Saliva Test Research Articles

The Emergence of Saliva as a Diagnostic and Prognostic Tool for Viral Infections

Saliva has emerged as a promising diagnostic fluid for viral infections, enabling the direct analysis of viral genetic material and the detection of infection markers such as proteins, metabolites, microRNAs, and immunoglobulins. This comprehensive review aimed to explore the use of saliva as a diagnostic tool for viral infections, emphasizing its advantages and limitations. Saliva stands out due to its simplicity and safety in collection, along with the convenience of self-collection without the need for healthcare supervision, while potentially being comparable to urine and blood in terms of effectiveness. Herein, we highlighted the significant potential of saliva in assessing viral loads and diagnosing viral infections, such as herpesviruses, HPV, PyV, TTV, SARS-CoV-2, and MPXV. The detection of viral shedding in saliva underscores its utility in early diagnosis, the monitoring of infection progression, and evaluating treatment responses. The non-invasive nature of saliva collection makes it an appealing alternative to more invasive methods, promoting better patient compliance and facilitating large-scale screening and surveillance. As such, we further highlight current evidence on the use of saliva as a prognostic tool. Although a significant amount of data is already available, further investigations are warranted to more comprehensively assess the added benefit from the utilization of salivary biomarkers in the clinics. Salivary biomarkers show great promise for the early detection and prevention of viral infection complications, potentially improving disease management and control at the population level. Integrating these non-invasive tools into routine clinical practice could enhance personalized healthcare strategies and patient outcomes. Future studies should focus on establishing standardization protocols, validating the accuracy of salivary diagnostics, and expanding clinical research to enhance the diagnostic and monitoring capabilities of salivary biomarkers.

Diagnostic potential of salivary IL-1β, IL-8, SAT, S100P, and OAZ1 in oral squamous cell carcinoma, oral submucous fibrosis, and oral lichen planus based on findings from a Sri Lankan cohort

The research examined the salivary concentrations of various biomarkers, such as OAZ1, SAT, S100P, IL-1β, and IL-8 aiming to detect early-stage oral squamous cell carcinoma (OSCC). These biomarkers show potential as indicators for detecting both pre-cancerous and cancerous states within the oral cavity. Analyzing these specific molecules in saliva could help clinicians enhance diagnostic accuracy and refine early detection methods for OSCC. The research encompassed a cohort of nine OSCC patients, ten with oral submucous fibrosis (OSF), eleven individuals with oral lichen planus (OLP), and ten healthy controls. The study focused on assessing the expression levels of key biomarkers—IL-1β, IL-8, SAT, S100P, and OAZ1 mRNA—in extracellular RNA extracted from saliva samples. This evaluation was conducted using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) with sequence-specific primers. Additionally, receiver operating characteristic curve (ROC) curve analysis was employed to gauge the efficacy of these biomarkers in detecting OSCC. Based on the results we observe, when these five biomarkers are used together, they give a 90% predictive probability for patients with OLP, an 80% predictive probability for OSF, and an impressive 100% predictive probability for patients with OSCC (AUC = 1.000, p = 0.000). This study demonstrates the efficacy of salivary transcriptome diagnostics in detecting OSCC. This novel clinical technique has the potential to be a powerful, efficient, and reliable tool for early detection of cancer. Salivary transcriptomes can be further analyzed to evaluate their effectiveness in other important illness contexts and for regular health monitoring.

The utility of alcohol saliva test strips compared to the breathalyzer in trauma patients in a resource-limited setting.

