Surveillance Web System and Mouthwash-Saliva qPCR for Labor Ambulatory SARS-CoV-2 Detection and Prevention

Gustavo Mora-Aguilera, Verónica Martínez-Bustamante, Gerardo Acevedo-Sánchez, Juan J. Coria-Contreras, Eduardo Guzmán-Hernández, Oscar E. Flores-Colorado, Coral Mendoza-Ramos, Gabriel Hernández-Nava, Ikuri Álvarez-Maya, M. Alejandra Gutiérrez-Espinosa, Raael Gómez-Linton, Ana Carolina Robles-Bustamante and Alberto Gallardo-Hernández
Additional contact information
Gustavo Mora-Aguilera: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Verónica Martínez-Bustamante: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Gerardo Acevedo-Sánchez: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Juan J. Coria-Contreras: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Eduardo Guzmán-Hernández: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Oscar E. Flores-Colorado: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Coral Mendoza-Ramos: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Gabriel Hernández-Nava: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Ikuri Álvarez-Maya: Center for Research and Applied Technology in Jalisco (CIATEJ), Jalisco 44270, CP, Mexico
M. Alejandra Gutiérrez-Espinosa: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Raael Gómez-Linton: Laboratory of Epidemiological Risk Analysis (LANREF), Montecillo Campus, Postgraduate College, Texcoco 56230, CP, Mexico
Ana Carolina Robles-Bustamante: Secretary of Health-CDMX, Mexico City 06900, CP, Mexico
Alberto Gallardo-Hernández: Secretary of Health-CDMX, Mexico City 06900, CP, Mexico

IJERPH, 2022, vol. 19, issue 3, 1-16

Abstract: This study provides a safe and low-cost in-house protocol for RT-qPCR-based detection of SARS-CoV-2 using mouthwash–saliva self-collected specimens to achieve clinical and epidemiological surveillance in a real-time web environment applied to ambulatory populations. The in-house protocol comprises a mouthwash–saliva self-collected specimen, heat virus inactivation, and primers to target virus N-gene region and the human RPP30-gene. Aligning with 209 SARS-CoV-2 sequences confirmed specificity including the Alpha variant from the UK. Development, validation, and statistical comparison with official nasopharyngeal swabbing RT-qPCR test were conducted with 115 specimens of ambulatory volunteers. A web–mobile application platform was developed to integrate a real-time epidemiological and clinical core baseline database with mouthwash–saliva RT-qPCR testing. Nine built-in algorithms were generated for decision-making on testing, confining, monitoring, and self-reports to family, social, and work environments. Epidemiological and clinical follow-up and SARS-CoV-2 testing generated a database of 37,351 entries allowing individual decision-making for prevention. Mouthwash–saliva had higher sensitivity than nasopharyngeal swabbing in detecting asymptomatic and mild symptomatic cases with 720 viral copy number (VCN)/mL as the detection limit (Ct = 37.6). Cycling threshold and viral loading were marginally different ( p = 0.057) between asymptomatic (35 Ct ± 2.8; 21,767.7 VCN/mL, range 720–77,278) and symptomatic (31.3 Ct ± 4.5; 747,294.3 VCN/mL, range 1433.6–3.08 × 10 6 ). We provided proof-of-concept evidence of effective surveillance to target asymptomatic and moderate symptomatic ambulatory individuals based on integrating a bio-safety level II laboratory, self-collected, low-risk, low-cost detection protocol, and a real-time digital monitoring system. Mouthwash–saliva was effective for SARS-CoV-2 sampling for the first time at the community level.

Keywords: coronavirus; monitoring; prevention; surveillance; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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