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. 2022 Nov:28 Suppl 2:2362-2390.
doi: 10.1111/odi.14216. Epub 2022 Apr 27.

Saliva as a diagnostic specimen for SARS-CoV-2 detection: A scoping review

Yifei Wang  1 , Akshaya Upadhyay  1 , Sangeeth Pillai  1 , Parisa Khayambashi  1 , Simon D Tran  1
Affiliations

Saliva as a diagnostic specimen for SARS-CoV-2 detection: A scoping review

Yifei Wang et al. Oral Dis. 2022 Nov.

Abstract

Objectives: This scoping review aims to summarize the diagnostic value of saliva assessed from current studies that (1) compare its performance in reverse transcriptase-polymerase chain reaction testing to nasopharyngeal swabs, (2) evaluate its performance in rapid and point-of-care COVID-19 diagnostic tests, and (3) explore its use as a specimen for detecting anti-SARS-CoV-2 antibodies.

Materials and methods: A systematic search was performed on the following databases: Medline and Embase (Ovid), World Health Organization, Centers for Disease Control and Prevention, and Global Health (Ovid) from January 2019 to September 2021. Of the 657 publications identified from the searches, n = 146 articles were included in the final scoping review.

Results: Our findings showcase that salivary samples exceed nasopharyngeal swabs in detecting SARS-CoV-2 using reverse transcriptase-polymerase chain reaction testing in several studies. A select number of rapid antigen and point-of-care tests from the literature were also identified capable of high detection rates using saliva. Moreover, anti-SARS-CoV-2 antibodies have been shown to be detectable in saliva through biochemical assays.

Conclusion: We highlight the potential of saliva as an all-rounded specimen in detecting SARS-CoV-2. However, future large-scale clinical studies will be needed to support its widespread use as a non-invasive clinical specimen for COVID-19 testing.

Keywords: COVID-19; COVID-19 nucleic acid testing; COVID-19 serological testing; COVID-19 testing; early diagnosis; point-of-care testing.

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Conflict of interest statement

None to declare.

The peer review history for this article is available at https://publons.com/publon/10.1111/odi.14216.

Figures

FIGURE 1
FIGURE 1
Flow diagram of study selection in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines
FIGURE 2
FIGURE 2
Image of SARS‐CoV‐2 showing its structural and genetic composition. Real‐time PCR COVID‐19 tests utilize the gene expression signal by detecting the mRNA for various structural proteins including spike (S), envelope (E), or nucleocapsid (N), and non‐structural proteins such as ORF1ab. The magnified view shows the RNA expression sequence of the SARS‐CoV‐2 coronavirus with localization of various mRNA targets. Image derived from Kubina and Dziedzic (2020)
See this image and copyright information in PMC

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