Saliva is superior over nasopharyngeal swab for detecting SARS-CoV2 in COVID-19 patients

Sci Rep. 2021 Nov 22;11(1):22640. doi: 10.1038/s41598-021-02097-2.

Abstract

Scaling up of diagnostic capacity is needed to mitigate the global pandemic of SARS-CoV2. However, there are challenges including shortage of sample collection swabs and transport medium. Saliva has been recommended as a simple, low-cost, non-invasive option. However, data from different populations and settings are limited. Here, we showed that saliva could be a good alternative sample to diagnose COVID-19 patients. Pair of NPS-saliva samples was collected from 152 symptomatic; confirmed COVID-19 patients, and compared their positivity rate, viral load, and duration of viral shedding. From 152 patients, 80 (52.63%) tested positive and 72 (47.37%) were negative for SARSA-CoV2 in NPS sample. In saliva, 129 (92.14%) were tested positive and 11 (7.86%) were negative on the day of admission to hospital. The overall percent agreement of RT-PCR result of Saliva to NPS was 70% (196/280). A comparison of viral load from 72 NPS-saliva pair samples on day of admission shows saliva contains significantly higher viral load (P < 0.001). In conclusion, saliva has higher yield in detecting SARS-CoV2, and COVID-19 patients show higher viral load and prolonged period of viral shedding in saliva. Therefore, we recommend saliva as a better alternative sample to NPS to diagnose COVID-19 patients.

Publication types

  • Comparative Study

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 Nucleic Acid Testing
  • Hospitalization
  • Humans
  • Nasopharynx / virology*
  • Pandemics
  • RNA, Viral
  • SARS-CoV-2 / genetics*
  • Saliva / virology*
  • Specimen Handling / methods*
  • Viral Load
  • Virus Shedding

Substances

  • RNA, Viral