Saliva sample for the massive screening of SARS-CoV-2 infection: a systematic review

OBJECTIVE: This systematic review aims to describe the value of saliva as a noninvasive sample for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in comparison with the current method for sample collection, the nasopharyngeal swab. STUDY DESIGN: We conducted a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. We searched in 5 databases (PubMed, Cochrane, EBSCO, Elsevier, and MEDLINE) and included articles published between December 2019 and July 2020. RESULTS: This review included 22 publications that met inclusion criteria, 17 of which were case series, 2 of which were case reports, and 3 of which were massive screenings. All articles compared saliva with nasopharyngeal swabs. The detection rate of SARS-CoV-2 in saliva was similar to that for nasopharyngeal swabs. The sensitivity ranged between 20% and 97%, and specificity ranged between 66% and 100%. CONCLUSIONS: This systematic review found that saliva might be an appropriate, fast, painless, simple, and noninvasive sample for SARS-CoV-2 detection, making it ideal for massive screening of SARS-CoV-2 infection.