ArticleJournal of clinical virology : the official publication of the Pan American Society for Clinical Virology2021
Natural spring water gargle and direct RT-PCR for the diagnosis of COVID-19 (COVID-SPRING study).
Article in Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Sensitivity of gargle samples compared to swabs for SARS-CoV-2 detection with nucleic acid amplification testing: a systematic review and meta-analysis.Virology journal · 2026Pooled it
- The effect of sample site and collection procedure on identification of SARS-CoV-2 infection.The Cochrane database of systematic reviews · 2024Pooled it
- Performance of saline and water gargling for SARS-CoV-2 reverse transcriptase PCR testing: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2022Pooled it
- Detection of Respiratory Pathogens in Saliva and Mouthwash Samples in Children.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Clinical Performance of Self-Collected Purified Water Gargle for Detection of Influenza a Virus Infection by Real-Time RT-PCR.Infection and drug resistance · 2024Article
- The Diagnostic Performance of Various Clinical Specimens for the Detection of COVID-19: A Meta-Analysis of RT-PCR Studies.Diagnostics (Basel, Switzerland) · 2023Review
- Clinical performance of SARS-CoV-2 detection on the cobas Liat using water gargle samples.Journal of clinical virology plus · 2022Article
- Evaluation of water gargle samples for SARS-CoV-2 detection using Abbott ID NOW COVID-19 assay.Journal of medical virology · 2022Article
- Article
- A case of primary COVID-19 pneumonia: plausible airborne transmission of SARS-CoV-2.European journal of medical research · 2022Article
- Natural spring water gargle samples as an alternative to nasopharyngeal swabs for SARS-CoV-2 detection using a laboratory-developed test.Journal of medical virology · 2022Article
- Evaluation of observed and unobserved self-collection of saline gargle samples for the detection of SARS-CoV-2 in outpatients.Diagnostic microbiology and infectious disease · 2022Article
- Comparison of SARS-CoV-2 detection with the Cobas® 6800/8800 system on gargle samples using two sample processing methods with combined oropharyngeal/nasopharyngeal swab.Journal of medical virology · 2021Article
- Observational
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNasopharyngeal swab has long been considered the specimen of choice for the diagnosis of respiratory viral infections, including SARS-CoV-2 infection, but it suffers from several drawbacks: its discomfort limits screening acceptability, and it is vulnerable to shortages in both specialized materials and trained healthcare workers in the context of a pandemic.
methodsWe prospectively compared natural spring water gargle to combined oro-nasopharyngeal swab (ONPS) for the diagnosis of coronavirus disease 2019 (COVID-19) in paired clinical specimens (1005 ONPS and 1005 gargles) collected from 987 unique early symptomatic as well as asymptomatic individuals from the community.
resultsUsing a direct RT-PCR method with the Allplex™ 2019-nCoV Assay (Seegene), the clinical sensitivity of the gargle was 95.3% (95% confidence interval [CI], 90.2 - 98.3%), similar to the sensitivity of the ONPS (93.8%; 95% CI, 88.2 - 97.3%), despite significantly lower viral RNA concentration in gargles, as reflected by higher cycle threshold values. No single specimen type detected all COVID-19 cases. SARS-CoV-2 RNA was stable in gargles at room temperature for at least 7 days.
conclusionThe simplicity of this sampling method coupled with the accessibility of spring water are clear advantages in a pandemic situation where testing frequency, turnaround time and shortage of consumables and trained staff are critical elements.
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