Diagnosis of SARS-CoV-2 by RT-PCR Using Different Sample Sources: Review of the Literature

Sara Torretta, Gianvincenzo Zuccotti, Valentina Cristofaro, Jacopo Ettori, Lorenzo Solimeno, Ludovica Battilocchi, Alessandra D’Onghia, Anna Bonsembiante, Lorenzo Pignataro, Paola Marchisio, Pasquale Capaccio

Research output: Contribution to journalReview articlepeer-review


Objective: The most widely used diagnostic technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is real-time reverse transcriptase-polymerase chain reaction (RT-PCR). It can be done on different samples: nasopharyngeal swabs (NPS) or oropharyngeal swabs (OPS), and self-collected saliva. However, negative findings do not rule out infection. Methods: A review was conceived to discuss advantages and limitations of the available diagnostic modalities for nonserologic diagnosis of SARS-CoV-2 based on RT-PCR; the article also proposes some practical suggestions to improve diagnostic reliability. Results: A total of 16 papers (corresponding to 452 patients) of the 56 initially identified were included. Most of the papers describe findings from different samples obtained in limited case series; comparative studies are missing. Conclusions: Diagnostic accuracy of NPS and OPS is suboptimal and the risk of contaminated aerosol dispersal is not negligible. The SARS-CoV-2 RNA can be found in self-collected saliva specimens of many infected patients within 7 to 10 days after symptom onset. There is an urgent need for comparative trials to define the diagnostic modality of choice. Adequate education and training of health care personnel is mandatory.

Original languageEnglish
Pages (from-to)131S-138S
JournalEar, Nose and Throat Journal
Issue number2
Publication statusPublished - 2021


  • COVID-19
  • emergency
  • infection
  • nasopharynx
  • swab

ASJC Scopus subject areas

  • Otorhinolaryngology


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