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      Detection of SARS‐CoV‐2 in saliva and characterization of oral symptoms in COVID‐19 patients

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          Abstract

          Objectives

          In order to provide a more comprehensive understanding of the effects of SARS‐CoV‐2 on oral health and possible saliva transmission, we performed RNA‐seq profiles analysis from public databases and also a questionnaire survey on oral‐related symptoms of COVID‐19 patients.

          Materials and methods

          To analyse ACE2 expression in salivary glands, bulk RNA‐seq profiles from four public datasets including 31 COVID‐19 patients were recruited. Saliva and oropharyngeal swabs were collected. SARS‐CoV‐2 nucleic acids in saliva were detected by real‐time polymerase chain reaction (RT‐PCR). Additionally, a questionnaire survey on various oral symptoms such as dry mouth and amblygeustia was also carried out on COVID‐19 patients.

          Results

          ACE2 expression was present at detectable levels in the salivary glands. In addition, of four cases with positive detection of salivary SARS‐CoV‐2 nucleic acids, three (75%) were critically ill on ventilator support. Furthermore, we observed the two major oral‐related symptoms, dry mouth (46.3%) and amblygeustia (47.2%), were manifested by a relatively high proportion of 108 COVID‐19 patients who accepted the questionnaire survey.

          Conclusions

          This study confirms the expression of ACE2 in the salivary glands and demonstrates the possibility of SARS‐CoV‐2 infection of salivary glands. Saliva may be a new source of diagnostic specimens for critically ill patients, since it can be easily collected without any invasive procedures. In addition, dry mouth and amblygeustia can be considered as initial symptoms of COVID‐19 infection.

          Abstract

          In this study, based on the confirmation of ACE2 receptor expression in salivary glands through database analysis, it was assumed and confirmed that RNA of SARS‐COV‐2 could be detected in saliva samples. At the same time, we also clinically observed that the initial oral‐related symptoms of SARS‐COV‐2 infection may be amblygeustia and dry mouth.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

            Dawei Wang, Bo Hu, Fangfang Zhu … (2020)
            In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
            Article 0 comments Cited 10809 times – based on 0 reviews     Review now
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              A pneumonia outbreak associated with a new coronavirus of probable bat origin

              Peng Zhou, Xing-Lou Yang, Xian-Guang Wang … (2020)
              Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats 1–4 . Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans 5–7 . Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV.
              Article 0 comments Cited 10126 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Yang Jin: whuhjy@126.com
                Lin Wang: lin_wang@hust.edu.cn
                Songlin Wang: slwang@ccmu.edu.cn
                Journal
                Journal ID (nlm-ta): Cell Prolif
                Journal ID (iso-abbrev): Cell Prolif
                Journal ID (doi): 10.1111/(ISSN)1365-2184
                Journal ID (publisher-id): CPR
                Title: Cell Proliferation
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0960-7722
                ISSN (Electronic): 1365-2184
                Publication date (Electronic): 19 October 2020
                Electronic Location Identifier: e12923
                Affiliations
                [ 1 ] Department of Stomatology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
                [ 2 ] Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration Wuhan China
                [ 3 ] Department of Geriatric Dentistry Peking University School and Hospital of Stomatology Beijing China
                [ 4 ] Department of Clinical Laboratory Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
                [ 5 ] Department of Respiratory Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
                [ 6 ] Salivary Gland Disease Center and Molecular Laboratory for Gene Therapy and Tooth Regeneration Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Capital Medical University Beijing China
                Author notes
                [*] [* ] Correspondence

                Yang Jin, Department of Respiratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

                Email: whuhjy@ 123456126.com

                Lin Wang, Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

                Email: lin_wang@ 123456hust.edu.cn

                Songlin Wang, Salivary Gland Disease Center and Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing 100050, China.

                Email: slwang@ 123456ccmu.edu.cn

                Author information
                https://orcid.org/0000-0002-9965-8990
                https://orcid.org/0000-0002-7438-3337
                Article
                Publisher ID: CPR12923
                DOI: 10.1111/cpr.12923
                PMC ID: 7645955
                PubMed ID: 33073910
                SO-VID: 0245f90e-a6d7-4c8e-92f6-a91bf6c487fb
                Copyright © © 2020 The Authors. Cell Proliferation Published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 31 July 2020
                Date revision received : 16 September 2020
                Date accepted : 20 September 2020
                Page count
                Figures: 3, Tables: 4, Pages: 7, Words: 9050
                Categories
                Subject: Original Manuscript
                Subject: Original Manuscripts
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.3 mode:remove_FC converted:06.11.2020

                ScienceOpen disciplines: Cell biology
                Keywords: amblygeustia,covid‐19 patients,dry mouth,saliva,sars‐cov‐2
                Data availability:
                ScienceOpen disciplines: Cell biology
                Keywords: amblygeustia, covid‐19 patients, dry mouth, saliva, sars‐cov‐2

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