Saliva sample for the massive screening of SARS-CoV-2 infection: a systematic review

Abstract

Objectives : This systematic review aims to describe the value of saliva as a non-invasive sample for the detection of SARS-CoV-2, in comparison with the current method for sample collection, the nasopharyngeal swabs. Methods : We conducted a systematic review of the literature, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. We searched in 5 databases: PubMed, Cochrane, EBSCO, Elsevier, and MEDLINE, and included articles published between December 2019 and July 2020. Results : This review included 22 publications that met inclusion criteria, 17 of which were case series, 2 case reports, and 3 massive screenings. All articles compared saliva with nasopharyngeal swabs. The detection rate of SARS-CoV-2 in saliva was similar to NPS. The sensitivity ranged between 20% and 97%, and specificity ranged between 66 and 100%. Conclusions : This systematic review found that saliva might be an appropriate, fast, painless, simple, and non-invasive sample for SARS-CoV-2 detection, making it ideal for massive screening of SARS-CoV-2 infection.

Performance of Self-Collected Saliva Testing Compared with Nasopharyngeal Swab Testing for the Detection of SARS-CoV-2

“…Although the saliva load is lower, the tests can be performed with a lower concordance rate [18]. In individuals who have a negative SCPS test for SARS-CoV-2, it may be necessary to consider the signs and symptoms of COVID-19 and perform a complementary NP test [19].…”

Impact of Full Vaccination with mRNA BNT162b2 on SARS-CoV-2 Infection: Genomic and Subgenomic Viral RNAs Detection in Nasopharyngeal Swab and Saliva of Health Care Workers

“…Thus, we aimed to investigate sgRNA expression during the course of SARS-CoV-2 infection in the vaccinated HCWs of our hospital. Moreover, based on the benefits of saliva testing as an alternative to nasopharyngeal swab (NPS) testing for diagnosing SARS-CoV-2 infection [ 14 , 15 , 16 ], we conducted the present study using both NPS and saliva specimens. Following local directives, since the start of the vaccination campaign at the beginning of 2021, infection surveillance was maintained for all the vaccinated HCWs through antigen testing or RT-PCR analysis on NPS, every week or every 21 days, depending on exposure risk.…”

Testing Saliva to Reveal the Submerged Cases of the COVID-19 Iceberg

“…Compared to the gold standard nasopharyngeal swab, testing saliva for SARS-CoV-2 has been shown to have at least equal, and sometimes higher, sensitivity for detecting asymptomatic carriers (Savela et al, 2021;Yokota et al, 2021). Recent meta-analyses comparing the efficiency of PCR detection when applied to nasopharyngeal and saliva samples (Butler-Laporte et al, 2021;Cañete et al, 2021;Khiabani and Amirzade-Iranaq, 2021;Lee et al, 2021;Moreira et al, 2021), confirm the high specificity of saliva, with sensitivity positively correlating with stage of infection (i.e., early) and sampling technique (Tan et al, 2021).…”