Salivary mental stress biomarkers in COVID-19 patients

Abstract

BackgroundDuring the COVID-19 pandemic, mental health disorders and level of stress show a major increase compared to before the pandemic. Coronavirus-related stress is recently the leading cause of negative impacts on global mental health. Thus, maintaining positive mental health is as important as maintaining physical health during COVID-19. The aim of this study was to analyze salivary mental stress biomarkers as cortisol, alpha-amylase, and chromogranin A in hospitalized patients with COVID-19 to compare their potential relationship with stress symptoms.Material and methodsA total of 80 adult hospitalized patients with moderate COVID-19 disease and a control group (n = 80) randomly selected were conducted as participants. Saliva cortisol (sCort), saliva alpha-amylase (sAA), and saliva and chromogranin A (sCgA) were determined by the ELISA method (Bio Vendor, USA). Symptoms of stress were measured with a stress symptom checklist (SSCL).ResultsThe patients group presented significantly higher levels of sCort, sAA, and sCgA compared with the control group. The correlation analysis showed a positive correlation with strong strength between sCort and sAA (r = 0.934, p < 0.01), as well as sAA with sCgA (r = 0.714, p < 0.01). A moderate positive correlation was found between sCort with sCgA (r = 0.618, p < 0.05). Based on their stress scores from the SSCL the patients were associated with high stress level (30.00%) and very high stress levels (67.5%). In terms of the controls, all the participants showed a low to moderate stress level. We found significant positive correlation between levels of stress and salivary biomarkers.ConclusionData from our study demonstrated that salivary biomarkers are promising tools of exploring COVID-19 related stress.

Salivary Biomarkers as Pioneering Indicators for Diagnosis and Severity Stratification of Pediatric Long COVID

“…Therefore, the potentiality of salivary ferritin levels to differentiate between the acute and the chronic phases of COVID-19 in children deserve further research. Surprisingly, we found that sAA and total protein levels were reduced in saliva of children with long COVID compared to controls, while both biomarkers use to be increased in disease (Nater and Rohleder 2009, Shaila, Pai et al 2013, Masters, Noyce et al 2015, Deneva, Ianakiev et al 2022). Nevertheless, our sAA results are consistent with previous studies showing that sAA levels decrease in both, rats and children, with chronic stress (Wolf, Nicholls et al 2008, Matsuura, Takimura et al 2012.…”

“…Furthermore, it was surprising to observe that the levels of only two of the five biomarkers measured to evaluate the immune response, ADA2 and tADA, were significantly altered in saliva of children with long COVID compared to controls (Figure 1C). Finally, the sAA and total protein levels, that usually increased in disease (Nater and Rohleder 2009, Shaila, Pai et al 2013, Masters, Noyce et al 2015, Deneva, Ianakiev et al 2022), were significantly reduced in children with long COVID compared to controls (Figures 1D and 1E).…”

“…Regarding biomarkers of stress, the measurement of salivary alpha-amylase (sAA) levels can also be very informative, since it is secreted by the parotid gland in response to sympathetic-adrenal-medullary system and increases in psychological and intense physical stress situations (Nater and Rohleder 2009). Indeed, sAA levels are increased in COVID-19 patients, positively correlating with their mental stress scores (Deneva, Ianakiev et al 2022).…”

High level of psychological stress in COVID-19 recovered individuals: role of copeptin as a potential biomarker

“…Also, the inflammatory changes post-COVID may have masked the effects of stress on salivary cortisol as nearly half of our subjects had evidence of persistent inflammation. While there is no study in post COVID subjects that assessed salivary cortisol, Deneva et al (2022) examined salivary cortisol, alpha amylase and Chromogranin A in adult hospitalized patients with COVID and demonstrated significantly high levels of these biomarkers in them.…”

Salivary biomarkers as pioneering indicators for diagnosis and severity stratification of pediatric long COVID

“…Regarding biomarkers of stress, the measurement of salivary alphaamylase (sAA) levels can also be very informative, since it is secreted by the parotid gland in response to sympathetic-adrenalmedullary system and increases in psychological and intense physical stress situations (Nater and Rohleder, 2009). Indeed, sAA levels are increased in COVID-19 patients, positively correlating with their mental stress scores (Deneva et al, 2022).…”