Saliva is a reliable tool to detect SARS-CoV-2

doi:10.1016/j.jinf.2020.04.005

. 2020 Jul;81(1):e45-e50.

doi: 10.1016/j.jinf.202004005. Epub 2020 Apr 14.

Saliva is a reliable tool to detect SARS-CoV-2

Lorenzo Azzi ¹, Giulio Carcano ², Francesco Gianfagna ³, Paolo Grossi ⁴, Daniela Dalla Gasperina ⁴, Angelo Genoni ⁵, Mauro Fasano ⁶, Fausto Sessa ⁷, Lucia Tettamanti ⁸, Francesco Carinci ⁹, Vittorio Maurino ⁸, Agostino Rossi ⁵, Angelo Tagliabue ⁸, Andreina Baj ⁵

Affiliations

¹ Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy. Electronic address: l.azzi@uninsubria.it.
² Unit of General, Emergency and Transplant Surgery, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
³ Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Naples, Italy.
⁴ Unit of Infectious and Tropical Diseases, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁵ Laboratory of Clinical Microbiology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁶ Laboratory of Biochemistry and Functional Proteomics, Department of Science and High Technology, University of Insubria, Busto Arsizio (VA), Italy.
⁷ Unit of Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁸ Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁹ Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.

PMID: 32298676
PMCID: PMC7194805
DOI: 10.1016/j.jinf.202004005

Saliva is a reliable tool to detect SARS-CoV-2

Lorenzo Azzi et al. J Infect. 2020 Jul.

. 2020 Jul;81(1):e45-e50.

doi: 10.1016/j.jinf.202004005. Epub 2020 Apr 14.

Authors

Lorenzo Azzi ¹, Giulio Carcano ², Francesco Gianfagna ³, Paolo Grossi ⁴, Daniela Dalla Gasperina ⁴, Angelo Genoni ⁵, Mauro Fasano ⁶, Fausto Sessa ⁷, Lucia Tettamanti ⁸, Francesco Carinci ⁹, Vittorio Maurino ⁸, Agostino Rossi ⁵, Angelo Tagliabue ⁸, Andreina Baj ⁵

Affiliations

¹ Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy. Electronic address: l.azzi@uninsubria.it.
² Unit of General, Emergency and Transplant Surgery, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
³ Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Naples, Italy.
⁴ Unit of Infectious and Tropical Diseases, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁵ Laboratory of Clinical Microbiology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁶ Laboratory of Biochemistry and Functional Proteomics, Department of Science and High Technology, University of Insubria, Busto Arsizio (VA), Italy.
⁷ Unit of Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁸ Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
⁹ Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.

PMID: 32298676
PMCID: PMC7194805
DOI: 10.1016/j.jinf.202004005

Abstract

Objectives: This study analyzed salivary samples of COVID-19 patients and compared the results with their clinical and laboratory data.

Methods: Salivary samples of 25 COVID-19 patients were analyzed by rRT-PCR. The following data were collected: age, sex, comorbidities, drugs. Lactate dehydrogenase (LDH) and ultrasensitive reactive C protein (usRCP) values were registered on the same day when a salivary swab was collected. Prevalence of positivity in saliva and association between clinical data and the cycle threshold as a semiquantitative indicator of viral load were considered.

Results: Twenty-five subjects were recruited into this study, 17 males and 8 females. The mean age was 61.5 +/- 11.2 years. Cardiovascular and/or dysmetabolic disorders were observed in 65.22% of cases. All the samples tested positive for the presence of SARS-CoV-2, while there was an inverse association between LDH and Ct values. Two patients showed positive salivary results on the same days when their pharyngeal or respiratory swabs showed conversion.

Conclusions: Saliva is a reliable tool to detect SARS-CoV-2. The role of saliva in COVID-19 diagnosis could not be limited to a qualitative detection of the virus, but it may also provide information about the clinical evolution of the disease.

Keywords: COVID-19; Coronavirus; SARS-CoV-2; Saliva; nCoV-2019.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interests None.

Figures

Fig 1

Fig. 1

Scatter plot of LDH (a) or usCRP (c) values on the rRT-PCR cycle threshold values. Women and men are indicated by red and blue points; the blue line represents the regression result and the light blue area is its 95% confidence intervals. Panels (b) and (d) showed the same plots using age- and sex-adjusted residuals of LDH and usCRP levels, respectively, instead of their measured values, and the regression result from age- and sex-adjusted analysis (Table 2). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

