Deep throat saliva as an alternative diagnostic specimen type for the detection of SARS‐CoV‐2

Abstract

Nasopharyngeal swabs (NPS) are widely accepted as specimens for the detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in the current pandemic of coronavirus disease 2019. However, the collection procedures for NPS specimens causes sneezing and coughing in most patients, which generate droplets or aerosol particles that are hazardous to the healthcare workers collecting these specimens. In this study, 95 patient‐matched paired deep throat saliva (DTS) and NPS specimens from 62 patients were analyzed. Samples were tested for SARS‐CoV‐2 by reverse‐transcription polymerase chain reaction (RT‐PCR). The rates of detection for DTS (53.7%) and NPS (47.4%) samples were comparable ( P = .13). It is important to note that the patients should be clearly instructed or supervised during DTS collection. In conclusion, SARS‐CoV‐2 detection by RT‐PCR was equivalent in DTS and NPS specimens.

Saliva as a possible tool for the SARS-CoV-2 detection: A review

“…No randomized controlled clinical trial was found. All manuscripts included were cross-sectional or cohort studies [ 6 , 7 , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] ] ( Table A.1 , Table A.2 , Table A.3 ).…”

“…In samples whose posterior oropharyngeal saliva is collected, other secretions are added besides the saliva that is secreted by larger or smaller salivary glands, which may come from the upper or lower respiratory tract and gingival fluid [ 7 , 55 ]. All studies that used this collection method demonstrated good performance in SARS-CoV-2 detection, including asymptomatic and pre-symptomatic infections [ 7 , 13 , 21 , 23 , 27 , 34 ].…”

Laboratory testing for the diagnosis of COVID-19

“…The use of deep-throat saliva, which is the self-collection of the posterior oropharyngeal secretion, was particularly studied in depth. The sensitivity is comparable to nasopharyngeal swab specimens [ 13 , 16 , 28 ]. As the result of heterogeneity of methods and study designs, the WHO do not currently recommend the use of saliva as the sole specimen type for clinical diagnosis of COVID-19 infection [ 4 ].…”

A Direct Comparison of Enhanced Saliva to Nasopharyngeal Swab for the Detection of SARS-CoV-2 in Symptomatic Patients

“…(3)(4)(5) Several studies have investigated the use of saliva as a specimen for testing for SARS-CoV-2 with mixed results. (3,(5)(6)(7)(8)(9)(10)(11) We, therefore, undertook a direct NPS to saliva specimen comparison to provide further clarification regarding the use of saliva as a potential specimen for testing.…”