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Published on: June 5, 2021
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Oral SARS-CoV-2 host responses predict the early COVID-19 disease course
William T Seaman1,2, Olive Keener2,3, Dinelka Nanayakkara4
1National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, USA.
Scientific Reports
|September 18, 2024
Summary
Oral fluids detect SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and host responses. Oral IgM correlated with symptoms, indicating its role in early infection and potential transmission.
Area of Science:
- Virology
- Immunology
- Clinical Diagnostics
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 interplay between oral viral presence, antibody levels, and clinical symptoms is crucial for managing COVID-19.
Purpose of the Study:
- To evaluate the relationships between oral SARS-CoV-2 viral load, oral and systemic anti-SARS-CoV-2 antibodies (IgM and IgG), and reported symptoms.
- To investigate the persistence of viral markers and immune responses in oral fluids over time.
- To explore potential cross-reactivity of SARS-CoV-2 N-antigen assays with host salivary proteins.
Main Methods:
- Collected oral fluids (saliva/throat wash) and serum from 45 SARS-CoV-2 RT-qPCR positive participants.
- Utilized RT-qPCR, N-antigen detection (immunoblot, lateral flow assay), and sequence confirmation for subgenomic RNA (sgRNA).
- Assessed anti-SARS-CoV-2 IgM and IgG responses using lateral flow assay (LFA) and ELISA; performed structural analysis of salivary proteins.
Main Results:
- N-antigen was detected in 86% of throat washes at baseline, with 60-83% persistence at 4 weeks.
- Symptomatic participants showed replication-associated sgRNA and high IgG/IgM levels in oral fluids.
- Oral and serum IgG strongly correlated with nasopharyngeal PCR results; saliva IgM negatively associated with cough, fatigue, and other symptoms.
Conclusions:
- Oral viral replication and persistence are linked to specific symptoms and early oral IgM responses in SARS-CoV-2 infection.
- Potential cross-reactivity of N-antigen assays with analogous host proteins warrants consideration.
- Oral fluid analysis provides valuable insights into SARS-CoV-2 infection dynamics, host response, and symptom correlation.
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