Abstract
Knowledge about the detection potential and detection rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in various body fluids and sites is important for dentists since they, directly or indirectly, deal with many of these fluids/sites in their daily practices. In this study, we attempt to review the latest evidence and meta-analysis studies regarding the detection rate of SARS-CoV-2 in different body specimens and sites as well as the characteristics of these sample. The presence/detection of SARS-CoV-2 viral biomolecules (nucleic acid, antigens, antibody) in different clinical specimens depends greatly on the specimen type and timing of collection. These specimens/sites include nasopharynx, oropharynx, nose, saliva, sputum, bronchoalveolar lavage, stool, urine, ocular fluid, serum, plasma and whole blood. The relative detection rate of SARS-CoV-2 viral biomolecules in each of these specimens/sites is reviewed in detail within the text. The infectious potential of these specimens depends mainly on the time of specimen collection and the presence of live replicating viral particles.
Highlights
Human viral infection and transmission can occur through multiple routes, including exposure to infected blood, exchange of saliva or aerosols generated from sneezing, coughing or dental procedures, fecal–oral, ingestion of contaminated food and drinks and sexual contact
Common examples of viruses isolated from the oral cavity include coronavirus, norovirus, human immunodeficiency virus (HIV), rotavirus, hepatitis C virus, influenza viruses herpes simplex viruses 1 and 2 and Epstein–Barr virus [1]
This study demonstrated that positive detection rate with nucleic acid amplification tests (NAATs) after 7 days from symptom onset was lower compared to ≤7 days (74% (95%CI: 62–85%) vs. 89%), which was observed for nasopharyngeal swabs in the same patients (91% vs. 99%, respectively) [22]
Summary
Human viral infection and transmission can occur through multiple routes, including exposure to infected blood, exchange of saliva or aerosols generated from sneezing, coughing or dental procedures, fecal–oral, ingestion of contaminated food and drinks and sexual contact. The knowledge of the detection rate and the infectivity potential of these specimens is essential This is of particular importance for dentists because they, in their daily practices, directly or indirectly deal with these specimens/sites which might be the port of entry, or replication and transmission site for SARS-CoV-2. A recent meta-analysis of studies comparing paired oropharyngeal and nasopharyngeal samples in confirmed cases found a similar positive detection rate between oropharyngeal and nasopharyngeal swabs (84% (95% CI: 57–100%) vs 88% (95% CI: 73–98%), respectively) using NAATs. Importantly, there is limited agreement between tests from these sites as the percent of individuals positive for both specimens was only 68% (95% CI: 36–93%) [22]. A meta-analysis of studies that compared combined oropharyngeal-nasal swabs and nasopharyngeal swabs for NAATs in confirmed cases found an identical positive detection rate (97% (95% CI: 90–100%)) between the two methods. The percent of individuals positive for both specimens was high (90% (95% CI: 84–96%)) [22]
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