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Mouth Washing Impaired SARS-CoV-2 Detection in Saliva

Unité de Parasitologie et Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, 13005 Marseille, France
Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, 13005 Marseille, France
IHU Méditerranée Infection, 13005 Marseille, France
Centre National de Référence du Paludisme, 13005 Marseille, France
Aix-Marseille-Université, IRD, MEPHI, IHU Méditerranée Infection, 13005 Marseille, France
CRCM Integrative Bioinformatics Platform, Centre de Recherche en Cancérologie de Marseille, INSERM, U1068, Institut Paoli-Calmettes, CNRS, UMR7258, Aix-Marseille Université UM 105, 13009 Marseille, France
Author to whom correspondence should be addressed.
Academic Editor: Anna Baraniak
Diagnostics 2021, 11(8), 1509;
Received: 2 July 2021 / Revised: 17 August 2021 / Accepted: 20 August 2021 / Published: 22 August 2021
Background: A previous study demonstrated the performance of the Salivette® (SARSTEDT, Numbrecht, Germany) as a homogeneous saliva collection system to diagnose COVID-19 by RT-qPCR, notably for symptomatic and asymptomatic patients. However, for convalescent patients, the corroboration of molecular detection of SARS-CoV-2 in paired nasopharyngeal swabs (NPS) and saliva samples was unsatisfactory. Objectives: The aim of the present work was to assess the concordance level of SARS-CoV-2 detection between paired sampling of NPSs and saliva collected with Salivette® at two time points, with ten days of interval. Results: A total of 319 paired samples from 145 outpatients (OP) and 51 healthcare workers (HW) were collected. Unfortunately, at day ten, 73 individuals were lost to follow-up, explaining some kinetic missing data. Due to significant waiting rates at hospitals, most of the patients ate and/or drank while waiting for their turn. Consequently, mouth washing was systematically proposed prior to saliva collection. None of the HW were diagnosed as SARS-CoV-2 positive using NPS or saliva specimens at both time points (n = 95) by RT-qPCR. The virus was detected in 56.3% (n = 126/224) of the NPS samples from OP, but solely 26.8% (n = 60/224) of the paired saliva specimens. The detection of the internal cellular control, the human RNase P, in more than 98% of the saliva samples, underlined that the low sensitivity of saliva specimens (45.2%) for SARS-CoV-2 detection was not attributed to an improper saliva sample storing or RNA extraction. Conclusions: This work revealed that mouth washing decreased viral load of buccal cavity conducting to impairment of SARS-CoV-2 detection. Viral loads in saliva neo-produced appeared insufficient for molecular detection of SARS-CoV-2. At the time when saliva tests could be a rapid, simple and non-invasive strategy to assess large scale schoolchildren in France, the determination of the performance of saliva collection becomes imperative to standardize procedures. View Full-Text
Keywords: saliva; COVID-19 diagnosis; coronavirus; SARS-CoV-2 saliva; COVID-19 diagnosis; coronavirus; SARS-CoV-2
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MDPI and ACS Style

Costa, M.M.; Benoit, N.; Tissot-Dupont, H.; Million, M.; Pradines, B.; Granjeaud, S.; Almeras, L. Mouth Washing Impaired SARS-CoV-2 Detection in Saliva. Diagnostics 2021, 11, 1509.

AMA Style

Costa MM, Benoit N, Tissot-Dupont H, Million M, Pradines B, Granjeaud S, Almeras L. Mouth Washing Impaired SARS-CoV-2 Detection in Saliva. Diagnostics. 2021; 11(8):1509.

Chicago/Turabian Style

Costa, Monique M., Nicolas Benoit, Hervé Tissot-Dupont, Matthieu Million, Bruno Pradines, Samuel Granjeaud, and Lionel Almeras. 2021. "Mouth Washing Impaired SARS-CoV-2 Detection in Saliva" Diagnostics 11, no. 8: 1509.

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