Saliva as an alternative diagnostic test in the detection of COVID-19

Keywords: Coronavirus, public health, diagnostic test, saliva

Abstract

The World Health Organization (WHO) announced that the 2019 coronavirus disease (COVID-19) epidemic, originating in Wuhan, China, has become a major public health challenge of international concern not only to China but also for countries around the world, within the clinical manifestations of this disease, fever, dry cough and dyspnoea have been reported as the most prevalent, followed by myalgia, sputum, sore throat, headache, diarrhea and general malaise; in connection with the current emergency situation, it is very important to prepare rapid and accurate diagnostic test methods for SARS-CoV-2 for the identification of suspected patients with the aim of controlling the outbreak in the community and in hospitals; recent studies have shown that saliva could be a valuable sample for diagnosis considered as a non-invasive procedure that has adequate precision and reliability regarding the detection of SARS-CoV-2 according to the RT-PCR technique, which makes it a valid alternative for the diagnosis and monitoring of the SARS-CoV-2 viral load, providing a cost-effective and convenient platform, with a relatively minimal risk of cross infection, thus considering it as an ideal diagnostic biofluid.

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References

Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. J Dent Res. 2020 May;99(5):481–7.

Melián-Rivas A, Calcumil-Herrera P, Boin-Bakit C, Carrasco-Soto R. Detección de COVID -19 (SARS-CoV-2) Mediante la Saliva: Una Alternativa Diagnóstica poco Invasiva. Int J Odontostomatol..2020;14(3):316–20.

Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr 2020;87:281–6.

Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.

Van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382:1564–7.

Chin AWH, Chu JTS, Perera MRA, Hui KPY, Yen H-L, Chan MCW, et al. Stability of SARS-CoV-2 in different environmental conditions. The Lancet Microbe. 2020;1(1):e10.

Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Vol. 12, Int J Oral Sci. 2020; 12:9.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–20.

COVID-19. Available from: https://www.entuk.org/covid-19

Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis. Vol. 24, Clin Oral Investig. 2020; 24:1619–21.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet.2020;395(10223):507–13.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - J Am Med Assoc.2020;323(11):1061–9.

Yang Y, Lu Q, Liu M, Wang Y, Zhang A, Jalali N, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. medRxiv. 2020;2020.02.10.20021675.

Nishiura H, Kobayashi T, Miyama T, Suzuki A, Jung S mok, Hayashi K, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19).J. Infect. Dis.2020;94(2):154–5.

Azzi L, Carcano G, Gianfagna F, Grossi P, Gasperina DD, Genoni A, et al. Saliva is a reliable tool to detect SARS-CoV-2. J Infect. 2020;81(1):e45–50.

Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514–23.

Del Rio C, Malani PN. 2019 Novel Coronavirus - Important Information for Clinicians.JAMA.2020;323: 1039–40.

Zerón A. El coronavirus se ha hecho viral. Rev ADM. 2020;77(2):58–61.

Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-1833.e3.

Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol. 2020;92(6):589–94.

Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;382(10):929–36.

Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Epidemiologic Features and Clinical Course of Patients Infected with SARS-CoV-2 in Singapore. JAMA. 2020;323(15):1488–94.

To KKW, Tsang OTY, Leung WS, Tam AR, Wu TC, Lung DC, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20(5):565–74.

To KKW, Tsang OTY, Yip CCY, Chan KH, Wu TC, Chan JMC, et al. Consistent Detection of 2019 Novel Coronavirus in Saliva. Clin Infect Dis. 2020;71(15):841–3.

Kim Y Il, Kim SG, Kim SM, Kim EH, Park SJ, Yu KM, et al. Infection and Rapid Transmission of SARS-CoV-2 in Ferrets. Cell Host Microbe . 2020;27(5):704-709.e2.

Morales Espinosa R, La ER. La Saliva como Biomuestra para Diagnóstico de Infección por SARS-CoV-2: Una Revisión Saliva as a Bio-sample for Diagnosis SARS-CoV-2 Infection: A review. Vol. 14, Int. J. Odontostomat. 2020; 14(3):327-330.

Tyrrell DA, Bynoe ML. Cultivation of viruses from a high proportion of patients with colds. Lancet. 1966;1(7428):76–7.

