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Real time reverse transcription polymerase chain reaction (rRTPCR) on nasopharyngeal and respiratory specimens represents the gold standard for the qualitative detection of SARS-CoV-2 infection. However, the nasopharyngeal swab requires a close contact between healthcare workers and the patients, which poses a risk of transmission of the virus to nurses and physicians. Furthermore, the collection of these specimens may be associated with various degrees of discomfort for the patient. In this study, SARS-CoV-2 was detected in all 25 patients’ first salivary swab, with different cycle threshold (Ct) values (range 18.12–32.23; mean value 27.16 ± 3.07), but all of them were under the Ct value of 33. The analysis indicated no differences in the Ct values with regard to the period elapsed after the onset of symptoms. A striking feature was highlighted in 2 patients who showed positive salivary results on the same days when their pharyngeal or bronchoalveolar swabs proved to be negative. A second salivary swab was taken on 8 patients after 4 days, and the results were consistent with the first analysis, without relevant differences in the Ct values.
The authors concluded that saliva is a reliable biological fluid that could be a candidate for a diagnostic rapid test because it can be easily performed by non-healthcare professionals in a screening program.
– Luiz Meirelles, DDS, MS, PhD
This abstract is available on the publisher's site.
This study analyzed salivary samples of COVID-19 patients and compared the results with their clinical and laboratory data.
Salivary samples of 25 COVID-19 patients were analyzed by rRT-PCR. The following data were collected: age, sex, comorbidities, drugs. Lactate dehydrogenase (LDH) and ultrasensitive reactive C protein (usRCP) values were registered on the same day when a salivary swab was collected. Prevalence of positivity in saliva and association between clinical data and the cycle threshold as a semiquantitative indicator of viral load were considered.
Twenty-five subjects were recruited into this study, 17 males and 8 females. The mean age was 61.5 +/- 11.2 years. Cardiovascular and/or dysmetabolic disorders were observed in 65.22% of cases. All the samples tested positive for the presence of SARS-CoV-2, while there was an inverse association between LDH and Ct values. Two patients showed positive salivary results on the same days when their pharyngeal or respiratory swabs showed conversion.
Saliva is a reliable tool to detect SARS-CoV-2. The role of saliva in COVID-19 diagnosis could not be limited to a qualitative detection of the virus, but it may also provide information about the clinical evolution of the disease.