Journal
CLINICAL BIOCHEMISTRY
Volume 117, Issue -, Pages 84-93Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.clinbiochem.2022.08.004
Keywords
COVID-19; Saliva; Nasopharyngeal swab; NAAT; Diagnostic accuracy; Systematic review
Categories
Ask authors/readers for more resources
Nucleic acid amplification testing (NAAT) is the preferred method for diagnosing COVID-19, and saliva has been suggested as an alternative to nasopharyngeal swabs (NPS). This systematic review and meta-analysis evaluated the diagnostic performance of saliva compared to NPS for COVID-19. The analysis included 23 studies with 25 cohorts and showed that saliva NAAT has high sensitivity (87%) and specificity (99%). These findings support the use of saliva NAAT as an alternative to NPS NAAT for COVID-19 diagnosis.
Nucleic acid amplification testing (NAAT) is the preferred method to diagnose coronavirus disease 2019 (COVID19). Saliva has been suggested as an alternative to nasopharyngeal swabs (NPS), but previous systematic reviews were limited by the number and types of studies available. The objective of this systematic review and metaanalysis was to assess the diagnostic performance of saliva compared with NPS for COVID-19. We searched Ovid MEDLINE, Embase, Cochrane, and Scopus databases up to 24 April 2021 for studies that directly compared paired NPS and saliva specimens taken at the time of diagnosis. Meta-analysis was performed using an exact binomial rendition of the bivariate mixed-effects regression model. Risk of bias was assessed using the QUADAS2 tool. Of 2683 records, we included 23 studies with 25 cohorts, comprising 11,582 paired specimens. A wide variety of NAAT assays and collection methods were used. Meta-analysis gave a pooled sensitivity of 87 % (95 % CI = 83-90 %) and specificity of 99 % (95 % CI = 98-99 %). Subgroup analyses showed the highest sensitivity when the suspected individual is tested in an outpatient setting and is symptomatic. Our results support the use of saliva NAAT as an alternative to NPS NAAT for the diagnosis of COVID-19.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available