Comparing saliva and nasopharyngeal swab specimens in the detection of COVID-19: A systematic review and meta-analysis

Nasiri, Kaveh; Dimitrova, Aleksandra

doi:10.1016/j.jds.2021.01.010

Cited by 46 publications

(52 citation statements)

References 38 publications

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“…Saliva presents numerous advantages, notably low invasive collection, it is easy to handle with the possibility of self-collection, permitting mass testing and preventing exposure of healthcare professionals [16]. Although reports about the screening properties accuracy of saliva for COVID-19 are more and more numerous [17][18][19][20], this biological fluid remains dispraised due to its variable diagnostic performance compared to the nasopharyngeal swab (NPS) [21]. The discrepancy observed could be attributed to several factors, such as the heterogeneity of saliva specimens (e.g.…”

Section: Introductionmentioning

confidence: 99%

Salivette, a relevant saliva sampling device for SARS-CoV-2 detection

Costa

Nicolas

Dormoi

et al. 2021

Journal of Oral Microbiology

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Background: The gold standard for COVID-19 diagnosis relies on quantitative reverse-transcriptase polymerase-chain reaction (RT-qPCR) from nasopharyngeal swab (NPS) specimens, but NPSs present several limitations. The simplicity, low invasive and possibility of self-collection of saliva imposed these specimens as a relevant alternative for SARS-CoV-2 detection. However, the discrepancy of saliva test results compared to NPSs made of its use controversial. Here, we assessed Salivettes®, as a standardized saliva collection device, and compared SARS-CoV-2 positivity on paired NPS and saliva specimens. Methods: A total of 303 individuals randomly selected among those investigated for SARS-CoV-2 were enrolled, including 30 (9.9%) patients previously positively tested using NPS (follow-up group), 90 (29.7%) mildly symptomatic and 183 (60.4%) asymptomatic. Results: The RT-qPCR revealed a positive rate of 11.6% (n = 35) and 17.2% (n = 52) for NPSs and saliva samples, respectively. The sensitivity and specificity of saliva samples were 82.9% and 91.4%, respectively, using NPS as reference. The highest proportion of discordant results concerned the follow-up group (33.3%). Although the agreement exceeded 90.0% in the symptomatic and asymptomatic groups, 17 individuals were detected positive only in saliva samples, with consistent medical arguments. Conclusion Saliva collected with Salivette® was more sensitive for detecting symptomatic and pre-symptomatic infections.

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Section: Introductionmentioning

confidence: 99%

Salivette, a relevant saliva sampling device for SARS-CoV-2 detection

Costa

Nicolas

Dormoi

et al. 2021

Journal of Oral Microbiology

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“…As a result, distinct results obtained when exploring the saliva samples for SARS-CoV-2 RNA detection were published. [12][13][14]23,24 The main parameter, characterizing the detection method, is the agreement between the results obtained by the method under investigation and the gold standard. Regarding the saliva and NP swab comparison, most studies provide good results of agreement, sometimes termed as overall percentage agreement (OPA).…”

Section: Discussionmentioning

confidence: 99%

“…As a result, distinct results obtained when exploring the saliva samples for SARS-CoV-2 RNA detection were published. 12–14 , 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

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Saliva Testing is a Robust Non-Invasive Method for SARS-CoV-2 RNA Detection

Paliksa¹,

Lopeta²,

Belevičius³

et al. 2021

IDR

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The precise diagnostic testing is of high importance in fighting the coronavirus pandemic. While nasopharyngeal (NP) swab testing is currently the gold standard, the SARS-CoV-2 virus could be also detected in some other body fluids. In this study, we aimed to compare the SARS-CoV-2 RNA detection results, obtained using saliva samples and NP swab samples, collected from infected patients and healthy volunteers. Patients and Methods: A total of 111 individuals were enrolled in this study: 53 healthy volunteers, participating in routine testing and 58 COVID-19 patients. Diagnosis for both groups was confirmed using a set of diagnostic CE-IVD labeled RT-qPCR kits. Most of the saliva samples were collected within 48 hours after the NP swabs were taken. RNA was purified from saliva samples and analyzed using a laboratory-developed kit (Diagnolita). Detection results for both sample types were compared and analyzed in terms of result agreement, Ct variation, and quantity of internal control, as well as population analysis. Results: We found a good concordance between the NP swab and saliva samples. The positive percent agreement was 98.28% (CI 90.76-99.96%) and negative percent agreement was 98.11% (CI 89.93-99.95%). Additionally, we observed a statistically significant (p<0.05) and moderately strong (R = 0.53) correlation between Ct values in saliva and NP swab samples. The saliva collection method is more robust since the Ct variation of internal control ribonuclease P mRNA detection is lower in saliva samples. Conclusion: Saliva sample testing is a robust and reliable non-invasive alternative to the NP swab method for SARS-CoV-2 RNA detection, as well as a promising tool for COVID-19 screening.

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“…A meta-analysis by Butler-Laporte [ 21 ] suggested comparable accuracy of saliva NAAT (pooled sensitivity of 83.2% and specificity 99.2%) to nasopharyngeal swab NAAT (pooled sensitivity 84.8% and specificity of 98.9%). Another meta-analysis by Nasiri [ 22 ] showed insignificant difference between nasopharyngeal swab and saliva specimens for COVID-19 disease diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of fresh drooled saliva for SARS-CoV-2 in travelers

Thabit

Peariasamy

Kuan

et al. 2021

Travel Medicine and Infectious Disease

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Background The standard for SARS-CoV-2 diagnosis is RT-PCR from nasopharyngeal or oropharyngeal swabs. Major airports require COVID-19 screening, and saliva has the potential as a substitute specimen for SARS-CoV-2 diagnosis. We investigated the utility of fresh drooled saliva against NPS for COVID-19 screening of travelers. Methods We recruited 81 travelers and 15 non-travelers (including ten controls) prospectively within a mean of 3·22 days of RT-PCR confirmed COVID-19. Each study participant provided 2 mls of early morning fresh drooled whole saliva separately into a sterile plastic container and GeneFiX™ saliva collection kit. The saliva specimens were processed within 4 h and tested for SARS-CoV-2 genes (E, RdRP, and N2) and the results compared to paired NPS RT-PCR for diagnostic accuracy. Results Majority of travellers were asymptomatic (75·0%) with a mean age of 34·26 years. 77 travelers were RT-PCR positive at the time of hospitalization whilst three travelers had positive contacts. In this group, the detection rate for SARS-CoV-2 with NPS, whole saliva, and GeneFiX™ were comparable (89·3%, 50/56; 87·8%, 43/49; 89·6%, 43/48). Both saliva collection methods were in good agreement (Kappa = 0·69). There was no statistical difference between the detection rates of saliva and NPS (p > 0·05). Detection was highest for the N2 gene whilst the E gene provided the highest viral load (mean = 27·96 to 30·10, SD = 3·14 to 3·85). Saliva specimens have high sensitivity (80·4%) and specificity (90·0%) with a high positive predictive value of 91·8% for SARS-CoV-2 diagnosis. Conclusion Saliva for SARS-CoV-2 screening is a simple accurate technique comparable with NPS RT-PCR.

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Comparing saliva and nasopharyngeal swab specimens in the detection of COVID-19: A systematic review and meta-analysis

Cited by 46 publications

References 38 publications

Salivette, a relevant saliva sampling device for SARS-CoV-2 detection

Salivette, a relevant saliva sampling device for SARS-CoV-2 detection

Saliva Testing is a Robust Non-Invasive Method for SARS-CoV-2 RNA Detection

Diagnostic accuracy of fresh drooled saliva for SARS-CoV-2 in travelers

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