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In this systematic review of the use of saliva for the diagnosis of COVID-19, the sensitivity of RT-qPCR–analyzed saliva specimens ranged from 66% to 92% and specificity ranged from 97% to 100% compared with the standard diagnosis with throat and nasopharyngeal swabs. Use of saliva specimens was shown to be cost-effective, was less invasive, offered a shorter turnaround time, and lowered the risk of transmission to healthcare workers.
Saliva has long been recognized as a promising biological matrix for early detection of diseases in general. Prior to adoption of salivary diagnostics for COVID-19, studies with larger cohorts of patients at different stages of the infectious process, with use of universal terms, standardization of sample collection protocols, and establishment of a sensitivity threshold for viral load in asymptomatic patients need to be performed. The use of saliva opens the possibility of rapid and less invasive diagnostic protocols using bioanalyses rather than the pathogen itself.
– Laurie C. Carter, DDS, PhD
This abstract is available on the publisher's site.
This review presents literature that highlights saliva's utility as a biofluid in the diagnosis and monitoring of COVID-19. A systematic search was performed in 5 electronic databases (PubMed, Embase, LILACS, Scopus, and Web of Science). Studies were eligible for inclusion if they assessed the potential diagnostic value and/or other discriminatory properties of biological markers in the saliva of patients with COVID-19. As of July 22, 2020, a total of 28 studies have investigated the presence of SARS-CoV-2 RNA in saliva. Several of those studies confirmed reliable detection of SARS-CoV-2 in the saliva of patients with COVID-19. Saliva offered sensitivity and specificity for SARS-CoV-2 detection comparable to that of the current standard of nasopharyngeal and throat swabs. However, the utility of saliva in diagnosing COVID-19 infection remains understudied. Clinical studies with larger patient populations that measure recordings at different stages during the disease are still necessary to confirm the accuracy of COVID-19 diagnosis with saliva. Nevertheless, the utility of saliva as a diagnostic tool opens the possibility of using rapid and less invasive diagnostic strategies by targeting bioanalytes rather than the pathogen.