Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and virulent human-infecting coronavirus that emerged in late December 2019 in Wuhan, China, causing a respiratory disease called coronavirus disease 2019 (COVID-19). SARS-CoV-2 has massively impacted global public health and caused widespread disruption to daily life. The pandemic has greatly accelerated the development of new diagnostic methods, as early detection of SARS-CoV-2 infection is essential for successful outbreak control. Real-time polymerase chain reaction with prior reverse transcription is currently considered the gold standard in SARS-CoV-2 diagnostics. Since the beginning of the pandemic nasopharyngeal swab has been the sample of choice. Due to the lack of materials and the inconvenience of nasopharyngeal swab collection, there has been a great interest in finding an alternative sample, such as saliva. We compared the usefulness of nasopharyngeal swab and saliva samples of 624 participants, collected between September 2021 and February 2022, for the detection of Delta and Omicron SARS-CoV-2 variants. The study aimed to assess if any differences among participants from both waves could be observed and if any difference in molecular diagnostic performance could be observed among the two sample types. We also evaluated a new molecular diagnostic platform. We demonstrated that the Delta variant of SARS-CoV-2 caused a more serious progress of an infection compared to the Omicron variant. Participants infected with the Delta variant were shown to have a higher viral load in both viral specimens. At the same time the research refuted the notion that a saliva sample could substitute for nasopharyngeal swab, since nasopharyngeal swab was shown to provide a better viral specimen. In saliva samples, we demonstrated a higher percentage of nucleic acid amplification inhibition, compared to nasopharyngeal swab, with the difference being statistically significant. During the evaluation of the new molecular diagnostic platform, we concluded that the new platform is not suitable for detecting the Omicron genetic variant.
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