tetano
Editor, Senior Moderator
J Korean Med Sci
. 2020 Aug 10;35(31):e287.
doi: 10.3346/jkms.2020.35.e287.
Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study
Seong Eun Kim[SUP] #[/SUP][SUP] 1 [/SUP], Ji Yeon Lee[SUP] #[/SUP][SUP] 2 [/SUP], Ahrang Lee[SUP] 1 [/SUP], Soosung Kim[SUP] 1 [/SUP], Kyung Hwa Park[SUP] 1 [/SUP], Sook In Jung[SUP] 1 [/SUP], Seung Ji Kang[SUP] 3 [/SUP], Tae Hoon Oh[SUP] 4 [/SUP], Uh Jin Kim[SUP] 4 [/SUP], Seung Yeob Lee[SUP] 5 [/SUP], Seung Jung Kee[SUP] 5 [/SUP], Hee Chang Jang[SUP] 6 [/SUP]
Affiliations
Abstract
Background: This study was performed to compare the viral load and kinetics of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in saliva with those in standard nasopharyngeal/oropharyngeal (NP/OP) swabs.
Methods: Fifteen patients with SARS-CoV-2 infection from four hospitals were prospectively enrolled and matched samples of nasopharyngeal/oropharyngeal swabs and saliva were collected at Day 1 of admission and every other day till consequently negative for two times. Real-time reverse transcription polymerase chain reaction (rRT-PCR) was performed to detect the envelope (E) and RNA-dependent RNA polymerase (RdRP) genes.
Results: The cycle threshold values of saliva were comparable to those of NP/OP swabs overall (P = 0.720, Mann-Whitney U test). However, the overall sensitivity of rRT-PCR using saliva was 64% (34/53), which is lower than the 77% (41/53) using NP/OP swabs. The sensitivity of rRT-PCR using saliva was especially lower in early stage of symptom onset (1-5 days; 8/15; 53%) and in patients who did not have sputum (12/22; 55%).
Conclusion: Saliva sample itself is not appropriate for initial diagnosis of coronavirus disease 2019 (COVID-19) to replace NP/OP swabs, especially for the person who does not produce sputum. COVID-19 cannot be excluded when the test using saliva is negative, and it is necessary to retest using NP/OP swabs.
Keywords: Nasopharyngeal Swab; Oropharyngeal Swab; SARS-CoV-2 PCR; Saliva.
. 2020 Aug 10;35(31):e287.
doi: 10.3346/jkms.2020.35.e287.
Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study
Seong Eun Kim[SUP] #[/SUP][SUP] 1 [/SUP], Ji Yeon Lee[SUP] #[/SUP][SUP] 2 [/SUP], Ahrang Lee[SUP] 1 [/SUP], Soosung Kim[SUP] 1 [/SUP], Kyung Hwa Park[SUP] 1 [/SUP], Sook In Jung[SUP] 1 [/SUP], Seung Ji Kang[SUP] 3 [/SUP], Tae Hoon Oh[SUP] 4 [/SUP], Uh Jin Kim[SUP] 4 [/SUP], Seung Yeob Lee[SUP] 5 [/SUP], Seung Jung Kee[SUP] 5 [/SUP], Hee Chang Jang[SUP] 6 [/SUP]
Affiliations
- PMID: 32776725
- DOI: 10.3346/jkms.2020.35.e287
Abstract
Background: This study was performed to compare the viral load and kinetics of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in saliva with those in standard nasopharyngeal/oropharyngeal (NP/OP) swabs.
Methods: Fifteen patients with SARS-CoV-2 infection from four hospitals were prospectively enrolled and matched samples of nasopharyngeal/oropharyngeal swabs and saliva were collected at Day 1 of admission and every other day till consequently negative for two times. Real-time reverse transcription polymerase chain reaction (rRT-PCR) was performed to detect the envelope (E) and RNA-dependent RNA polymerase (RdRP) genes.
Results: The cycle threshold values of saliva were comparable to those of NP/OP swabs overall (P = 0.720, Mann-Whitney U test). However, the overall sensitivity of rRT-PCR using saliva was 64% (34/53), which is lower than the 77% (41/53) using NP/OP swabs. The sensitivity of rRT-PCR using saliva was especially lower in early stage of symptom onset (1-5 days; 8/15; 53%) and in patients who did not have sputum (12/22; 55%).
Conclusion: Saliva sample itself is not appropriate for initial diagnosis of coronavirus disease 2019 (COVID-19) to replace NP/OP swabs, especially for the person who does not produce sputum. COVID-19 cannot be excluded when the test using saliva is negative, and it is necessary to retest using NP/OP swabs.
Keywords: Nasopharyngeal Swab; Oropharyngeal Swab; SARS-CoV-2 PCR; Saliva.