Elevated Salivary Inflammatory Biomarkers are Associated with SARS-CoV-2 Infection Severity

Hanadi Abdullah Alwafi; Soad Shaker Ali; Sunil Babu Kotha; Layla Waleed Abuljadayel; Maha Ibrahim; Ibrahim Rashad Noor Elahi; Hebah Abdullah Alwafi; Mohammed S Almuhayawi; Matthew D Finkelman; Nagla A El-Shitany

doi:10.1155/2022/1543918

Elevated Salivary Inflammatory Biomarkers are Associated with SARS-CoV-2 Infection Severity

Can J Infect Dis Med Microbiol. 2022 Aug 4:2022:1543918. doi: 10.1155/2022/1543918. eCollection 2022.

Authors

Affiliations

¹ Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.
² Department of Histology and Cell Biology, Faculty of Medicine, Assiut University, Assiut, Egypt.
³ Yousef Abdullatif Jameel Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Maharashtra, India.
⁵ Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
⁶ Department of Hematology, MSF for Medical Research and Development, Jeddah, Saudi Arabia.
⁷ Department of Public Health, Directorate of Health Affairs, Jeddah, Saudi Arabia.
⁸ Security Force Hospital, Dammam, Saudi Arabia.
⁹ Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁰ Division of Biostatistics and Experimental Design, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA.
¹¹ Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt.

Abstract

High levels of inflammatory cytokines in serum have been reported in patients with severe SARS-CoV-2 infection. There is growing interest in recognizing the role of inflammatory biomarkers in saliva in diagnosing systemic diseases. This study assumed that estimating biomarkers in saliva samples from patients infected with SARS-CoV-2 would distinguish between mild and severe cases. Saliva was collected from 142 controls and 158 SARS-CoV-2 patients (mild 72 and severe 86) to measure interleukin-6 (IL-6), C-reactive protein (CRP), and C-X-C motif chemokine ligand-10 (CXCL-10). IL-6 and CXCL-10 were significantly increased in patients with mild and severe SARS-CoV-2 infections. CRP was significantly increased only in severe SARS-CoV-2 cases. All biomarkers were significantly higher in severe cases than in mild cases (p < 0.001). Among patients with SARS-CoV-2 infection, men showed significantly higher CRP and CXCL-10 levels than females (p < 0.01 and 0.05, respectively). In addition, elderly patients (40-80 years) had significantly higher IL-6, CRP, and CXCL-10 (p < 0.001). Patients with diabetes and hypertension showed elevated IL-6, CRP, and CXCL-10 (p < 0.001). There was a significant positive correlation between IL-6, CRP, CXCL-10, and between age, IL-6, CRP, and CXCL-10. Saliva may have a future value in measuring the inflammatory biomarkers associated with the severity of SARS-CoV2 infection and therapeutic monitoring.