Salivary SARS-CoV-2 RNA for diagnosis of COVID-19 patients: A systematic review and meta-analysis of diagnostic accuracy

IF 5.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Japanese Dental Science Review Pub Date : 2023-06-21 DOI:10.1016/j.jdsr.2023.06.004

Douglas Carvalho Caixeta , Luiz Renato Paranhos , Cauane Blumenberg , Marcelo Augusto Garcia-Júnior , Marco Guevara-Vega , Elisa Borges Taveira , Marjorie Adriane Costa Nunes , Thúlio Marquez Cunha , Ana Carolina Gomes Jardim , Carlos Flores-Mir , Robinson Sabino-Silva

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引用次数: 2

Abstract

Accurate, self-collected, and non-invasive diagnostics are critical to perform mass-screening diagnostic tests for COVID-19. This systematic review with meta-analysis evaluated the accuracy, sensitivity, and specificity of salivary diagnostics for COVID-19 based on SARS-CoV-2 RNA compared with the current reference tests using a nasopharyngeal swab (NPS) and/or oropharyngeal swab (OPS). An electronic search was performed in seven databases to find COVID-19 diagnostic studies simultaneously using saliva and NPS/OPS tests to detect SARS-CoV-2 by RT-PCR. The search resulted in 10,902 records, of which 44 studies were considered eligible. The total sample consisted of 14,043 participants from 21 countries. The accuracy, specificity, and sensitivity for saliva compared with the NPS/OPS was 94.3 % (95 %CI = 92.1;95.9), 96.4 % (95 %CI = 96.1;96.7), and 89.2 % (95 %CI = 85.5;92.0), respectively. Besides, the sensitivity of NPS/OPS was 90.3 % (95 %CI = 86.4;93.2) and saliva was 86.4 % (95 %CI = 82.1;89.8) compared to the combination of saliva and NPS/OPS as the gold standard. Based on low to moderate certainty level these findings suggest a similarity in SARS-CoV-2 RNA detection between NPS/OPS swabs and saliva, and the association of both testing approaches as a reference standard can increase by 3.6 % the SARS-CoV-2 detection compared with NPS/OPS alone. This study supports saliva as an attractive alternative for diagnostic platforms to provide a non-invasive detection of SARS-CoV-2.

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唾液SARS-CoV-2 RNA诊断COVID-19患者:诊断准确性的系统回顾和荟萃分析

准确、自我收集和非侵入性诊断对于执行新冠肺炎的按摩屏诊断测试至关重要。与目前使用鼻咽拭子（NPS）和/或口咽拭子（OPS）的参考测试相比，这项系统综述和荟萃分析评估了基于SARS-CoV-2 RNA的新冠肺炎唾液诊断的准确性、敏感性和特异性。在七个数据库中进行了电子搜索，同时使用唾液和NPS/OPS测试通过RT-PCR检测SARS-CoV-2，以查找新冠肺炎诊断研究。搜索得到10902份记录，其中44项研究被认为符合条件。总样本包括来自21个国家的14043名参与者。与NPS/OPS相比，唾液的准确性、特异性和敏感性分别为94.3%（95%CI=92.1；95.9）、96.4%（95%CI=96.1；96.7）和89.2%（95%CI=85.5；92.0）。此外，与唾液和NPS/OPS组合作为金标准相比，NPS/OPS的敏感性为90.3%（95%CI=86.4；93.2），唾液的敏感性为86.4%（95%CI=82.1；89.8）。基于低到中等的确定性水平，这些发现表明，NPS/OPS拭子和唾液之间的严重急性呼吸系统综合征冠状病毒2型RNA检测存在相似性，与单独的NPS/OPS相比，这两种检测方法作为参考标准的关联可使严重急性呼吸系统冠状病毒2型检测增加3.6%。这项研究支持唾液作为诊断平台的一种有吸引力的替代品，以提供对严重急性呼吸系统综合征冠状病毒2型的无创检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese Dental Science Review DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

9.90

自引率

1.50%

发文量

审稿时长

32 days

期刊介绍： The Japanese Dental Science Review is published by the Japanese Association for Dental Science aiming to introduce the modern aspects of the dental basic and clinical sciences in Japan, and to share and discuss the update information with foreign researchers and dentists for further development of dentistry. In principle, papers are written and submitted on the invitation of one of the Editors, although the Editors would be glad to receive suggestions. Proposals for review articles should be sent by the authors to one of the Editors by e-mail. All submitted papers are subject to the peer- refereeing process.