A Comparative Study Between Nasopharyngeal/Oropharyngeal, Faecal and Saliva Viral Shedding In Ghanaian COVID-19 Patients attending Komfo Anokye Teaching Hospital (KATH), Kumasi from October – December, 2020

ABSTRACT Background Diagnostic testing for the current SARS-CoV-2 infections involves the collection and testing of invasive pharyngeal specimens by qualified Health workers. Though fully clad in personal protective equipment, the concern is that sampling in close proximity to the patient poses as a major health hazard. The present study sought to verify if saliva or faeces could become a possible surrogate for pharyngeal samples for SARS-CoV 2 testing in suspected Ghanaian COVID-19 patients. Objectives To ascertain if there is SARS-CoV 2 viral shedding in the saliva and faecal samples of Ghanaian COVID-19 patients, their sensitivity and specificity as compared to pharyngeal samples. Method Fifty (50) recruited COVID-19 patients who have been confirmed via RT-PCR using their nasopharyngeal/oropharyngeal samples and twenty (20) SARS-CoV 2 negative suspected patients each provided some faecal and saliva sample for RT-PCR analysis for SARS-CoV 2. Results Forty-three (43) out of the fifty (50) COVID-19 patients recruited representing 86% tested positive for SARS-CoV 2 via their saliva sample whiles all their faecal samples tested positive for SARS-CoV 2 representing 100%. The sensitivity of saliva samples was 86% whiles the specificity was 100% but the sensitivity and specificity of the faecal samples were all 100%. Conclusion There is indeed viral shedding of SARS-CoV 2 in the saliva and faeces of Ghanaian COVID-19 patients just like their counterparts in other parts of the world. Saliva and faeces could possibly become an alternative sample to the current in place of the invasive pharyngeal samples for SARS-CoV 2 testing in resource limited settings. Further research to explore this possibility at different testing sites with larger sample size is recommended.