Comparing SARS-CoV-2 Viral Load in Human Saliva to Oropharyngeal Swabs, Nasopharyngeal Swabs, and Sputum: A Systematic Review and Meta-Analysis

Mouri R.J. Faruque; Floris J. Bikker; Marja L. Laine

doi:10.1155/2023/5807370

Comparing SARS-CoV-2 Viral Load in Human Saliva to Oropharyngeal Swabs, Nasopharyngeal Swabs, and Sputum: A Systematic Review and Meta-Analysis

Mouri R.J. Faruque^*
, Floris J. Bikker
, Marja L. Laine

^*Corresponding author for this work

Research output: Contribution to Journal › Review article › Academic › peer-review

Abstract

A systematic review and meta-analysis were conducted to investigate the SARS-CoV-2 viral load in human saliva and compared it with the loads in oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, the salivary viral loads of symptomatic and asymptomatic COVID-19 patients were compared. Searches were conducted using four electronic databases: PubMed, Embase, Scopus, and Web of Science, for studies published on SARS-CoV-2 loads expressed by C_T values or copies/mL RNA. Tree reviewers evaluated the included studies to confrm eligibility and assessed the risk of bias. A total of 37 studies were included. Mean C_T values in saliva ranged from 21.5 to 39.6 and mean copies/mL RNA ranged from 1.91 × 10¹ to 6.98 × 10¹¹. Meta-analysis revealed no signifcant diferences in SARS-CoV-2 load in saliva compared to oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, no signifcant diferences were observed in the salivary viral load of symptomatic and asymptomatic COVID-19 patients. We conclude that saliva specimen can be used as an alternative for SARS-CoV-2 detection in oropharyngeal swabs, nasopharyngeal swabs, and sputum.

Original language	English
Article number	5807370
Pages (from-to)	1-24
Number of pages	24
Journal	Canadian Journal of Infectious Diseases and Medical Microbiology
Volume	2023
Early online date	10 Aug 2023
DOIs	https://doi.org/10.1155/2023/5807370
Publication status	Published - 2023

Bibliographical note

Publisher Copyright:
Copyright © 2023 Mouri R. J. Faruque et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funding

We thank the authors of included studies for sharing their datasets for meta-analysis. We also thank Zainab Assy, Henk Brand, Wendy Kaman, and Toon Ligtenberg for their helpful discussion. This research was fnancially supported by the institution of the authors.

Funders	Funder number
UK Research and Innovation	104821

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title = "Comparing SARS-CoV-2 Viral Load in Human Saliva to Oropharyngeal Swabs, Nasopharyngeal Swabs, and Sputum: A Systematic Review and Meta-Analysis",

abstract = "A systematic review and meta-analysis were conducted to investigate the SARS-CoV-2 viral load in human saliva and compared it with the loads in oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, the salivary viral loads of symptomatic and asymptomatic COVID-19 patients were compared. Searches were conducted using four electronic databases: PubMed, Embase, Scopus, and Web of Science, for studies published on SARS-CoV-2 loads expressed by CT values or copies/mL RNA. Tree reviewers evaluated the included studies to confrm eligibility and assessed the risk of bias. A total of 37 studies were included. Mean CT values in saliva ranged from 21.5 to 39.6 and mean copies/mL RNA ranged from 1.91 × 101 to 6.98 × 1011. Meta-analysis revealed no signifcant diferences in SARS-CoV-2 load in saliva compared to oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, no signifcant diferences were observed in the salivary viral load of symptomatic and asymptomatic COVID-19 patients. We conclude that saliva specimen can be used as an alternative for SARS-CoV-2 detection in oropharyngeal swabs, nasopharyngeal swabs, and sputum.",

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Comparing SARS-CoV-2 Viral Load in Human Saliva to Oropharyngeal Swabs, Nasopharyngeal Swabs, and Sputum: A Systematic Review and Meta-Analysis. / Faruque, Mouri R.J.; Bikker, Floris J.; Laine, Marja L.
In: Canadian Journal of Infectious Diseases and Medical Microbiology, Vol. 2023, 5807370, 2023, p. 1-24.

Research output: Contribution to Journal › Review article › Academic › peer-review

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AB - A systematic review and meta-analysis were conducted to investigate the SARS-CoV-2 viral load in human saliva and compared it with the loads in oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, the salivary viral loads of symptomatic and asymptomatic COVID-19 patients were compared. Searches were conducted using four electronic databases: PubMed, Embase, Scopus, and Web of Science, for studies published on SARS-CoV-2 loads expressed by CT values or copies/mL RNA. Tree reviewers evaluated the included studies to confrm eligibility and assessed the risk of bias. A total of 37 studies were included. Mean CT values in saliva ranged from 21.5 to 39.6 and mean copies/mL RNA ranged from 1.91 × 101 to 6.98 × 1011. Meta-analysis revealed no signifcant diferences in SARS-CoV-2 load in saliva compared to oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, no signifcant diferences were observed in the salivary viral load of symptomatic and asymptomatic COVID-19 patients. We conclude that saliva specimen can be used as an alternative for SARS-CoV-2 detection in oropharyngeal swabs, nasopharyngeal swabs, and sputum.

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Comparing SARS-CoV-2 Viral Load in Human Saliva to Oropharyngeal Swabs, Nasopharyngeal Swabs, and Sputum: A Systematic Review and Meta-Analysis

Abstract

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