Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARS-CoV-2 A Systematic Review and Meta-analysis
January 15, 2021
Guillaume Butler-Laporte, MD; Alexander Lawandi, MD, MSc; Ian Schiller, MSc; Mandy C. Yao, MSc; Nandini Dendukuri, PhD; Emily G. McDonald, MD, MSc; Todd C. Lee, MD, MPH
JAMA Internal Medicine
This systematic review assessed the diagnostic accuracy of saliva and nasopharyngeal (NP) swab nucleic acid amplification testing (NAAT) for detection of SARS-CoV-2 and diagnosis of COVID-19. Eight peer-reviewed studies and 8 preprints were included in the meta-analyses with a total of 5922 patients included. Fifteen of the studies included ambulatory patients, while 9 exclusively enrolled from an outpatient population with mild or no symptoms. The authors found that the saliva NAAT pooled sensitivity was 83.2% with a pooled specificity of 99.2%. The performance was similar to that of the NP swab NAAT testing, which had a sensitivity of 84.8% and a specificity of 98.9%. These findings support larger-scale research on the use of saliva specimens for NAAT as an alternative to NP swab specimens. The authors conclude that given the ease of sample procurement and increased patient comfort, testing centers should consider adopting saliva as their first sample choice, particularly during mass community screenings.
Butler-Laporte G, Lawandi A, Schiller I, et al. Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARS-CoV-2: A Systematic Review and Meta-analysis. JAMA Intern Med 2021; published online Jan. DOI:10.1001/jamainternmed.2020.8876.