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Case Reports
. 2020 May 25;35(20):e195.
doi: 10.3346/jkms.2020.35.e195.

Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva

Jin Gu Yoon #  1 , Jung Yoon #  2 , Joon Young Song  3 , Soo Young Yoon  2 , Chae Seung Lim  2 , Hye Seong  1 , Ji Yun Noh  1 , Hee Jin Cheong  1 , Woo Joo Kim  1
Affiliations
Case Reports

Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva

Jin Gu Yoon et al. J Korean Med Sci. .

Abstract

Background: Patients with coronavirus disease 2019 (COVID-19) can unknowingly spread the virus to several people during the early subclinical period.

Methods: We evaluated the viral dynamics in various body fluid specimens, such as nasopharyngeal swab, oropharyngeal swab, saliva, sputum, and urine specimens, of two patients with COVID-19 from hospital day 1 to 9. Additional samples of the saliva were taken at 1 hour, 2 hours, and 4 hours after using a chlorhexidine mouthwash. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load was determined by real-time reverse transcriptase polymerase chain reaction (rRT-PCR).

Results: SARS-CoV-2 was detected from all the five specimens of both patients by rRT-PCR. The viral load was the highest in the nasopharynx (patient 1 = 8.41 log10 copies/mL; patient 2 = 7.49 log10 copies/mL), but it was also remarkably high in the saliva (patient 1 = 6.63 log10 copies/mL; patient 2 = 7.10 log10 copies/mL). SARS-CoV-2 was detected up to hospital day 6 (illness day 9 for patient 2) from the saliva of both patients. The viral load in the saliva decreased transiently for 2 hours after using the chlorhexidine mouthwash.

Conclusion: SARS-CoV-2 viral load was consistently high in the saliva; it was relatively higher than that in the oropharynx during the early stage of COVID-19. Chlorhexidine mouthwash was effective in reducing the SARS-CoV-2 viral load in the saliva for a short-term period.

Keywords: COVID-19; Chlorhexidine; SARS-CoV-2; Saliva; Viral Load.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Viral dynamics of severe acute respiratory syndrome coronavirus 2 in patient 1 (A) and 2 (B): viral load from serial nasopharyngeal, oropharyngeal, saliva, sputum, and urine samples.
NP = nasopharynx, OP = oropharynx.
Fig. 2
Fig. 2. Impact of chlorhexidine mouthwash on the severe acute respiratory syndrome coronavirus 2 viral load in the saliva.
HD = hospital day.
See this image and copyright information in PMC

Comment in

References

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