Abstract
Since its emergence in December 2019, SARS-CoV-2 is causing one of the most devastating pandemics in human history. Currently, the most important method for definitive diagnosis of COVID-19 is identification of SARS-CoV-2 RNA in nasopharyngeal swab samples by RT-PCR. Nasopharyngeal swab sampling is a discomforting procedure sometimes with adverse effects, which also poses a risk for infection for the personnel performing the sampling. We have developed a new method for concentrating biological samples, which enabled us to use gargle and mouthwash samples to be used in RT-PCR, for the diagnosis of COVID-19, as an alternative to nasopharyngeal swab samples. We have analyzed nasopharyngeal and gargle and mouthwash samples, before and after concentration, of 363 patients by RT-PCR for the presence of SARS-CoV-2. Among 114 patients in which SARS-CoV-2 was identified in at least one of their samples, the virus was identified in 76 (66.7%), 67 (58.8%), and 101 (88.6%) of nasopharyngeal swab, gargle, and mouthwash samples before and after concentration, respectively. When concentrated by our new method, gargle and mouthwash samples can be used instead of nasopharyngeal samples in identification of SARS-CoV-2 by RT-PCR, with the same or better sensitivity. Eliminating the need for nasopharyngeal sampling will save the patients from an invasive and painful procedure and will lower the risk of infection for the healthcare personnel taking the sample. This easy sampling procedure may decrease the workload of hospitals, shorten the turnaround time of obtaining test results, and thus enable rapid isolation of infected patients.
Highlights
Severe acute respiratory syndrome (SARS-CoV-2) is a positive-sense and single-stranded RNA virus [1]
We have investigated the possibility of using gargle and mouthwash samples, after concentrating them by a new product named MyMagiCon® (GigaBioMol, Bio-T, Istanbul, Turkey) that we have recently developed, for the diagnosis of COVID-19, as an alternative to nasopharyngeal swab sampling
Storing mouthwash samples either at room temperature or 4 °C showed no significant difference in the stability of viral RNA
Summary
Severe acute respiratory syndrome (SARS-CoV-2) is a positive-sense and single-stranded RNA (ssRNA) virus [1]. Since its emergence in December 2019, SARS-CoV-2 is continuing to cause one of the most devastating pandemics in human history. COVID-19 led the entire world to face an economic crisis, which makes it harder to control the pandemic. Several vaccines are in application, it is estimated that it will take at least until the end of 2021 to control the pandemic. Until majority of the world population develops immunity by effective vaccination or by being infected, protective masks, social distancing, and quarantine rules will continue to be the most important measures to slow down the speed of transmission in order to stop overwhelming the health systems [2].
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