com dinâmica de transmissão e mecanismos imunológicos semelhantes à COVID-19, em populações semelhantes à analisada neste trabalho.
RESUMO
Abstract Asymptomatic infections with SARS-CoV-2 are associ ated with viral transmission and have a key role in the propagation of the pandemic. Understanding viral shed ding during asymptomatic infections is critical. Unfor tunately, data on asymptomatic SARS-CoV-2 infection in children is extremely limited. To determine the presence of viral viable shedding, we prospectively followed two healthy children of a family where both parents devel oped mild COVID-19 (April 2021). SARS-CoV-2 detection was made by RT-PCR and virus isolation by cell culture from saliva samples. Positive samples were sequenced to identify variants of SARS-CoV-2. Serum samples were evaluated to determine the presence of antibodies using a single enzyme-linked immunosorbent assay (ELISA, COVIDAR IgG). Both children were SARS-CoV-2 positive and asymptomatic. In addition, the virus grew in cell cul ture from saliva samples. Furthermore, one child showed viable SARS-CoV-2 for at least 17 days after the onset symptoms from his father. The recommended isolation period for asymptomatic contacts during the acquisition of data had been established for 10 days; however, this child remained with viable virus beyond that period. The positive samples from both children were consistent with B.1.1.28.1 lineage (Gamma). In both asymptomatic children, anti-Spike IgG was detected. Asymptomatic children may represent a source of infection that should not be underestimated during this pandemic.
Resumen Las infecciones asintomáticas por SARS-CoV-2 están asociadas a la transmisión viral y tienen un papel cla ve en la propagación de la pandemia. Comprender la excreción viral durante las infecciones asintomáticas es fundamental. Desafortunadamente, los datos sobre la infección asintomática por SARS-CoV-2 en niños son extremadamente limitados. Para determinar la presencia de excreción de virus viable, se siguió prospectivamente a dos niños sanos de una familia en la que ambos padres desarrollaron COVID-19 leve (abril 2021). La detección de SARS-CoV-2 se realizó por RT-PCR y el aislamiento del virus por cultivo celular a partir de muestras de saliva. Las muestras positivas se secuenciaron para identificar variantes de SARS-CoV-2. En las muestras de suero se determinó la presencia de anticuerpos utilizando un ensayo de ELISA (COVIDAR IgG). Ambos niños fueron positivos para SARS-CoV-2 y asintomáticos. Además, el virus creció en cultivos celulares a partir de muestras de saliva. Uno de los niños mantuvo SARS-CoV-2 via bles durante al menos 17 días después de la aparición de los síntomas de su padre. El período de aislamiento recomendado para contactos asintomáticos durante la adquisición de datos se había establecido en 10 días, sin embargo, este niño permaneció con virus viable más allá de ese período. Las muestras positivas de estos niños correspondieron al linaje B.1.1.28.1 (Gamma). En ambos niños asintomáticos se detectó anticuerpos IgG anti-Spike. Concluimos que los niños asintomáticos pueden representar una fuente de infección que no debe subestimarse durante esta pandemia.
RESUMO
Abstract Health care workers (HCWs) are at high risk for SARS-CoV-2. In addition, pre-symptomatic or asymptomatic transmission accounts for around half of the cases. Saliva testingis an option to detect SARS-CoV-2 infection. To determine the performance of saliva samplesfor screening, HCWs were tested for SARS-CoV-2 by RT-PCR. Those with a positive result insaliva were tested by nasopharyngeal swabbing for viral RNA detection and blood collectionto search for the presence of specific antibodies. In September---October 2020, 100 HCWs wereenrolled and followed up. Six subjects (6%) tested positive in saliva. Of them, 5/6 were positivein a subsequent nasopharyngeal swab and 4/6 developed signs and symptoms compatible withCOVID-19. Among the latter, 3 seroconverted while asymptomatic HCWs remained seronega-tive. Saliva screening was helpful for identifying SARS-CoV-2 infection in HCWs. This screeningpermitted rapid personnel isolation avoiding further transmission of the virus in the hospitalsetting.
Resumen El personal de salud (PS) tiene un alto riesgo de contraer SARS-CoV-2. La transmisión presintomática/asintomática representa alrededor de la mitad de los casos y el análisis a partir de muestras de saliva puede ser una opción para detectar la infección. Para determinar el rendimiento de estas muestras, 100 voluntarios del PS se sometieron a la detección de SARS-CoV-2 por RT-PCR en muestras de saliva en el período septiembre-octubre de 2020. De aquellos con resultado positivo en saliva, se tomaron hisopados nasofaríngeos para detectar ARN viral y muestras de suero para evaluar anticuerpos específicos. Se detectó ARN viral en la saliva de seis individuos (6%). De ellos, 5/6 fueron SARS-CoV-2 positivos en hisopado nasofaríngeo y 4/6 desarrollaron signos y síntomas compatibles con COVID-19. Entre estos últimos, tres serocon-virtieron, en tanto que los voluntarios asintomáticos permanecieron seronegativos. La muestra de saliva fue útil para identificar la infección por SARS-CoV-2 en esta cohorte del personal de salud y así proceder al rápido aislamiento de los individuos infectados, lo que evitó una mayor transmisión del virus en el ámbito hospitalario.