COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Diagnosis Altawalah H, AlHuraish F, Alkandari WA, et al. Saliva specimens for detection of severe acute respiratory syndrome coronavirus 2 in Kuwait: A cross-sectional study. J Clin Virol. 2020 Nov;132:104652. doi: 10.1016/j.jcv.2020.104652. Epub 2020 Oct 1.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) and represents a global pandemic affecting more than 26 million people and has claimed >870,000 lives worldwide. Diagnostic tests for SARS-COV-2 infection commonly use nasopharyngeal swabs (NPS). As an alternative specimen, we investigated the potential use of the real-time reverse transcriptase PCR (RT-PCR) detection of SARS-COV-2 in saliva samples in large suspected-COVID-19 patients in Kuwait. NPS and saliva samples pairs were prospectively collected from 891 COVID-19 suspected patients in Kuwait and analyzed using TaqPath™ COVID-19 multiplex RT-PCR. Of the 891 patients, 38.61 % (344/891) were positive for SARS-CoV-2, 4.83 % (43/891) were equivocal, and 56.56 % (504/891) were negative with NPS by RT-PCR. For saliva, 34.23 % (305/891) were positive for SARS-CoV-2, 3.14 (28/891) were equivocal, and 62.63 % (558/891) were negative. From 344 confirmed cases for SARS-CoV-2 with NPS samples, 287 (83.43 %) (95 % CI, 79.14-86.99) were positive with saliva specimens. Moreover, the diagnostic sensitivity and specificity of RT-PCR for the diagnosis of COVID-19 in saliva were 83.43 % (95 % CI: 79.07-87.20) and 96.71 % (95 % CI: 94.85-98.04 %), respectively. An analysis of the agreement between the NPS and saliva specimens demonstrated 91.25 % observed agreement (? coefficient = 0.814, 95 % CI, 0.775-0.854). This study demonstrates that saliva can be a noninvasive specimen for detection of SARS-CoV-2 by RT-PCR.

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