Zhou P, Yang X Lou, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–3.

Zhang T, Wu Q, Zhang Z. Probable Pangolin Origin of SARS-CoV-2 Associated with the COVID-19 Outbreak. Curr Biol. 2020;30(7):1346-1351.e2.

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet . 2020;395(10224):565–74.

Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, et al. A Novel Coronavirus Associated with Severe Acute Respiratory Syndrome. N Engl J Med. 2003;348(20):1953–66.

Zaki AM, Van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814–20.

Khurshid Z, Yahya F, Asiri I, Al Wadaani H. Human Saliva: Non-Invasive Fluid for Detecting Novel Coronavirus (2019-nCoV). Int. J. Environ. Res. Public Health.2020 ;17(7): 2225.

Fakheran O, Dehghannejad M, Khademi A. Saliva as a diagnostic specimen for detection of SARS-CoV-2 in suspected patients: A scoping review Infect. Dis. Poverty.2020; 9:7.

Kwon KT, Ko JH, Shin H, Sung M, Kim JY. Drive-through screening center for covid-19: A safe and efficient screening system against massive community outbreak. J Korean Med Sci. 2020;35(11):10.

Xu R, Cui B, Duan X, Zhang P, Zhou X, Yuan Q. Saliva: potential diagnostic value and transmission of 2019-nCoV. Int J Oral Sci. 2020;12(1):1-6.

Fang Z, Zhang Y, Hang C, Ai J, Li S, Zhang W. Comparisons of viral shedding time of SARS-CoV-2 of different samples in ICU and non-ICU patients. J. Infect.2020;81:147–78.

Humphrey SP, Williamson RT. A review of saliva: Normal composition, flow, and function. J Prosthet Dent . 2001;85(2):162–9.

Baghizadeh Fini M. Oral saliva and COVID-19 .Oral Oncol. 2020;108: 104821.

Moreno-Contreras J, Espinoza MA, Sandoval-Jaime C, Cantú-Cuevas MA, Barón-Olivares H, Ortiz-Orozco OD, et al. Saliva Sampling and Its Direct Lysis, an Excellent Option To Increase the Number of SARS-CoV-2 Diagnostic Tests in Settings with Supply Shortages. J. Clin. Microbiol. 2020;58(10)

Procop GW, Shrestha NK, Vogel S, Van Sickle K, Harrington S, Rhoads DD, et al. A Direct Comparison of Enhanced Saliva to Nasopharyngeal Swab for the Detection of SARS-CoV-2 in Symptomatic Patients. J Clin Microbiol. 2020;16.

Bjustrom-Kraft J, Woodard K, Giménez-Lirola L, Rotolo M, Wang C, Sun Y, et al. Porcine epidemic diarrhea virus (PEDV) detection and antibody response in commercial growing pigs. BMC Vet Res. 2016;12(1):1–8.

Niederwerder MC, Nietfeld JC, Bai J, Peddireddi L, Breazeale B, Anderson J, et al. Tissue localization, shedding, virus carriage, antibody response, and aerosol transmission of Porcine epidemic diarrhea virus following inoculation of 4-week-old feeder pigs. J Vet Diagnostic Investig. 2016 ;28(6):671–8.

Khurshid Z, Zafar M, Khan E, Mali M, Latif M. Human saliva can be a diagnostic tool for Zika virus detection. J. Infect. Public Health. 2019;12:. 601–4.

Boppana SB, Ross SA, Shimamura M, Palmer AL, Ahmed A, Michaels MG, et al. Saliva polymerase-chain-reaction assay for cytomegalovirus screening in newborns. N Engl J Med.2011;364(22):2111–8.

Khan R, Khurshid Z, Yahya Ibrahim Asiri F. Advancing Point-of-Care (PoC) Testing Using Human Saliva as Liquid Biopsy. Diagnostics. 2017;7(3):39.

Carbone Z, Haydee CN, González ;, Mercedes M, Martínez ;, Elena S. La saliva: una mirada hacia el diagnóstico. RAAO.2016;15(2): 39-43.

Tvarijonaviciute A, Martinez-Lozano N, Rios R, Marcilla de Teruel MC, Garaulet M, Cerón JJ. Saliva as a non-invasive tool for assessment of metabolic and inflammatory biomarkers in children. Clin Nutr.2020 ;39(8):2471–8.

Centro de Protección de la Salud - Enfermedad por coronavirus (COVID-19) - Cartas a los médicos. Available from: https://www.chp.gov.hk/en/miniweb/letters/100063.html

Wang WK, Chen SY, Liu IJ, Chen YC, Chen HL, Yang CF, et al. Detection of SARS-associated coronavirus in throat wash and saliva in early diagnosis. Emerg Infect Dis. 2004;10(7):1213–9.

To KK, Lu L, Yip CC, Poon RW, Fung AM, Cheng A, et al. Additional molecular testing of saliva specimens improves the detection of respiratory viruses. Emerg Microbes Infect. 2017 Jun 7;6(6):e49.

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of chest CT for COVID-19: Comparison to RT-PCR.Radiology. 2020;296: E115–7.

Zheng S, Yu F, Fan J, Zou Q, Xie G, Yang X, et al. Saliva as a Diagnostic Specimen for SARS-CoV-2 by a PCR-Based Assay: A Diagnostic Validity Study. SSRN Electron J. 2020 ;18.

Chen L, Zhao J, Peng J, Li X, Deng X, Geng Z, et al. Detection of 2019-nCoV in Saliva and Characterization of Oral Symptoms in COVID-19 Patients. SSRN Electron J. 2020;30.

Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: Retrospective cohort study. BMJ . 2020;369:8.

Williams E, Bond K, Zhang B, Putland M, Williamson DA. Saliva as a noninvasive specimen for detection of sars-cov-2. J. Clin. Microbiol. 2020;58: 5.

Yoon JG, Yoon J, Song JY, Yoon SY, Lim CS, Seong H, et al. Clinical significance of a high SARS-CoV-2 viral load in the Saliva. J Korean Med Sci.2020;35(20).

Han MS, Seong MW, Heo EY, Park JH, Kim N, Shin S, et al. Sequential analysis of viral load in a neonate and her mother infected with SARS-CoV-2. Clin Infect Dis. 2020;4.

Corstjens PLAM, Abrams WR, Malamud D. Detecting viruses by using salivary diagnostics. J Am Dent Assoc. 2012;143:12S-18S.

Parry J V., Perry KR, Mortimer PP. Sensitive assays for viral antibodies in saliva: an alternative to tests on serum. Lancet .1987; 330(8550): 72-75.

McKie A, Vyse A, Maple C. Novel methods for the detection of microbial antibodies in oral fluid. Lancet Infect. 2002;2(1):18-24.

Hettegger P, Huber J, Paßecker K, Soldo R, Kegler U, Nöhammer C, et al. High similarity of IgG antibody profiles in blood and saliva opens opportunities for saliva based serology. PLoS One;14(6):1–17.

Mortimer PP, Parry J V. Detection of antibody to HIV in saliva: a brief review. Clin Diagn Virol.1994;2(4–5):231–43.

González V, Martró E, Folch C, Esteve A, Matas L, Montoliu A, et al. Detection of hepatitis C virus antibodies in oral fluid specimens for prevalence studies. Eur J Clin Microbiol Infect Dis. 2008;27(2):121–6.

Flodgren GM. Immunity after SARS-CoV-2 infection, 1st update – a rapid review. Lancet Infect. Dis.2020;23:23.

Ceron J, Lamy E, Martinez-Subiela S, Lopez-Jornet P, Capela-Silva F, Eckersall P, et al. Use of Saliva for Diagnosis and Monitoring the SARS-CoV-2: A General Perspective. J Clin Med. 2020;9(5):1491.

Published
2020-12-05
How to Cite
Castañeda-Hurtado, P. J., Islas Granillo, H., & Navarrete-Hernández, J. de J. (2020). Saliva as an alternative diagnostic test in the detection of COVID-19. Educación Y Salud Boletín Científico Instituto De Ciencias De La Salud Universidad Autónoma Del Estado De Hidalgo, 9(17), 107-115. https://doi.org/10.29057/icsa.v9i17.6523