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Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva

Journal of Korean Medical Science 2020년 35권 20호 p.195 ~ 195
윤진구 ( Yoon Jin-Gu ) - Korea University College of Medicine Department of Internal Medicine

 ( Yoon Jung ) - Korea University College of Medicine Department of Laboratory Medicine
송준영 ( Song Joon-Young ) - Korea University College of Medicine Department of Internal Medicine
윤수영 ( Yoon Soo-Young ) - Korea University College of Medicine Department of Laboratory Medicine
임채승 ( Lim Chae-Seung ) - Korea University College of Medicine Department of Laboratory Medicine
성혜 ( Seong Hye ) - Korea University College of Medicine Department of Internal Medicine
노지윤 ( Noh Ji-Yun ) - Korea University College of Medicine Department of Internal Medicine
정희진 ( Cheong Hee-Jin ) - Korea University College of Medicine Department of Internal Medicine
김우주 ( Kim Woo-Joo ) - Korea University College of Medicine Department of Internal Medicine

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.

키워드

SARS-CoV-2; COVID-19; Viral Load; Saliva; Chlorhexidine
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