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CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(S 01): S123-S129
DOI: 10.1055/s-0040-1713020
Review Article

COVID-19 Pandemic and Role of Human Saliva as a Testing Biofluid in Point-of-Care Technology

Hiba Hamid
1   Department of Oral Biology, Liaquat College of Medicine and Dentistry, Karachi, Pakistan
,
Zohaib Khurshid
2   Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
,
Necdet Adanir
3   Department of Restorative Dentistry, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
,
Muhammad S. Zafar
4   Department of Restorative Dentistry, College of Dentistry, Taibah University, Medina Munawara, Saudi Arabia
5   Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
,
Sana Zohaib
6   Department of Biomedical Engineering, College of Engineering, King Faisal University, Al Ahsa, Saudi Arabia
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Abstract

Novel coronavirus disease 2019 (COVID-19) outbreak has termed as a controllable pandemic, and the entire world has come to a standstill trying to mitigate the disease with health systems. Health care providers, around the globe, are fighting day and night. Currently, rapid testing is taking place with the help of nasopharyngeal, oropharyngeal swab, bronchoalveolar lavage, sputum, urine, and blood. All these approaches are invasive or embarrassing to the infected person. It is observed that salivary glands are hosting severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) because of angiotensin-converting enzyme 2 and the detection of high viral loads in the saliva and is playing a crucial role in virus transmission, especially from individuals showing absolutely no symptoms. Saliva is proving to be a promising noninvasive sample specimen for the diagnosis of COVID-19, thus helping to monitor the infection and prevent it from further spreading by prompt isolation.

