Diagnostic Salivary Tests for SARS-CoV-2

The diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection relies on the detection of viral RNA by real-time reverse transcription polymerase chain reaction (rRT-PCR) performed with respiratory specimens, especially nasopharyngeal swabs. However, this procedure requires...

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Bibliographic Details
Published in:Journal of Dental Research 2021-02, Vol.100 (2), p.115-123
Main Authors: Azzi, L., Maurino, V., Baj, A., Dani, M., d’Aiuto, A., Fasano, M., Lualdi, M., Sessa, F., Alberio, T.
Format: Article
Language:English
Subjects:
Airports
Body fluids
Coronaviruses
COVID-19 - diagnosis
COVID-19 Testing - methods
Diagnosis
Humans
Infections
Medical diagnosis
Medical personnel
Polymerase chain reaction
Real-Time Polymerase Chain Reaction
Respiratory tract
Reverse transcription
Reviews
Ribonucleic acid
RNA
RNA, Viral
Saliva
Saliva - virology
Salivary gland
SARS-CoV-2 - isolation & purification
Secretions
Severe acute respiratory syndrome coronavirus 2
Spike protein
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Summary:The diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection relies on the detection of viral RNA by real-time reverse transcription polymerase chain reaction (rRT-PCR) performed with respiratory specimens, especially nasopharyngeal swabs. However, this procedure requires specialized medical personnel, centralized laboratory facilities, and time to provide results (from several hours up to 1 d). In addition, there is a non-negligible risk of viral transmission for the operator who performs the procedure. For these reasons, several studies have suggested the use of other body fluids, including saliva, for the detection of SARS-CoV-2. The use of saliva as a diagnostic specimen has numerous advantages: it is easily self-collected by the patient with almost no discomfort, it does not require specialized health care personnel for its management, and it reduces the risks for the operator. In the past few months, several scientific papers, media, and companies have announced the development of new salivary tests to detect SARS-CoV-2 infection. Posterior oropharyngeal saliva should be distinguished from oral saliva, since the former is a part of respiratory secretions, while the latter is produced by the salivary glands, which are outside the respiratory tract. Saliva can be analyzed through standard (rRT-PCR) or rapid molecular biology tests (direct rRT-PCR without extraction), although, in a hospital setting, these procedures may be performed only in addition to nasopharyngeal swabs to minimize the incidence of false-negative results. Conversely, the promising role of saliva in the diagnosis of SARS-CoV-2 infection is highlighted by the emergence of point-of-care technologies and, most important, point-of-need devices. Indeed, these devices can be directly used in workplaces, airports, schools, cinemas, and shopping centers. An example is the recently described Rapid Salivary Test, an antigen test based on the lateral flow assay, which detects the presence of the virus by identifying the spike protein in the saliva within a few minutes.
ISSN:0022-0345
1544-0591
DOI:10.1177/0022034520969670