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Salivary biomarkers in COVID-19 patients: the rabbit out of the hat!
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  • Cecilia Napodano,
  • Cinzia Anna Callà,
  • Antonella Fiorito,
  • Mariapaola Marino,
  • Eleonora Taddei,
  • Tiziana Di Cesare,
  • Giulio Cesare Passali,
  • Riccardo Di Santo,
  • Massimo Fantoni,
  • Andrea Urbani,
  • Gaetano Paludetti,
  • Gian Ludovico Rapaccini,
  • Gabriele Ciasca,
  • Umberto Basile
Cecilia Napodano
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Cinzia Anna Callà
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Antonella Fiorito
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Mariapaola Marino
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Eleonora Taddei
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Tiziana Di Cesare
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Giulio Cesare Passali
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Riccardo Di Santo
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Massimo Fantoni
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Andrea Urbani
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Gaetano Paludetti
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Gian Ludovico Rapaccini
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Gabriele Ciasca
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Umberto Basile
Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Corresponding Author:[email protected]

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Abstract

Background: The ongoing outbreak of Coronavirus Disease 2019 (COVID-19) represents a major threat to human health, which impairs the functionality of several organs. One of the hardest challenges in the fight against COVID-19 is the development of wide-scale, effective, and rapid laboratory tests to control disease severity, progression, and possible sudden worsening. Monitoring patients in real-time is indeed highly demanded in this pandemic era when physicians need reliable and quantitative tools to prioritize patients’ access to intensive care departments. In this regard, salivary biomarkers are extremely promising, as they allow for a fast and non-invasive specimens’ collection, which can be repeated multiple times. Methods: We compare salivary levels of immunoglobulin A subclasses (IgA1 and IgA2) and free-light chains (FLC k and λ) in a cohort of 29 SARS-CoV-2 patients and 21 healthy subjects. Results: We found that each biomarkers differs significantly between the two groups, with p-values ranging from 10-8 to 10-4. The performance ranking of these markers, shows that λFLC level (p=1.4e-8) is the best-suited candidate to discriminate the two groups, with an accuracy of 0.94 (0.87-1.00 95% CI), a precision of 0.91 (0.81-1.00 95% CI), a sensitivity of 1.00 (0.96-1.00 95% CI) and a specificity of 0.86 (0.70-1.00 95% CI). Conclusion: These results suggest λFLC as an ideal indicator of patient conditions. This is more strengthened in consideration that λFLC half-life (approximately 6 hours) is significantly shorter than the IgA one (21 days): thus λFLC appears displaying the potential to effectively monitor patients fluctuation in real-time