Saliva viral load better correlates with clinical and immunological profiles in children with coronavirus disease 2019

Chua, Gilbert T.; Wong, Joshua Sung Chih; To, Kelvin Kai-Wang; Lam, Ivan C.S.; Yau, Yat Sun; Chan, Wai Hung; Ho, Polly P. K.; Duque, Jaime S. Rosa; Yip, Cyril Chik-Yan; Ng, Anthony Chin-Ki; Wong, Wilfred Hing Sang; Kwong, Joyce H. Y.; Leung, Kwok‐Yin; Wan, P. T.; Lam, Kelly Yin Ching; Wong, Ian C K; Kwok, Janette; Ho, Marco H. K.; Chan, Godfrey C. F.; Lau, Yu Lung; Ip, Patrick; Kwan, Mike Yat Wah

doi:10.1080/22221751.2021.1878937

Cited by 24 publications

(31 citation statements)

References 34 publications

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“…Notably, compared to age-matched males, young females (<38 years old) showed lower salivary viral load that increases with age, while no clear age-related effects were found in males. Clinical severity and immunological profiles seem to better correlate with viral load in saliva than in NOP swabs [38,39], so our findings could be attributed to distinct immune responses between genders leading to higher viral shedding and disease severity in males [40], and could also explain the higher proportion of asymptomatic females in couples positive for SARS-CoV-2 [41]. These observations further suggest that salivary viral load together with older age, male gender and other risk factors could be important to predict disease duration, severity and mortality [39,42].…”

Section: Discussionmentioning

confidence: 95%

A Novel Saliva RT-LAMP Workflow for Rapid Identification of COVID-19 Cases and Restraining Viral Spread

et al. 2021

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Rapid diagnostics is pivotal to curb SARS-CoV-2 transmission, and saliva has emerged as a practical alternative to naso/oropharyngeal (NOP) specimens. We aimed to develop a direct RT-LAMP (reverse transcription loop-mediated isothermal amplification) workflow for viral detection in saliva, and to provide more information regarding its potential in curbing COVID-19 transmission. Clinical and contrived specimens were used to optimize formulations and sample processing protocols. Salivary viral load was determined in symptomatic patients to evaluate the clinical performance of the test and to characterize saliva based on age, gender and time from onset of symptoms. Our workflow achieved an overall sensitivity of 77.2% (n = 90), with 93.2% sensitivity, 97% specificity, and 0.895 Kappa for specimens containing >102 copies/μL (n = 77). Further analyses in saliva showed that viral load peaks in the first days of symptoms and decreases afterwards, and that viral load is ~10 times lower in females compared to males, and declines following symptom onset. NOP RT-PCR data did not yield relevant associations. This work suggests that saliva reflects the transmission dynamics better than NOP specimens, and reveals gender differences that may reflect higher transmission by males. This saliva RT-LAMP workflow can be applied to track viral spread and, to maximize detection, testing should be performed immediately after symptoms are presented, especially in females.

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Section: Discussionmentioning

confidence: 95%

A Novel Saliva RT-LAMP Workflow for Rapid Identification of COVID-19 Cases and Restraining Viral Spread

et al. 2021

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“…However, there are a few studies of paediatric patients and different ways to sampling for SARS-CoV-2 detection and their results are conflicting [5][6][7] . Our results showed that saliva had the same diagnostic performance than that of NPS for SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Saliva as a Reliable Sample for COVID-19 Diagnosis in Paediatric Patients

Félix¹,

A²,

Ribeiro

et al. 2021

Preprint

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Saliva has been described a less invasive and easy to handle sample, compared to nasopharyngeal swabs (NPS), in the diagnosis of COVID-19 in adults. Although the advantages of using saliva is still more evident in paediatric patients, little is now about its sensitivity in this group. The aim of this study was to compare the performance of saliva to that of NPS in the detection of SARS-CoV-2 in paediatric patients with mild symptoms. This study evaluated saliva samples from children with suspected COVID-19 who attended public healthcare services of Araraquara, Sao Paulo, Brazil. Children were asked to spit into a sterile container for collection of about 1ml of saliva after the NPS collection. SARS-COV-2 detection was performed by using the Altona RealStar SARS-CoV-2 RT-PCR Kit 1.0. The sample consisted of 50 patients, in which 27 were girls (54%) and 23 were boys (46%). Ten were positive for SARS-CoV-2 in at least one sample collected. The mean age was 10.24 years old and saliva was collected after 4.76 days from the symptoms. Saliva and NPS have showed the same performance in the SARS-CoV-2 detection (k = 0.865, P < 0.001). In conclusion, saliva is a reliable alternative sample for COVID-19 diagnosis in paediatric population.

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“…Notably, compared to age-matched males, young females (< 38 years old) showed lower salivary viral load that increases with age, while no clear age-related effects were found in males. Clinical severity and immunological profiles seem to better correlate with viral load in saliva than in NOP swabs (35,36), so our findings could be attributed to distinct immune responses between genders leading to higher viral shedding and disease severity in males (37), and could also explain the higher proportion of asymptomatic females in couples positive for SARS-CoV-2 (38). These observations further suggest that salivary viral load together with older age, male gender and other risk factors could be important to predict disease duration, severity and mortality (36,39).…”

Section: Discussionmentioning

confidence: 82%

A novel RT-LAMP workflow for rapid salivary diagnostics of COVID-19 and effects of age, gender and time from symptom onset

Kobayashi

Brito

Moreira

et al. 2021

Preprint

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Objectives: Rapid diagnostics is pivotal to curb SARS-CoV-2 transmission, and saliva has emerged as a practical alternative to naso/oropharyngeal (NOP) specimens. We aimed to develop a direct RT-LAMP workflow for viral detection in saliva, and to provide more information regarding its potential in COVID-19 diagnostics. Methods: Clinical and contrived specimens were used to screen/optimize formulations and sample processing protocols. Salivary viral load was determined in symptomatic patients to evaluate clinical performance (n = 90) and to characterize saliva based on age, gender and time from onset of symptoms (n = 49). Results: The devised workflow achieved 93.2% sensitivity, 97% specificity, and 0.895 Kappa for salivas containing >102 copies/μL. Further analyses in saliva showed peak viral load in the first days of symptoms and lower viral loads in females, particularly among young individuals (<38 years). NOP RT-PCR data did not yield relevant associations. Conclusions: This novel saliva RT-LAMP workflow can be applied to point-of-care testing. This work reinforces that saliva better correlates with transmission dynamics than NOP specimens, and reveals gender differences that may reflect higher transmission by males. To maximize detection, testing should be done immediately after symptom onset, especially in females.

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Saliva viral load better correlates with clinical and immunological profiles in children with coronavirus disease 2019

Cited by 24 publications

References 34 publications

A Novel Saliva RT-LAMP Workflow for Rapid Identification of COVID-19 Cases and Restraining Viral Spread

A Novel Saliva RT-LAMP Workflow for Rapid Identification of COVID-19 Cases and Restraining Viral Spread

Saliva as a Reliable Sample for COVID-19 Diagnosis in Paediatric Patients

A novel RT-LAMP workflow for rapid salivary diagnostics of COVID-19 and effects of age, gender and time from symptom onset

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