Keywords

saliva - COVID-19 - SARS-CoV-2 - testing - point of care - virus


Publication History

Article published online:
03 June 2020

© 2020. European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223) 497-506
    CrossrefPubMedGoogle Scholar
  • 2 Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. In: Maier HJ, Bickerton E, Britton P. eds. Coronaviruses: Methods and Protocols. Vol. 1282. New York, NY: Springer; 2015: 1-23
    Google Scholar
  • 3 Kim YI, Kim SG, Kim SM. et al. Infection and rapid transmission of SARS-CoV-2 in ferrets. Cell Host Microbe 2020; 27 (05) 704-709.e2 DOI: 10.1016/j.chom.2020.03.023.
    CrossrefPubMedGoogle Scholar
  • 4 Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology 2018; 23 (02) 130-137
    CrossrefPubMedGoogle Scholar
  • 5 Zaki AM, van S Boheemen, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 2012; 367 (19) 1814-1820
    CrossrefPubMedGoogle Scholar
  • 6 To KK, Tsang OT, Chik-Yan Yip C. et al. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis 2020; 4–6: ciaa149
    Google Scholar
  • 7 Wu Y, Ho W, Huang Y. et al. SARS-CoV-2 is an appropriate name for the new coronavirus. Lancet 2020; 395 (10228) 949-950
    CrossrefPubMedGoogle Scholar
  • 8 Khurshid Z, Asiri FYI, Al Wadaani H. Human saliva: non-invasive fluid for detecting novel coronavirus (2019-nCoV). Int J Environ Res Public Health 2020; 17 (07) 22-25
    CrossrefPubMedGoogle Scholar
  • 9 Azzi L, Carcano G, Gianfagna F. et al. Saliva is a reliable tool to detect SARS-CoV-2. J Infect 2020; 81 (01) e45-e50 S0163-4453(20)30213-9
    CrossrefPubMedGoogle Scholar
  • 10 Xu R, Cui B, Duan X, Zhang P, Zhou X, Yuan Q. Saliva: potential diagnostic value and transmission of 2019-nCoV. Int J Oral Sci 2020; 12 (01) 11
    CrossrefPubMedGoogle Scholar
  • 11 Sohrabi C, Alsafi Z, O’Neill N. et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020; 76: 71-76
    CrossrefPubMedGoogle Scholar
  • 12 Chen N, Zhou M, Dong X. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395 (10223) 507-513
    CrossrefPubMedGoogle Scholar
  • 13 Thomas-Rüddel D, Winning J, Dickmann P. et al. Coronavirus disease 2019 (COVID-19): Update for anesthesiologists and intensivists March 2020 [published online ahead of print, 2020 Mar 24]. Anaesthesist 2020; 1-10 DOI: 10.1007/s00101-020-00760-3.
    CrossrefPubMedGoogle Scholar
  • 14 Wang D, Hu B, Hu C. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323 (11) 1061-1069
    CrossrefPubMedGoogle Scholar
  • 15 Patel R, Babady E, Theel ES. et al. Report from the American Society for Microbiology COVID-19 International Summit, 23 March 2020: value of diagnostic testing for SARS-CoV-2/COVID-19. MBio 2020; 11 (02) e00722-20
    CrossrefPubMedGoogle Scholar
  • 16 Report of the WHO-China Joint Mission on Coronavirus Disease. 2019 (COVID-19). Available at: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. Accessed May 8, 2020
  • 17 To KK, Tsang OT, Leung WS. et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis 2020; 20 (05) 565-574
    CrossrefPubMedGoogle Scholar
  • 18 Zheng S, Yu F, Fan J. et al. Saliva as a diagnostic specimen for SARS-CoV-2 by a PCR-based assay: a diagnostic validity study. Clin Microbiol Infect 2020; 25 (03) 372-378
    Google Scholar
  • 19 Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine. J Dent Res 2020; 99 (05) 481-487
    CrossrefPubMedGoogle Scholar
  • 20 Winichakoon P, Chaiwarith R, Liwsrisakun C. et al. Negative Nasopharyngeal and Oropharyngeal Swab Does Not Rule Out COVID-19 2 Downloaded from. J Clin Microbiol 2020; 58 (05) e00297-e007320
    CrossrefPubMedGoogle Scholar
  • 21 Bai Y, Yao L, Wei T. et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA 2020; 323 (14) 1406-1407
    CrossrefPubMedGoogle Scholar
  • 22 Khurshid Z, Zafar M, Khan E, Mali M, Latif M. Human saliva can be a diagnostic tool for Zika virus detection. J Infect Public Health 2019; 12 (05) 601-604
    CrossrefPubMedGoogle Scholar
  • 23 Khurshid Z, Zohaib S, Najeeb S, Zafar MS, Slowey PD, Almas K. Human saliva collection devices for proteomics: an update. Int J Mol Sci 2016; 17 (06) 846
    CrossrefPubMedGoogle Scholar
  • 24 Khurshid Z, Zafar MS, Khan RS, Najeeb S, Slowey PD, Rehman IU. Role of salivary biomarkers in oral cancer detection. Adv Clin Chem 2018; 86: 23-70
    CrossrefPubMedGoogle Scholar
  • 25 Sahibzada HA, Khurshid Z, Khan RS. et al. Salivary IL-8, IL-6 and TNF-αas potential diagnostic biomarkers for oral cancer. Diagnostics (Basel) 2017; 7 (02) 21
    CrossrefPubMedGoogle Scholar
  • 26 Abdul Rehman S, Khurshid Z, Hussain Niazi F. et al. Role of salivary biomarkers in detection of cardiovascular diseases (CVD). Proteomes 2017; 5 (03) 21