The correlation between alcohol consumption and injury is undeniable. However, past research relying on self-reporting alcohol use likely resulted in underreporting and emphasizing the need to increase alcohol testing, especially in resource-limited settings where the burden of injuries is highest. This is a prospective analysis of injured patients presenting to the trauma center at Kamuzu Central Hospital in Lilongwe, Malawi. We collected information including patient age, sex, admission date, mechanism of injury, breathalyzer test and Rapid ResponseTM Alcohol Saliva Test Strips (AST) result, and survival. A total of 805 trauma patients were included. The overall prevalence of alcohol consumption in this trauma cohort is 18.3%. There was a 95.5% agreement between the AST and breathalyzer test with a Kappa coefficient of 0.83. The sensitivity and specificity of the AST were determined to be 78.5% (CI 75.7-81.2) and 99.3% (CI 98.7-99.9), respectively. ROC analyses showed the AST to have excellent discrimination with an area under the curve of 0.88 (95% CI 0.85-0.92). The prevalence of alcohol-related injury is high in Malawi and the use of the Alcohol Saliva Test Strips is feasible and correlated with results derived from the breathalyzer. Routine alcohol testing for trauma patients presenting to a resource-limited setting is imperative and should be implemented.

Original salivary sex hormone data of naturally menstruating athletes and hormonal contraceptive users

ObjectivesThere is a lack of data on salivary sex hormones across the menstrual cycle (MC) or hormonal contraceptive (HC) cycle of elite athletes. We aimed to provide original data on salivary sex hormones (17β-estradiol, progesterone and free testosterone) in naturally menstruating female athletes with a regular cycle or irregular cycle and using combined HC. A secondary purpose was to compare these data with published data from the general population according to the menstrual status (MC or HC or irregularly menstruating).Methods367 saliva tests were performed on 44 elite athletes during 6 months of follow-up to certify for cycle regularity. Athletes were grouped into regular MC, n=13; irregular MC, n=5; and HC, n=26. We compared salivary data of regular MC across six cycle phases (menses, mid-follicular, late follicular, early luteal, mid-luteal and late luteal phases) with published data from women with a similar MC or HC status from the general population.ResultsWe provided salivary original data according to six sub-phases among elite athletes with regular MC. HC athletes showed lower salivary sex hormonal levels, markedly after the first week of active HC compared with regular MC. Athletes with irregular cycles do not show a progesterone rise from the first half to the second half of the cycle (Δirregular=0.38 (1.90), a rise detectable within regular MC group ΔregularMC=2.86 (2.88)).ConclusionsWe provided original data for salivary sex hormone levels in elite female athletes. These references may be valuable for research investigating MC or combined HC data, particularly in longitudinal follow-ups requiring repeated measurements.

Salivary diagnostics: opportunities and challenges

Salivary diagnostics: opportunities and challenges

Updates on Caries Risk Assessment-A Literature Review.

This narrative review aims to provide an update on caries risk assessment (CRA) and the available CRA tools. CRA can be used to monitor the status of oral care, as well as for documentation and research purposes. Caries risk is determined by the interplay of risk and protective factors. Common risk factors include suboptimal oral hygiene practices, previous caries experience, low plaque acidity, frequent snacking, cariogenic diet, enamel defects, reduced salivary flow, polypharmacy, and radiotherapy experience. Caries risk can be reduced through some preventive measures, such as the use of fluoride, gum chewing, dental sealants. The CRA process can be categorized as single or multifactor tools. Single-factor CRA tools include diet analysis questionnaires, cariogenic bacteria testing and saliva testing kits, whereas multifactor CRA tools encompass Caries Management by Risk Assessment (CAMBRA), Cariogram, and PreViser. Some CRA tools may quantify risk and protective factors to compute caries risk. Additionally, they can generate visual and educational presentations that foster success in oral care. Clinicians consider CRA beneficial for developing personalized care plans. However, the literature fails to reflect this and reveals limited studies supporting its use as evidence-based practice for caries management.

A retrospective analysis of patients suffering from halitosis over a 17-year period.

