Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Pregnant Women Treated with Nirmatrelvir/Ritonavir (Paxlovid) Using Salivary Polymerase Chain Reaction: A Prospective Cohort Study

利用唾液聚合酶链式反应检测接受尼马替韦/利托那韦(Paxlovid)治疗的孕妇体内严重急性呼吸综合征冠状病毒2:一项前瞻性队列研究

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Abstract

OBJECTIVES: We aim to study the relative viral load using salivary polymerase chain reaction among pregnant women treated with Paxlovid. METHODS: Pregnant women with coronavirus disease 2019 were allocated to two groups: those receiving Paxlovid and those receiving no antiviral agents. We compared the nasopharyngeal and salivary relative viral loads and their changes in saliva specimens. RESULTS: Among the thirty-seven pregnant women, seventeen received Paxlovid, and twenty received no antiviral agents. The viral cycle threshold value of saliva was significantly higher than that from nasopharynx, with a median ± interquartile range of 26.44 ± 7.68 versus 17.6 ± 9.6 in the Paxlovid group (p = 0.005). Following treatment, the median salivary viral load decreased by 13.40 cycle threshold values in the Paxlovid group (from a median of [Day 0 Ct] to [Day 4/5 Ct]), compared to a change of -1.59 cycle threshold values in the no-antiviral group (from a median of [Day 0 Ct] to [Day 4/5 Ct]) (p = 0.021). The detection rate of coronavirus disease 2019 using salivary polymerase chain reaction was 83.8% (31/37). CONCLUSIONS: This study showed that saliva is a useful diagnostic tool for coronavirus disease 2019 in pregnant women, and a significant decrease in the relative viral load of saliva was observed in those treated with Paxlovid.

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