    CrossrefPubMedGoogle Scholar
  • 27 Khurshid Z, Moin SF, Khan RS, Agwan MAS, Alwadaani AH, Zafar MS. Human salivary protein extraction from RNAPro·SAL™, Pure·SAL™, and passive drooling method. Eur J Dent 2017; 11 (03) 385-389
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Chen L, Zhao J, Peng J, et al. Detection of SARS-CoV-2 in saliva and characterization of oral symptoms in COVID-19 patients. Cell Prolif 2020;53(12):e12923 doi:10.1111/cpr.12923
  • 29 Hamming I, Timens W, Bulthuis ML. Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203 (02) 631-637
    CrossrefPubMedGoogle Scholar
  • 30 Khurshid Z. Salivary point-of-care technology. Eur J Dent 2018; 12 (01) 1-2 DOI: 10.4103/ejd.ejd_376_17.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Loeffelholz MJ, Tang YW. Laboratory diagnosis of emerging human coronavirus infections - the state of the art. Emerg Microbes Infect 2020; 9 (01) 747-756 DOI: 10.1080/22221751.2020.1745095.
    CrossrefPubMedGoogle Scholar
  • 32 Kozel TR, Burnham-Marusich AR. Point-of-care testing for infectious diseases: Past, present, and future. J Clin Microbiol 2017; 55 (08) 2313-2320
    CrossrefPubMedGoogle Scholar
  • 33 Gamio L; The New York Times. The Workers Who Face the Greatest Coronavirus Risk. Available at: https://www.nytimes.com/interactive/2020/03/15/business/economy/coronavirus-worker-risk.html. Accessed May 8, 2020
  • 34 Bonebreak CM, Demirci U, Kuo WP. The potential of salivary point of care diagnostics. J Appl Oral Sci 2011;19(4)
  • 35 LaBarre P, Boyle D, Hawkins K, Weigl B. Instrument-free nucleic acid amplification assays for global health settings. In: Kumar BVKV, Prabhakar S, Ross AA. et al, eds. Sensing Technologies for Global Health, Military Medicine, Disaster Response, and Environmental Monitoring; and Biometric Technology for Human Identification VIII>. Vol 8029. Bellingham, WA: SPIE; 2011: 802902
    Google Scholar
  • 36 Kosack CS, Page AL, Klatser PR. A guide to aid the selection of diagnostic tests. Bull World Health Organ 2017; 95 (09) 639-645
    CrossrefPubMedGoogle Scholar
  • 37 Guo ZD, Wang ZY, Zhang SF. et al. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis 2020; 26 (07) 1583-1591 DOI: 10.3201/eid2607.200885.
    CrossrefPubMedGoogle Scholar
  • 38 Gan WH, Lm JW, Koh D. Preventing intra-hospital infection and transmission of coronavirus disease 2019 in health-care workers. Saf Health Work 2020; 11 (02) 241-243 DOI: 10.1016/j.shaw.2020.03.001.
    CrossrefPubMedGoogle Scholar
  • 39 Black JRM, Bailey C, Przewrocka J, Dijkstra KK, Swanton C. COVID-19: the case for health-care worker screening to prevent hospital transmission. Lancet 2020; 395 (10234) 1418-1420
    CrossrefPubMedGoogle Scholar
  • 40 Malon RS, Sadir S, Balakrishnan M, Córcoles EP. Saliva-based biosensors: noninvasive monitoring tool for clinical diagnostics. BioMed Res Int 2014; 2014: 962903
    CrossrefPubMedGoogle Scholar
  • 41 Bhakta SA, Borba R, Taba Jr. M, Garcia CD, Carrilho E. Determination of nitrite in saliva using microfluidic paper-based analytical devices. Anal Chim Acta 2014; 809: 117-122
    CrossrefPubMedGoogle Scholar
  • 42 de Castro LF, de Freitas SV, Duarte LC, de Souza JAC, Paixão TRLC, Coltro WKT. Salivary diagnostics on paper microfluidic devices and their use as wearable sensors for glucose monitoring. Anal Bioanal Chem 2019; 411 (19) 4919-4928
    CrossrefPubMedGoogle Scholar
  • 43 Campuzano S, Yánez-Sedeño P, Pingarrón JM. Electrochemical bioaffinity sensors for salivary biomarkers detection. TrAC Trends in Analytical Chemistry 2017; 86: 14-24 DOI: 10.1016/j.trac.2016.10.002.
    CrossrefGoogle Scholar
  • 44 Xu J, Li Y, Gan F, Du Y, Yao Y. Salivary Glands: Potential Reservoirs for COVID-19 Asymptomatic Infection. J Dent Res 2020; 99 (08) 989 DOI: 10.1177/0022034520918518.
    CrossrefPubMedGoogle Scholar
  • 45 Liu L, Wei Q, Alvarez X. et al. Epithelial cells lining salivary gland ducts are early target cells of severe acute respiratory syndrome coronavirus infection in the upper respiratory tracts of rhesus macaques. J Virol 2011; 85 (08) 4025-4030
    CrossrefPubMedGoogle Scholar
  • 46 Wang WK, Chen SY, Liu IJ. et al. SDetection of SARS-associated coronavirus in throat wash and saliva in early diagnosis. Emerg Infect Dis 2004; 10 (07) 1213-1219 DOI: 10.3201/eid1007.031113.
    CrossrefPubMedGoogle Scholar
  • 47 Ahmed MA, Jouhar R, Ahmed N. et al. Fear and practice modifications among dentists to combat novel coronavirus disease (COVID-19) outbreak. Int J Environ Res Public Health 2020; 17 (08) 2821 DOI: 10.3390/ijerph17082821.
    CrossrefPubMedGoogle Scholar