Halitosis is a socially avoided topic with an increasing worldwide prevalence. This study aimed to investigate the correlation between the different forms of halitosis and factors such as: gender, smoking, stress, and oral hygiene. We analysed data from patients registered at the Center of Salivary Diagnostics, Hyposalivation and Halitosis at the University Center for Dental Medicine Basel over a 17-year period, using both subjective and objective approaches to determine the presence of halitosis. The data was statistically analysed using chi-squared and Wilcoxon rank-sum tests. Although halitosis is of multifactorial origin, an oral cause was found in 3 out of 4 patients. Men showed higher values of volatile sulfur compounds (VSC) (p = 0.002) indicative of halitosis than women, while women displayed better oral hygiene (p < 0.001), yet were twice as likely to suffer from halitophobia than males. Patients with higher tongue coating scores (p < 0.001) and periodontitis (p < 0.001) had higher levels of VSC, contributing to bad breath, whereas patients with symptoms such as stress (p = 0.81) or smoking (p = 0.28) did not reveal significantly altered measurements. This study sheds light on the complex and multifactorial nature of halitosis over a long period of time. It further underlines the importance of individualized treatment strategies, given halitosis' multifactorial nature, in order to contribute to the patients' treatment needs.

The relationship between salivary cytokines and oral cancer and their diagnostic capability for oral cancer: a systematic review and network meta-analysis

BackgroundOral cancer (OC) is a common malignancy in clinical practice. Saliva testing is a convenient and noninvasive early diagnostic technique for OC. Several salivary cytokines have been identified as potential biomarkers for OC, including IL-8, IL-6, TNF-α, IL-1β, and IL-10. Nonetheless, the optimal cytokine for OC diagnosis remains inconclusive and highly contentious.MethodsPubMed, Embase, Web of Science, and Cochrane Library databases were comprehensively retrieved to collect all case–control studies on OC. A meta-analysis was performed to compare the levels of salivary IL-8, IL-6, IL-10, TNF-α, and IL-1β in OC patients and healthy controls. Network meta-analysis (NMA) was carried out to probe into the accuracy of these salivary cytokines in diagnosing OC.ResultsThis analysis included 40 studies, encompassing 1280 individuals with OC and 1254 healthy controls. Significantly higher levels of salivary IL-8, IL-6, TNF-α, IL-1β, and IL-10 were observed in patients with OC in comparison to healthy controls. The results of NMA showed that TNF-α had the highest diagnostic accuracy for OC, with a sensitivity of 79% and a specificity of 92%, followed by IL-6 (sensitivity: 75%, specificity: 86%) and IL-8 (sensitivity: 80%, specificity: 80%).ConclusionThis study suggests that IL-8, IL-6, IL-10, TNF-α, and IL-1β may be potential diagnostic biomarkers for OC. Among them, TNF-α, IL-6, and IL-8 are highly accurate in the diagnosis of OC. Nevertheless, further studies that eliminate other confounding factors are warranted, and more standardized procedures and large-scale studies are needed to support the clinical use of saliva testing.

Saliva-STAT: Sample-to-answer saliva test for COVID-19

Highly accessible and highly accurate diagnostics are necessary to combat rapidly-spreading infectious diseases, such as the recent COVID-19 pandemic. While lateral flow antigen tests have become pervasive, they are insufficiently sensitive to detect early or asymptomatic disease. Nucleic acid amplification tests provide the needed sensitivity, but accessibility of these tests continues to be a challenge due to the need for precise sample processing steps. Here we report a sample-to-answer test for saliva samples (saliva-STAT) that utilizes a battery-powered handheld instrument and a low-cost easily-manufacturable sample cassette to perform a nucleic acid amplification test for viral pathogens. To enable a completely automated assay, we leverage thermally responsive alkane partitions (TRAPs) and paramagnetic beads for virus purification and concentration, as well as reagent addition and mixing. Notably, the saliva STAT easily accommodates directly-dispensed saliva samples (in contrast to microfluidic devices), which is necessary for self-testing. Using the saliva-STAT platform, we demonstrate detection of down to 0.2 copies/μL of SARS-CoV-2 virus in saliva samples. We envision that the saliva-STAT could be used in walk-in clinics, mobile clinics, public testing locations, and in the home. With minor adjustments to the assay, the saliva-STAT platform can easily be adapted for other respiratory viruses, such as Influenza.

Concordance of Cytomegalovirus Saliva and Urine Testing in Infants for the Detection of Congenital Infection.

