Clinical significance of a high SARS-CoV-2 viral load in the Saliva

Jin Gu Yoon, Jung Yoon, Joon Young Song, Soo Young Yoon, Chae Seung Lim, Hye Seong, Ji Yun Noh, Hee Jin Cheong, Woo Joo Kim

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    215 Citations (Scopus)

    Abstract

    Background: Patients with coronavirus disease 2019 (COVID-19) can unknowingly spread the virus to several people during the early subclinical period. Methods: We evaluated the viral dynamics in various body fluid specimens, such as nasopharyngeal swab, oropharyngeal swab, saliva, sputum, and urine specimens, of two patients with COVID-19 from hospital day 1 to 9. Additional samples of the saliva were taken at 1 hour, 2 hours, and 4 hours after using a chlorhexidine mouthwash. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load was determined by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Results: SARS-CoV-2 was detected from all the five specimens of both patients by rRT-PCR. The viral load was the highest in the nasopharynx (patient 1 = 8.41 log10 copies/mL; patient 2 = 7.49 log10 copies/mL), but it was also remarkably high in the saliva (patient 1 = 6.63 log10 copies/mL; patient 2 = 7.10 log10 copies/mL). SARS-CoV-2 was detected up to hospital day 6 (illness day 9 for patient 2) from the saliva of both patients. The viral load in the saliva decreased transiently for 2 hours after using the chlorhexidine mouthwash. Conclusion: SARS-CoV-2 viral load was consistently high in the saliva; it was relatively higher than that in the oropharynx during the early stage of COVID-19. Chlorhexidine mouthwash was effective in reducing the SARS-CoV-2 viral load in the saliva for a short-term period.

    Original languageEnglish
    Article numberE195
    JournalJournal of Korean medical science
    Volume35
    Issue number20
    DOIs
    Publication statusPublished - 2020 May 25

    Bibliographical note

    © 2020 The Korean Academy of Medical Sciences.

    Keywords

    • COVID-19
    • Chlorhexidine
    • SARS-CoV-2
    • Saliva
    • Viral load

    ASJC Scopus subject areas

    • General Medicine

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