Alliance for Pandemic Preparedness

January 12, 2021

The Sensitivity and Costs of Testing for SARS-CoV-2 Infection With Saliva Versus Nasopharyngeal Swabs

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A systematic review and meta-analysis (37 studies with 7,332 paired nasopharyngeal swab and saliva samples) found that while saliva samples had slightly lower sensitivity to detect SARS-CoV-2, they could be more cost-effective.  Against a reference standard of a positive result on either sample, saliva sensitivity was 7.9% lower than nasopharyngeal swab sensitivity among persons without previous SARS-CoV-2 infection and 1.5% higher among persons with a previous SARS-CoV2 diagnosis. However, taking into account personnel, transportation and laboratory costs, nasopharyngeal swab had an incremental cost per additional infection detected of $8,093 compared to saliva.

Bastos et al. (Jan 12, 2021). The Sensitivity and Costs of Testing for SARS-CoV-2 Infection With Saliva Versus Nasopharyngeal Swabs. Annals of Internal Medicine. https://doi.org/10.7326/M20-6569