Saliva as a diagnostic specimen for detection of SARS-CoV-2 in suspected patients: a scoping review

Infect Dis Poverty. 2020 Jul 22;9(1):100. doi: 10.1186/s40249-020-00728-w.


Background: From the begging months of 2020 a severe acute respiratory syndrome coronavirus (SARS-CoV-2, also called 2019-nCoV) caused a devastating global outbreak. At present, the diagnosis of coronavirus disease 2019 (COVID-19) is made through a nasopharyngeal swab based on reverse transcription polymerase chain reaction (RT-PCR) technique. However, some recent studies suggested the possible role of oral fluids and saliva in the detection of SARS-CoV-2. The purpose of this scoping review is evaluating the available evidence regarding the efficacy of saliva as a diagnostic specimen in COVID-19 patients.

Methods: A systematic literature review of six databases (PubMed, Scopus, The Cochrane Central Register of Controlled Trials [CENTRAL], Science Direct, Web of Science and Google scholar) was carried out without any restrictions on date of publication to identify the reliability of saliva as a diagnostic specimen for detection of SARS-CoV-2 in suspected patients.

Results: Nine eligible articles were included in this review based on our described method. All the included studies are based on clinical surveys among patients with confirmed SARS-CoV-2 infection. Most of studies included in this review, reported that there is no statistically significant difference between nasopharyngeal or sputum specimens and saliva samples regarding viral load.

Conclusions: Despite limitations of this study, the findings of this review suggest that the use of self-collected saliva as a non-invasive specimen has proper accuracy and reliability regarding detection of SARS-CoV-2 based on RT-PCR technique.

Keywords: 2019-nCoV; COVID-19; PCR; Review; SARS-CoV-2; Saliva.

Publication types

  • Systematic Review

MeSH terms

  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / diagnosis*
  • Humans
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Reproducibility of Results
  • SARS-CoV-2
  • Saliva / virology*
  • Viral Load*