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AIM: This study aims to verify whether standardized saliva collection is suitable for SARS-CoV-2 molecular detection and IgA measurement. METHODS: 43 COVID-19 inpatients and 326 screening subjects underwent naso-pharyngeal (NP)-swab and saliva collection (Salivette). Inpatients also underwent repeated blood collections to evaluate inflammation and organs involvement. In all patients and subjects, SARS-CoV-2 (gene E) rRT-PCR was undertaken in saliva and NP-swabs. Salivary IgA and serum IgA, IgG, IgM were measured on inpatients\' samples. RESULTS: NP-swabs and saliva were both SARS-CoV-2 positive in 7 (16%) or both negative in 35 (82%) out of 43 patients successfully included in the study. NP-swabs and saliva results did not perfectly match in one patient (saliva positive, NP-swab negative). Positive molecular results were significantly associated with disease duration (p = 0.0049). 326/326 screening subjects were SARS-CoV-2 negative on both NP-swabs and saliva. Among the 27 saliva samples tested for IgA, 18 were IgA positive. Salivary IgA positivity was associated with pneumonia (p = 0.002) and CRP values (p = 0.0183), not with other clinical and molecular data, or with serum immunoglubulins. CONCLUSIONS: A standardized saliva collection can be adopted to detect SARS-CoV-2 infection in alternative to NP-swabs. Preliminary data on salivary IgA support the use of saliva also for patient monitoring.
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Introduction Saliva has been proposed as a valid alternative to naso-pharyngeal swabs for detecting viral SARS-CoV-2 RNA sequences In addition salivary glands have been described as a potential SARSCoV-2 virus reservoir, thus supporting the search for antibodies in saliva Furthermore, the non-invasive nature of saliva collection is conducive to self-collection, patients\' compliance for repeated testing, and reduction of risk to operators, thus making saliva an eligible matrix in the SARS-CoV-2 diagnostic process Aim The aim of this study was to verify whether standardized and safe saliva collection is suitable for SARS-CoV-2 molecular detection and IgA class antibody measurement Methods A total of 49 COVID-19 patients hospitalized at the University-Hospital of Padova (Italy) and 326 subjects who underwent screening underwent naso-pharyngeal (NP) swab and saliva collection using Salivette® Repeat blood collections were performed to evaluate hematological and coagulation parameters, biochemical markers of inflammation, and renal, liver, heart and pancreatic involvement in hospitalized patients In all patients and subjects, saliva SARS-CoV-2 (gene E) rRT-PCR was undertaken in parallel with NP swabs Salivary IgA and serum IgA, IgG, IgM were measured on samples from hospitalized patients Results NP swabs were SARSCoV-2 positive in 9/49 patients The comparison with saliva testing was possible for 43/49 patients, 7 of whom shared positivity, and 35 negativity while in one, the saliva result, not NP-swab, was positive Positive molecular testing results were significantly associated with disease duration (p=0 0049) All the 326 screened subjects were SARS-CoV-2 negative on both NP and saliva swabs Among the 27 saliva samples tested for IgA, 18 were IgA positive Salivary IgA positivity was significantly associated with pneumonia (p=0 002) and CRP values (p=0 0183), not with other clinical and molecular data, or with immunoglubulins in serum Conclusions The results reported in the present study demonstrate that a standardized and safe saliva collection method can be adopted to detect SARS-CoV-2 infection in alternative to NP-swabs Preliminary data on salivary IgA also support the use of saliva in local adaptive immunity patient monitoring
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