COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Diagnosis Medeiros da Silva RC, Nogueira Marinho LC, de Araujo Silva DN, et al. Saliva as a possible tool for the SARS-CoV-2 detection: A review. Travel Med Infect Dis. 2020 Nov - Dec;38:101920. doi: 10.1016/j.tmaid.2020.101920. Epub 2020 Nov 19.
Abstract

BACKGROUND: Salivary tests for the new coronavirus (SARS-CoV-2) diagnosis have been suggested as alternative methods for the nasopharyngeal and oropharyngeal tests.

METHOD: Two reviewers independently performed a search in the following electronic databases: PubMed, Medline, Cochrane Library, Web of Science, Embase and Scopus to identify cross-sectional and cohort studies that used saliva samples for SARS-CoV-2 detection. The search strategy was: ("saliva") and ("SARS-CoV-2" or "coronavirus" or "COVID-1").

RESULTS: A total of 363 studies were identified and 39 were selected for review. Salivary samples for SARS-CoV-2 detection was as consistent and sensitive as the nasopharyngeal swabs in most studies, having been effective in detecting asymptomatic infections previously tested negative in nasopharyngeal samples. Viral nucleic acids found in saliva obtained from the duct of the salivary gland may indicate infection in that gland. Live viruses could be detected in saliva by viral culture.

CONCLUSIONS: Salivary samples show great potential in SARS-CoV-2 detection and may be recommended as a simple and non-invasive alternative.

Ratings
Discipline / Specialty Area Score
Public Health
Pediatric Neonatology
Hospital Doctor/Hospitalists
Internal Medicine
Family Medicine (FM)/General Practice (GP)
Pediatric Hospital Medicine
General Internal Medicine-Primary Care(US)
Pediatrics (General)
Infectious Disease
Emergency Medicine
Pediatric Emergency Medicine
Comments from MORE raters

Emergency Medicine rater

From my own experience, I find nasopharryngeal swabs are not very nice. If there would be an alternative, it would be highly recommendable to do further investigations in this field.

General Internal Medicine-Primary Care(US) rater

The review shows that saliva could be a tool for the coronavirus detection given its high sensibility and specificity, when compared with nasopharyngeal swabs, and supervision. Without supervision, the results are substantially lower. The performance should be made when symptoms arise, into the first week, and in the morning.