Saliva as a Candidate for COVID-19 Diagnostic Testing: A Meta-Analysis

Frontiers in Medicine

article

László Márk Czumbel¹  Martin C. Steward²  Gábor Varga¹  Szabolcs Kiss³  Nelli Farkas³  Iván Mandel⁵  Anita Hegyi⁵  Ákos Nagy⁵  Zsolt Lohinai⁶  Zsolt Szakács³  Péter Hegyi³ 

[1] Department of Oral Biology, Faculty of Dentistry, Semmelweis University;School of Medical Sciences, University of Manchester, United Kingdom;Institute for Translational Medicine, Medical School, University of Pécs;Doctoral School of Clinical Medicine, University of Szeged;Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs;Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University

关键词: coronavirus;    SARS-CoV-2;    COVID-19;    diagnostic tests;    saliva;    systematic review;    meta-analysis;   

DOI  :  10.3389/fmed.2020.00465

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: COVID-19 is a serious and potentially deadly disease. Early diagnosis of infected individuals will play an important role in stopping its further escalation. The present gold standard for sampling is the nasopharyngeal swab method. However, several recent papers suggested that saliva-based testing is a promising alternative that could simplify and accelerate COVID-19 diagnosis. Objectives: Our aim was to conduct a meta-analysis on the reliability and consistency of SARS-CoV-2 viral RNA detection in saliva specimens. Methods: We have reported our meta-analysis according to the Cochrane Handbook. We searched the Cochrane Library, Embase, Pubmed, Scopus, Web of Science and clinical trial registries for eligible studies published between 1 January and 25 April 2020. The number of positive tests and the total number of tests conducted were collected as raw data. The proportion of positive tests in the pooled data were calculated by score confidence-interval estimation with the Freeman–Tukey transformation. Heterogeneity was assessed using the I 2 measure and the χ 2 -test. Results: The systematic search revealed 96 records after removal of duplicates. Twenty-six records were included for qualitative analysis and 5 records for quantitative synthesis. We found 91% (CI 80–99%) sensitivity for saliva tests and 98% (CI 89–100%) sensitivity for nasopharyngeal swab (NPS) tests in previously confirmed COVID-19 patients, with moderate heterogeneity among the studies. Additionally, we identified 18 registered, ongoing clinical trials of saliva-based tests for detection of the virus. Conclusion: Saliva tests offer a promising alternative to NPS for COVID-19 diagnosis. However, further diagnostic accuracy studies are needed to improve their specificity and sensitivity.

【 授权许可】

CC BY