See this image and copyright information in PMC

Comment in

Comparison of SARS-CoV-2 detection in nasopharyngeal swab and saliva.
Iwasaki S, Fujisawa S, Nakakubo S, Kamada K, Yamashita Y, Fukumoto T, Sato K, Oguri S, Taki K, Senjo H, Sugita J, Hayasaka K, Konno S, Nishida M, Teshima T. Iwasaki S, et al. J Infect. 2020 Aug;81(2):e145-e147. doi: 10.1016/j.jinf.2020年05月07日1. Epub 2020 Jun 4. J Infect. 2020. PMID: 32504740 Free PMC article. No abstract available.
SARS-CoV-2 RNA detection in tears and conjunctival secretions of COVID-19 patients with conjunctivitis.
Güemes-Villahoz N, Burgos-Blasco B, Arribi-Vilela A, Arriola-Villalobos P, Vidal-Villegas B, Mendez-Fernandez R, Delgado-Iribarren A, Garcia-Feijoo J. Güemes-Villahoz N, et al. J Infect. 2020 Sep;81(3):452-482. doi: 10.1016/j.jinf.2020年05月07日0. Epub 2020 Jun 3. J Infect. 2020. PMID: 32504746 Free PMC article. No abstract available.
Rapid Salivary Test suitable for a mass screening program to detect SARS-CoV-2: A diagnostic accuracy study.
Azzi L, Baj A, Alberio T, Lualdi M, Veronesi G, Carcano G, Ageno W, Gambarini C, Maffioli L, Saverio SD, Gasperina DD, Genoni AP, Premi E, Donati S, Azzolini C, Grandi AM, Dentali F, Tangianu F, Sessa F, Maurino V, Tettamanti L, Siracusa C, Vigezzi A, Monti E, Iori V, Iovino D, Ietto G; ASST dei Sette Laghi Rapid Salivary Test Nurse staff Research Group; Grossi PA, Tagliabue A, Fasano M. Azzi L, et al. J Infect. 2020 Sep;81(3):e75-e78. doi: 10.1016/j.jinf.2020年06月04日2. Epub 2020 Jun 21. J Infect. 2020. PMID: 32579988 Free PMC article. No abstract available.
Viral dynamics of SARS-CoV-2 in saliva from infected patients.
Zhu J, Guo J, Xu Y, Chen X. Zhu J, et al. J Infect. 2020 Sep;81(3):e48-e50. doi: 10.1016/j.jinf.2020年06月05日9. Epub 2020 Jun 25. J Infect. 2020. PMID: 32593658 Free PMC article. No abstract available.
USEFULNESS OF SALIVA SAMPLES FOR DETECTING SARS-CoV-2 RNA AMONG LIVER DISEASE PATIENTS.
Villar LM, da Costa VD, Marques BCL, da Silva LL, Santos AC, Mendonça ACDF, Marques VA, do Nascimento GP, Lewis-Ximenez LL, de Paula VS. Villar LM, et al. J Infect. 2021 Jan;82(1):e4-e5. doi: 10.1016/j.jinf.2020年07月01日7. Epub 2020 Jul 23. J Infect. 2021. PMID: 32711040 Free PMC article. No abstract available.
Serial semiquantitative detection of SARS-CoV-2 in saliva samples.
Mao MH, Guo JJ, Qin LZ, Han ZX, Wang YJ, Yang D. Mao MH, et al. J Infect. 2021 Mar;82(3):414-451. doi: 10.1016/j.jinf.202010002. Epub 2020 Oct 6. J Infect. 2021. PMID: 33031835 Free PMC article. No abstract available.
Evaluation of the rapid antigen test Panbio COVID-19 in saliva and nasal swabs in a population-based point-of-care study.
Agulló V, Fernández-González M, Ortiz de la Tabla V, Gonzalo-Jiménez N, García JA, Masiá M, Gutiérrez F. Agulló V, et al. J Infect. 2021 May;82(5):186-230. doi: 10.1016/j.jinf.202012007. Epub 2020 Dec 9. J Infect. 2021. PMID: 33309541 Free PMC article. No abstract available.
Concerns about the clinical usefulness of saliva specimens for the diagnosis of COVID-19.
Kodana M, Kitagawa Y, Takahashi R, Matsuoka M, Fushimi N, Sakai J, Ishibashi N, Imai K, Takeuchi S, Tarumoto N, Maesaki S, Ikezono T, Maeda T. Kodana M, et al. J Infect. 2021 Jul;83(1):119-145. doi: 10.1016/j.jinf.202104007. Epub 2021 Apr 16. J Infect. 2021. PMID: 33872667 Free PMC article. No abstract available.

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[1] World Health Organization2019-nCoV Situation report – 1 21 January 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2....

[2] World Health Organization2019-nCoV Situation report – 1 21 January 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2....

[3] Lu H., Stratton C.W., Tang Y.-W. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol. 2020;92:401–402. - PMC - PubMed

[4] Lu H., Stratton C.W., Tang Y.-W. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol. 2020;92:401–402. - PMC - PubMed

[5] Rehman S.U., Shafique L., Ihsan A. Evolutionary trajectory for the emergence of a Novel Coronavirus SARS-CoV-2. Pathogens. 2020;9(3) doi: 10.3390/pathogens9030240. - DOI - PMC - PubMed

[6] Rehman S.U., Shafique L., Ihsan A. Evolutionary trajectory for the emergence of a Novel Coronavirus SARS-CoV-2. Pathogens. 2020;9(3) doi: 10.3390/pathogens9030240. - DOI - PMC - PubMed

[7] Lupia T., Scabini S., Mornese Pinna S. 2019 novel coronavirus (2019-nCoV) outbreak: a new challenge. J Glob Antimicrob Resist. 2020;21:22–27. - PMC - PubMed

[8] Lupia T., Scabini S., Mornese Pinna S. 2019 novel coronavirus (2019-nCoV) outbreak: a new challenge. J Glob Antimicrob Resist. 2020;21:22–27. - PMC - PubMed

[9] Centers for Disease Control and Prevention (CDC) Update: novel influenza A (H1N1) virus infections – worldwide,Mmay 6, 2009. MMWR Morb Mortal Wkly Rep. 2009;58:453–458. - PubMed

[10] Centers for Disease Control and Prevention (CDC) Update: novel influenza A (H1N1) virus infections – worldwide,Mmay 6, 2009. MMWR Morb Mortal Wkly Rep. 2009;58:453–458. - PubMed

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Saliva is a reliable tool to detect SARS-CoV-2

Affiliations

Saliva is a reliable tool to detect SARS-CoV-2

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Comment in

References

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous