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Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva.
J Korean Med Sci. 2020 May 25; 35(20):e195.JK

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.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. infection@korea.ac.kr.Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32449329

Citation

Yoon, Jin Gu, et al. "Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva." Journal of Korean Medical Science, vol. 35, no. 20, 2020, pp. e195.
Yoon JG, Yoon J, Song JY, et al. Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva. J Korean Med Sci. 2020;35(20):e195.
Yoon, J. G., Yoon, J., Song, J. Y., Yoon, S. Y., Lim, C. S., Seong, H., Noh, J. Y., Cheong, H. J., & Kim, W. J. (2020). Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva. Journal of Korean Medical Science, 35(20), e195. https://doi.org/10.3346/jkms.2020.35.e195
Yoon JG, et al. Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva. J Korean Med Sci. 2020 May 25;35(20):e195. PubMed PMID: 32449329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva. AU - Yoon,Jin Gu, AU - Yoon,Jung, AU - Song,Joon Young, AU - Yoon,Soo Young, AU - Lim,Chae Seung, AU - Seong,Hye, AU - Noh,Ji Yun, AU - Cheong,Hee Jin, AU - Kim,Woo Joo, Y1 - 2020/05/25/ PY - 2020/04/23/received PY - 2020/05/19/accepted PY - 2020/5/26/entrez PY - 2020/5/26/pubmed PY - 2020/5/28/medline KW - COVID-19 KW - Chlorhexidine KW - SARS-CoV-2 KW - Saliva KW - Viral Load SP - e195 EP - e195 JF - Journal of Korean medical science JO - J Korean Med Sci VL - 35 IS - 20 N2 - 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. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/32449329/Clinical_Significance_of_a_High_SARS_CoV_2_Viral_Load_in_the_Saliva_ L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2020.35.e195 DB - PRIME DP - Unbound Medicine ER -