Congenital cytomegalovirus is a leading cause of neurodevelopmental impairment and sensorineural hearing loss. We evaluated infants ≤21 days postnatal age who had both urine and saliva cytomegalovirus testing and determined concordance between the 2 tests and influence of very low birth weight on concordance. Discordance was low overall between urine and saliva testing; however, discordance was high in very low birth weight infants.

Effect of Using Mouthwash Containing Cibotium barometz J. Smith on Cariogenic Bacteria and Acid-producing Ability of Saliva: A Randomised Blinded Clinical Trial.

To examine the anti-caries effect of mouthwashes containing Cibotium barometz J. Smith (CB), a natural substance, and compare it with chlorhexidine and saline solution. A randomised, blinded clinical trial was conducted on 76 study participants. The differences between the 3 gargle groups (saline gargle: SAL; chlorhexidine gargle: CHX; CB gargle group: CB) and the differences over time (baseline, after 1 week, after 2 weeks) were compared. To this end, ANOVA was performed on caries-related clinical indicators (e.g. O'Leary plaque index, caries activity, and satisfaction). The O'Leary index, caries activity, and saliva tests, gradually improved in group CB at one and two weeks. In the case of bacterial tests, unlike SAL and CHX, only in group CB did the decrease occur one and two weeks later. The caries-related indicators decreased significantly over time in group CB compared to SAL and CHX groups, and there was also a statistically significant difference in interaction between groups and time (p<0.05). The mouthwash containing CB extract showed statistically significant improvement in biofilm adhesion as well as the saliva and bacterial tests compared to SAL and CHX. However, since there were differences in the initial oral conditions of the three groups, additional long-term research is needed through crossover clinical trials to supplement these.

Salivary Diagnostics in Oral and Systemic Diseases - A Review

Salivary diagnostics, an emerging field in medical research, leverages the analysis of saliva for non- invasive detection, monitoring, and management of various diseases. This abstract explores the potential of saliva as a diagnostic fluid, highlighting its advantages such as ease of collection, cost-effectiveness, and patient acceptability compared to traditional blood or tissue sampling. Key biomarkers identified in saliva include proteins, nucleic acids, and metabolites that reflect systemic health conditions, oral diseases, infectious agents, and even systemic diseases like cancer and diabetes. Advances in technology, such as biosensors and genomic analysis, enhance the sensitivity and specificity of salivary diagnostics, paving the way for personalized medicine and early intervention strategies. Challenges including standardization, variability in saliva composition, and regulatory approval are also discussed, underscoring the need for further research and clinical validation. Salivary diagnostics holds promise as a valuable tool in future healthcare, potentially transforming how diseases are diagnosed and managed globally.

Evaluation and comparison of one-step real-time PCR and one-step RT-LAMP methods for detection of SARS-CoV-2

BackgroundThere is an increasing disease trend for SARS-COV-2, so need a quick and affordable diagnostic method. It should be highly accurate and save costs compared to other methods. The purpose of this research is to achieve these goals.MethodsThis study analyzed 342 samples using TaqMan One-Step RT-qPCR and fast One-Step RT-LAMP (Reverse Transcriptase Loop-Mediated Isothermal Amplification). The One-Step LAMP assay was conducted to assess the sensitivity and specificity.ResultsThe research reported positive samples using two different methods. In the RT-LAMP method, saliva had 92 positive samples (26.9%) and 250 negative samples (73.09%) and nasopharynx had 94 positive samples (27.4%) and 248 negative samples (72.51%). In the RT-qPCR method, saliva had 86 positive samples (25.1%) and 256 negative samples (74.8%) and nasopharynx had 93 positive samples (27.1%) and 249 negative samples (72.8%). The agreement between the two tests in saliva and nasopharynx samples was 93% and 94% respectively, based on Cohen’s kappa coefficient (κ) (P < 0.001). The rate of sensitivity in this technique was reported at a dilution of 1 × 101 and 100% specificity.ConclusionsBased on the results of the study the One-Step LAMP assay has multiple advantages. These include simplicity, cost-effectiveness, high sensitivity, and specificity. The One-Step LAMP assay shows promise as a diagnostic tool. It can help manage disease outbreaks, ensure prompt treatment, and safeguard public health by providing rapid, easy-to-use testing.

