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Oral SARS-CoV-2 host responses predict the early COVID-19 disease course
William T Seaman1, Olive Keener2, Wenwen Mei2
1National Institute of Dental and Craniofacial Research, National Institutes of Health.
Research Square
|August 30, 2023
Summary
Oral fluids detect SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) and host responses. Oral viral persistence correlates with symptoms and early immune responses, with potential host protein mimicry.
Area of Science:
- Virology
- Immunology
- Infectious Diseases
Background:
- Oral fluids offer a non-invasive method for detecting SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) and associated host immune responses.
- Understanding the dynamics of oral viral shedding and antibody presence is crucial for managing COVID-19 transmission and disease progression.
Approach:
- Collected saliva/throat wash samples from 47 SARS-CoV-2 RT-qPCR positive subjects (asymptomatic and symptomatic).
- Utilized RT-qPCR, N-antigen detection (immunoblot, lateral flow assay), and antibody assays (IgM, IgG) to analyze oral samples.
- Performed structural analysis to identify potential cross-reactivity between SARS-CoV-2 N-antigen and host salivary proteins.
Key Points:
- Oral N-antigen was frequently detected and persisted for at least 4 weeks, with potential cross-reactivity to host proteins observed.
- Symptomatic subjects showed replication-associated viral RNA, high IgG, and notable IgM levels at baseline, which persisted at 4 weeks.
- Oral IgG strongly correlated with nasopharyngeal RT-qPCR positivity, while oral IgM negatively associated with symptom severity and positively with female gender.
Conclusions:
- Oral viral replication and persistence are linked to specific symptoms, early antibody responses (IgM/IgG), and gender during early SARS-CoV-2 infection.
- N-antigen detection in oral fluids may be influenced by structural mimicry of analogous host proteins, impacting diagnostic accuracy.
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