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Biochimica Clinica ; 44(SUPPL 2):S67, 2020.
Article | WHO COVID | ID: covidwho-983996


Introduction Saliva has been proposed as a valid alternative to naso-pharyngeal swabs for detecting viral SARS-CoV-2 RNA sequences In addition salivary glands have been described as a potential SARSCoV-2 virus reservoir, thus supporting the search for antibodies in saliva Furthermore, the non-invasive nature of saliva collection is conducive to self-collection, patients' compliance for repeated testing, and reduction of risk to operators, thus making saliva an eligible matrix in the SARS-CoV-2 diagnostic process Aim The aim of this study was to verify whether standardized and safe saliva collection is suitable for SARS-CoV-2 molecular detection and IgA class antibody measurement Methods A total of 49 COVID-19 patients hospitalized at the University-Hospital of Padova (Italy) and 326 subjects who underwent screening underwent naso-pharyngeal (NP) swab and saliva collection using Salivette® Repeat blood collections were performed to evaluate hematological and coagulation parameters, biochemical markers of inflammation, and renal, liver, heart and pancreatic involvement in hospitalized patients In all patients and subjects, saliva SARS-CoV-2 (gene E) rRT-PCR was undertaken in parallel with NP swabs Salivary IgA and serum IgA, IgG, IgM were measured on samples from hospitalized patients Results NP swabs were SARSCoV-2 positive in 9/49 patients The comparison with saliva testing was possible for 43/49 patients, 7 of whom shared positivity, and 35 negativity while in one, the saliva result, not NP-swab, was positive Positive molecular testing results were significantly associated with disease duration (p=0 0049) All the 326 screened subjects were SARS-CoV-2 negative on both NP and saliva swabs Among the 27 saliva samples tested for IgA, 18 were IgA positive Salivary IgA positivity was significantly associated with pneumonia (p=0 002) and CRP values (p=0 0183), not with other clinical and molecular data, or with immunoglubulins in serum Conclusions The results reported in the present study demonstrate that a standardized and safe saliva collection method can be adopted to detect SARS-CoV-2 infection in alternative to NP-swabs Preliminary data on salivary IgA also support the use of saliva in local adaptive immunity patient monitoring

ERJ Open Research ; 6(4):1-9, 2020.
Article | WHO COVID | ID: covidwho-917913


Objectives: The aim of this study was to validate a composed coronavirus disease 2019 (COVID-19) chest radiography score (CARE) based on the extension of ground-glass opacity (GG) and consolidations (Co), separately assessed, and to investigate its prognostic performance Methods: COVID-19-positive patients referring to our tertiary centre during the first month of the outbreak in our area and with a known outcome were retrospectively evaluated Each lung was subdivided into three areas and a three-grade score assessing the extension of GG and Co was used The CARE was derived from the sum of the subscores A mixed-model ANOVA with post hoc Bonferroni correction was used to evaluate whether differences related to the referring unit (emergency room, COVID-19 wards and intensive care unit (ICU)) occurred Logistic regression analyses were used to investigate the impact of CARE, patients’ age and sex on the outcome To evaluate the prognostic performance of CARE, receiver operating characteristic curves were computed for the entire stay and at admission only Results: A total of 1203 chest radiographs of 175 patients (120 males;mean age 67 81±15 5 years old) were examined On average, each patient underwent 6 8±10 3 radiographs Patients in ICU as well as deceased patients showed higher CARE scores (p<0 05, each) Age, Co and CARE significantly influenced the outcome (p<0 05 each) The CARE demonstrated good accuracy (area under the curve (AUC)=0 736) using longitudinal data as well as at admission only (AUC=0 740) A CARE score of 17 5 during hospitalisation showed 75% sensitivity and 69 9% specificity Conclusions: The CARE was demonstrated to be a reliable tool to assess the severity of pulmonary involvement at chest radiography with a good prognostic performance