Feasibility, performances and predictive value of congenital CMV neonatal screening on saliva swabs

BackgroundEarly diagnosis of congenital CMV infection (cCMVI) allows for early intervention and follow-up to detect delayed hearing loss. While CMV PCR in urine is the gold standard for cCMVI diagnosis, saliva testing is often performed. ObjectivesOur aim was to determine (i) if swab saliva sampling needed standardization, (ii) if a threshold value in “virus copies per million cells (Mc)” in saliva samples could improve clinical specificity, and (iii) to establish a correlation between viral load in saliva and symptomatology/outcome of cCMVI. Materials and methodsIn our institution, universal newborn screening is performed on saliva swabs at delivery or until day 3 of life. If positive, CMV PCR in urine is done within 2 weeks to confirm or exclude cCMVI. ResultsCell quantification showed that saliva swab sampling was well performed as 95.4 % samples had more than 100 cells/10 µL. There was a good correlation between saliva viral load in copies/mL and in copies/Mc (Pearson's r = 0.96, p < 0.0001). However, threshold values, established to determine a viral load level at which we could confidently identify infected newborns, did not improve positive predictive value (21.8 % for copies/mL and 21 % for copies/Mc vs 25.4 % without threshold) but instead reduced sensitivity (88 % and 85% vs 100 % without threshold). Samples collected on day 2 or 3 had better positive predictive value (38.7 %) compared to those collected on day 1 (23.8 %). Symptomatology at birth was not significantly associated with viral load in saliva at diagnosis. However, sequelae occurrence was associated with viral load in saliva (copies/Mc). DiscussionOur results confirm that saliva swab is a suitable sample for universal neonatal screening. However, identifying newborns that will develop sequelae remains an issue in the management of cCMVI.

Newborn Screening for Congenital Cytomegalovirus in Canada

What Is the Issue Congenital cytomegalovirus (cCMV) infection is a leading cause of childhood hearing loss. It is estimated that 85% to 90% of newborns infected with cCMV will not show any symptoms at birth. Of those newborns with cCMV infection who are asymptomatic at birth, 10% to 15% will go on to develop long-term symptoms, including vision loss, hearing loss, and developmental delays. What Did We Do? This brief provides a summary about newborn screening for cCMV in Canada, including whether screening is available for cCMV in each province and territory, and if so, whether screening is universal or targeted using publicly available information. What Did We Find? Currently in Canada, 4 provinces (Alberta, Saskatchewan, Manitoba, Ontario) have or are implementing universal newborn screening for cCMV. Three provinces (British Columbia, New Brunswick, Nova Scotia) have province-wide targeted screening programs that offer cCMV testing to newborns who fail newborn hearing tests or who have suspected cCMV as identified by a clinician. Current clinical guidance and practice remain mixed on whether targeted or universal newborn screening is recommended, with each having a different distribution of benefits and harms. cCMV infections can be detected using blood, urine, or saliva tests. Most universal newborn screening programs use dried blood spot tests, which are likely to produce false-negative results; saliva tests have a lower number of false-negative results but can result in a higher number of false-positives. Some programs recommend additional testing using a different method (either saliva or urine) after an initial positive test as a validation. What Does This Mean? As both universal and targeted newborn screening programs have been adopted by several jurisdictions in Canada, there is wide recognition that cCMV infection is a serious health issue and that early detection is important. Moreover, there is an opportunity to generate data and evidence about test performance and program impact over time that could support future decision-making. As evidence and new test and treatment options become available, such data will help to inform the type of newborn screening approach used for cCMV.

The Association between Salivary Metabolites and Gingival Bleeding Score in Healthy Subjects: A Pilot Study.

