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Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study.
J Korean Med Sci. 2020 Aug 10; 35(31):e287.JK

Abstract

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.

Links

Publisher Full Text
ncbi.nlm.nih.gov
jkms.org
PMC Free PDF

Authors+Show Affiliations

Kim SE
Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
Lee JY
Department of Infectious Diseases, Keimyung University Dongsan Hospital, Daegu, Korea.
Lee A
Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
Kim S
Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
Park KH
Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
Jung SI
Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
Kang SJ
Department of Infectious Diseases, Chonnam National University Bitgoeul Hospital, Gwangju, Korea.
Oh TH
Department of Infectious Diseases, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Kim UJ
Department of Infectious Diseases, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Lee SY
Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju, Korea.
Kee SJ
Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju, Korea.
Jang HC
Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea. haroc153@naver.com.

MeSH

AdolescentAdultAgedAged, 80 and overBetacoronavirusCOVID-19Coronavirus InfectionsFemaleHumansMaleMiddle AgedNasopharynxPandemicsPneumonia, ViralProspective StudiesRNA, ViralReal-Time Polymerase Chain ReactionRepublic of KoreaSARS-CoV-2SalivaViral LoadYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32776725

Citation

Kim, Seong Eun, et al. "Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study." Journal of Korean Medical Science, vol. 35, no. 31, 2020, pp. e287.
Kim SE, Lee JY, Lee A, et al. Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study. J Korean Med Sci. 2020;35(31):e287.
Kim, S. E., Lee, J. Y., Lee, A., Kim, S., Park, K. H., Jung, S. I., Kang, S. J., Oh, T. H., Kim, U. J., Lee, S. Y., Kee, S. J., & Jang, H. C. (2020). Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study. Journal of Korean Medical Science, 35(31), e287. https://doi.org/10.3346/jkms.2020.35.e287
Kim SE, et al. Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study. J Korean Med Sci. 2020 Aug 10;35(31):e287. PubMed PMID: 32776725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Viral Load Kinetics of SARS-CoV-2 Infection in Saliva in Korean Patients: a Prospective Multi-center Comparative Study. AU - Kim,Seong Eun, AU - Lee,Ji Yeon, AU - Lee,Ahrang, AU - Kim,Soosung, AU - Park,Kyung Hwa, AU - Jung,Sook In, AU - Kang,Seung Ji, AU - Oh,Tae Hoon, AU - Kim,Uh Jin, AU - Lee,Seung Yeob, AU - Kee,Seung Jung, AU - Jang,Hee Chang, Y1 - 2020/08/10/ PY - 2020/06/26/received PY - 2020/08/03/accepted PY - 2020/8/11/entrez PY - 2020/8/11/pubmed PY - 2020/8/20/medline KW - Nasopharyngeal Swab KW - Oropharyngeal Swab KW - SARS-CoV-2 PCR KW - Saliva SP - e287 EP - e287 JF - Journal of Korean medical science JO - J Korean Med Sci VL - 35 IS - 31 N2 - 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. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/32776725/Viral_Load_Kinetics_of_SARS_CoV_2_Infection_in_Saliva_in_Korean_Patients:_a_Prospective_Multi_center_Comparative_Study_ L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2020.35.e287 DB - PRIME DP - Unbound Medicine ER -