COVID-19: SARS-CoV-2 Detection in Saliva, Oropharyngeal and Nasopharyngeal Specimens
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ClinicalTrials.gov Identifier: NCT04715607 |
Recruitment Status :
Completed
First Posted : January 20, 2021
Last Update Posted : September 30, 2021
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
SARS-CoV Infection Covid19 Coronavirus | Diagnostic Test: Sequence of testing. | Not Applicable |
The reference test to evaluate patients with suspected respiratory infection caused by virus is a real-time reverse transcription-polymerase chain reaction (RT-PCR) from a nasopharyngeal swab (NPS). However, other specimen collection methods like oropharyngeal swabs (OPS) and a saliva specimen collection have also been accepted by the Centers for Disease Control and Prevention for SARS-CoV-2 testing during the current coronavirus disease 19 (COVID-19) pandemic. It is unclear how much the SARS-CoV-2 detection rate differs when using different sampling methods and the aim of this study is to compare the expected COVID-19 detection rate using saliva, oropharyngeal swabs or nasopharyngeal swab in a public setting.
We, therefore, aim to investigate the detection rate of SARS-CoV-2 in Saliva, oropharyngeal swab, and nasopharyngeal swab specimen samples collected in symptomatic and non-symptomatic individuals tested for COVID-19 in a public test center during the COVID-19 pandemic.
Individuals referred for outpatient COVID-19 testing center will be invited to participate in a prospective clinical study. They will have saliva, OPS, and NPS specimen collection performed at the same time and analyzed separately for SARS-CoV-2. The rate for SARS-CoV-2 detection in saliva, OPS, and NPS will be compared using a logistic regression mixed-effect analysis. A Sample Size Calculation estimated that a sample of 18,000 participants would be needed for the trial with 80% power at a significance level of 5%.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 27947 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | All participants will have Saliva collected and recieve nasopharyngeal swabs and oropharyngeal swabs for SARS-COV2. To avoid systematic bias we plan to randomize the sequence of testing. |
Masking: | Double (Investigator, Outcomes Assessor) |
Primary Purpose: | Diagnostic |
Official Title: | Comparison of Detection Rate of SARS-CoV-2 in Saliva, Oropharyngeal and Nasopharyngeal Specimens in a Public COVID-19 Test Setting |
Actual Study Start Date : | January 22, 2021 |
Actual Primary Completion Date : | May 30, 2021 |
Actual Study Completion Date : | May 31, 2021 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Nasopharyngeal swab, oropharyngeal swab, and salvia collection
The participants will first be tested with nasopharyngeal swabs followed by oropharyngeal swab and saliva collection. The collection material, virus transport medium and laboratory equipment for each method is the same in both arms |
Diagnostic Test: Sequence of testing.
The participants will be tested in the following sequences of sampling technique: (1) nasopharyngeal swab, oropharyngeal swab, and salvia collection OR (2) oropharyngeal swab, salvia collection, and nasopharyngeal swab OR (3) salvia collection, nasopharyngeal swab, and oropharyngeal swab. Only the sequence is different in the different arm, while the sampling technique for each method is the same in all arms. |
Active Comparator: Oropharyngeal swab, salvia collection, and nasopharyngeal swab
The participants will first be tested with oropharyngeal swabs followed by saliva collection and nasopharyngeal swab. The collection material, virus transport medium and laboratory equipment for each method is the same in both arms |
Diagnostic Test: Sequence of testing.
The participants will be tested in the following sequences of sampling technique: (1) nasopharyngeal swab, oropharyngeal swab, and salvia collection OR (2) oropharyngeal swab, salvia collection, and nasopharyngeal swab OR (3) salvia collection, nasopharyngeal swab, and oropharyngeal swab. Only the sequence is different in the different arm, while the sampling technique for each method is the same in all arms. |
Active Comparator: Salvia collection, nasopharyngeal swab, and oropharyngeal swab
The participants will first be tested with saliva collection followed by nasopharyngeal swab and oropharyngeal swabs. The collection material, virus transport medium and laboratory equipment for each method is the same in both arms |
Diagnostic Test: Sequence of testing.
The participants will be tested in the following sequences of sampling technique: (1) nasopharyngeal swab, oropharyngeal swab, and salvia collection OR (2) oropharyngeal swab, salvia collection, and nasopharyngeal swab OR (3) salvia collection, nasopharyngeal swab, and oropharyngeal swab. Only the sequence is different in the different arm, while the sampling technique for each method is the same in all arms. |
- SARS-CoV-2 detection rates for oropharyngeal swabs (OPS) compared with nasopharyngeal swabs and saliva collection. [ Time Frame: 48 hours after testing ]Due to the high specificity of RT-PCR, we will define a participant with an RT-PCR positive result from either Saliva, OPS or NPS as having a COVID-19 infection. The combined Saliva/OPS/NPS result will therefore be used as the diagnostic reference standard to calculate the sensitivity for the Saliva, OPS and NPS tests.
- SARS-CoV-2 RT-PCR cycle threshold (Ct) values [ Time Frame: 48 hours after testing ]Ct values are compared between testing methods
- OPS, NPS and saliva test discomfort and likelihood to get retested [ Time Frame: immediately after testing (10 minutes) ]Discomfort scores (1-10) and likelihood to get retested are compared between testing methods
- Ratio of mutations in SARS-CoV-2 [ Time Frame: 48 hours after testing ]Detection rate of any mutations in SARS-CoV-2

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 16 Years to 120 Years (Child, Adult, Older Adult) |
Sexes Eligible for Study: | All |
Gender Based Eligibility: | Yes |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- volunteers, who are attending the COVID-19 test facilities to obtain a RT-PCR test.
- oral and written informed consent to participate before entering the study.
Exclusion Criteria:
- Failure to understand and provide informed consent.
- Neck breathers (tracheostomy/laryngectomy patients) or other nasopharyngeal or oropharyngeal anomalies that do not allow for sampling using swabs.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04715607
Denmark | |
Valby COVID-19 teststed | |
Copenhagen, Valby, Denmark, 2500 |
Principal Investigator: | Tobias Todsen, MD, PhD | Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet | |
Study Director: | Nikolai Kirkby, MD, PhD | Department of Clinical Microbiology, Rigshospitalet |
Responsible Party: | Tobias Todsen, MD, PhD, Assistant professor Tobias Todsen, Rigshospitalet, Denmark |
ClinicalTrials.gov Identifier: | NCT04715607 |
Other Study ID Numbers: |
2021-01 |
First Posted: | January 20, 2021 Key Record Dates |
Last Update Posted: | September 30, 2021 |
Last Verified: | September 2021 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | No |
COVID-19 Severe Acute Respiratory Syndrome Respiratory Tract Infections Infections Pneumonia, Viral Pneumonia Virus Diseases |
Coronavirus Infections Coronaviridae Infections Nidovirales Infections RNA Virus Infections Lung Diseases Respiratory Tract Diseases |