Periodontal diseases, including gingivitis and periodontitis, are among the most prevalent diseases in humans. Gingivitis is the mildest form of periodontal disease, characterized by inflammation of the gingiva caused by the accumulation of dental plaque. Salivary diagnostics are becoming increasingly popular due to the variation in saliva composition in response to pathological processes. We used a metabolomics approach to investigate whether a specific saliva metabolic composition could indicate preclinical stage of gingivitis. 1H-NMR spectroscopy was used to obtain the salivary metabolite profiles of 20 healthy subjects. Univariate/multivariate statistical analysis evaluated the whole saliva metabolite composition, and the Full-Mouth Bleeding Score (FMBS) was employed as a classification parameter. Identifying a signature of specific salivary metabolites could distinguish the subjects with high FMBS scores but still within the normal range. This set of metabolites may be due to the enzymatic activities of oral bacteria and be associated with the early stages of gingival inflammation. Although this analysis is to be considered exploratory, it seems feasible to establish an FMBS threshold that distinguishes between the absence and presence of early inflammatory alterations at the salivary level.

A Predictive Noninvasive Single-Nucleotide Variation-Based Biomarker Signature for Resectable Pancreatic Cancer: Protocol for a Prospective Validation Study.

Single-nucleotide variations (SNVs; formerly SNPs) are inherited genetic variants that can be easily determined in routine clinical practice using a simple blood or saliva test. SNVs have potential to serve as noninvasive biomarkers for predicting cancer-specific patient outcomes after resection of pancreatic ductal adenocarcinoma (PDAC). Two recent analyses led to the identification and validation of three SNVs in the CD44 and CHI3L2 genes (rs187115, rs353630, and rs684559), which can be used as predictive biomarkers to help select patients most likely to benefit from pancreatic resection. These variants were associated with an over 2-fold increased risk for tumor-related death in three independent PDAC study cohorts from Europe and the United States, including The Cancer Genome Atlas cohorts (reaching a P value of 1×10-8). However, these analyses were limited by the inherent biases of a retrospective study design, such as selection and publication biases, thereby limiting the clinical use of these promising biomarkers in guiding PDAC therapy. To overcome the limitations of previous retrospectively designed studies and translate the findings into clinical practice, we aim to validate the association of the identified SNVs with survival in a controlled setting using a prospective cohort of patients with PDAC following pancreatic resection. All patients with PDAC who will undergo pancreatic resection at three participating hospitals in Switzerland and fulfill the inclusion criteria will be included in the study consecutively. The SNV genotypes will be determined using standard genotyping techniques from patient blood samples. For each genotyped locus, log-rank and Cox multivariate regression tests will be performed, accounting for the relevant covariates American Joint Committee on Cancer stage and resection status. Clinical follow-up data will be collected for at least 3 years. Sample size calculation resulted in a required sample of 150 patients to sufficiently power the analysis. The follow-up data collection started in August 2019 and the estimated end of data collection will be in May 2027. The study is still recruiting participants and 142 patients have been recruited as of November 2023. The DNA extraction and genotyping of the SNVs will be performed after inclusion of the last patient. Since no SNV genotypes have been determined, no data analysis has been performed to date. The results are expected to be published in 2027. This is the first prospective study of the CD44 and CHI3L2 SNV-based biomarker signature in PDAC. A prospective validation of this signature would enable its clinical use as a noninvasive predictive biomarker of survival after pancreatic resection that is readily available at the time of diagnosis and can assist in guiding PDAC therapy. The results of this study may help to individualize treatment decisions and potentially improve patient outcomes. DERR1-10.2196/54042.

