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KMID : 0191120200350310287
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Journal of Korean Medical Science
2020 Volume.35 No. 31 p.287 ~ p.287
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Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study
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Kim Seong-Eun
Lee Ji-Yeon
Lee Ah-Rang
Kim Soo-Sung
Park Kyung-Hwa
Jung Sook-In
Kang Seung-Ji
Oh Tae-Hoon
Kim Uh-Jin
Lee Seung-Yeob
Kee Seung-Jung
Jang Hee-Chang
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Abstract
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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.
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KEYWORD
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SARS-CoV-2 PCR, Saliva, Nasopharyngeal Swab, Oropharyngeal Swab
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