Correlation of salivary hs-CRP With conventional cardiovascular risk markers and hba1c in prediabetic subjects

Prediabetes has attracted considerable attention because it increases the risk of developing diabetes and cardiovascular disease. Prediabetes is also associated with obesity and dyslipidemia. Chronic low-grade inflammation is a crucial element in the clinical course of metabolic syndrome, and cardiovascular and cerebrovascular diseases. C-Reactive Protein (CRP) is a biomarker of inflammation that tends to increase in patients with diabetes and prediabetes. Most serological markers of diabetes are detected using invasive techniques that cause anxiety and pain. Therefore, the use of noninvasive techniques for frequent biomarker monitoring is necessary. Salivary diagnostics is an upcoming field for sensitive biomarker detection, such as hs-CRP. HbA1C is a valuable glycemic risk marker and has proven to be a reliable test of time. Both HbA1C and CRP play pivotal roles in diabetes and prediabetes. hs-CRP is a measure of CRP level with greater accuracy. The lower limit of its measurement is 0.01 mg/L and the measurement is more than100 times as sensitive than the CRP measurement (lower limit 5 mg/L). Therefore, our study aimed to evaluate and establish a relationship between these factors in prediabetics. Since metabolic syndrome and prediabetes are the cause and effect of each other, correlating anthropometric measurements and lipid profile with HbA1C and hs-CRP will be our focus.

Diagnostic Value of Saliva RT-PCR Test within Suspected SARS-CoV-2 Cases in Indonesia

Introduction: The ongoing SARS-CoV-2 pandemic has profoundly emphasized the pressing need for accurate and reliable diagnostic procedures. Given the potential health risks associated with nasopharyngeal swabs, there has been growing interest in seeking alternative diagnostic mediums. In this context, our study delved into evaluating saliva as a potential diagnostic tool, simultaneously assessing its efficiency in relation to patient demographics and their exhibited clinical symptoms. Methods: Spanning from May to December 2020, we conducted a comprehensive cross-sectional analysis. We meticulously examined medical records to gather insights on patient characteristics, existing health conditions, onset of symptoms, clinical manifestations, and compared the results obtained from both salivary and nasopharyngeal RT-PCR tests for SARS-CoV-2. Results: Among the individuals suspected of SARS-CoV-2 infection, the mean age stood at 52.4 years, with males representing 60.3% of this group. Interestingly, a significant 76.9% reported underlying health conditions, predominantly hypertension and diabetes. The most commonly reported symptoms encompassed respiratory challenges, notably coughing and shortness of breath, succeeded by symptoms like nausea, fever, and a general sense of fatigue. The performance of saliva tests, in terms of accuracy, appeared to be significantly influenced by the timing of symptom emergence. Conclusion: The RT-PCR tests utilizing saliva samples demonstrated considerable promise, especially during the early stages of symptom manifestation, providing a reliable alternative to traditional nasopharyngeal swabs. The findings suggest a superior diagnostic sensitivity when utilizing saliva during the initial phases of a SARS-CoV-2 infection.

A novel test for hyposalivation using a sugar cube.

Hyposalivation is a highly prevalent condition in old persons. The aim of this study was to assess a novel tool for the diagnosis of hyposalivation using a sugar cube and to compare its reliability to other validated test methods. Five tests were performed: unstimulated salivary flow test by draining method (USFT), oral moisture device Mucus® (MCS), sugar cube test (SCT), stimulated salivary flow test by chewing gum (CG) and Saxon test (SX). The sugar cube test consisted in measuring the time needed to disintegrate a standard-sized sugar cube N°4 (5.6 g) placed beneath the tongue. Bivariate correlation analyses were performed. ROC curve analysis and the Youden Index were used to determine the cut-off value. Sensitivity and specificity were calculated according to the determined cut-off point. A total of 121 participants were recruited, with an average age of 49.8 ± 18.2 years. The USFT was best correlated with the SCT. No correlation was found between SCT and the stimulated saliva tests (CG, SX) as well as the MCS test. According to the Youden index, 140 s is appropriate to diagnose hyposalivation. Sensitivity of .64 and specificity of .91 were found for SCT using USFT as gold standard. The mean subjective evaluation score of the SCT was 3.1 ± 1, significantly higher than USFT 2.6 ± 1.1 (p < .05). The sugar cube test proved to be a useful method for assessing unstimulated salivation, reducing test execution time and causing less participant discomfort than the gold standard unstimulated salivary flow test.