Saliva could be used to predict COVID-19 severity in children, early analysis finds

October 09, 2021

2 minutes read

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The authors do not report any material financial disclosures.

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Researchers may have found a way to predict the severity of COVID-19 infection in children by examining their saliva, according to a multi-institutional study presented at the AAP National Conference and Exhibition.

Usha Sethuraman, MD, a professor of pediatric emergency medicine at Central Michigan University and DMC Children’s Hospital in Michigan, collaborated with physicians from Penn State College of Medicine, Wayne State University, UPMC Children’s Hospital in Pittsburgh and the University of Pittsburgh on the project.

Researchers may have found a way to predict the severity of COVID-19 in children on the basis of saliva samples. Source: Adobe Stock

Sethuraman said in an interview with Healio that the inspiration for the study came from an author’s presentation work Steven Hicks, MD, PhD, a Penn State professor and pediatrician who explored the role of micro RNA (miRNA) – a type of non-coding RNA – in conjugates.

“That led me to think, Why not apply this to the COVID situation to help us decide which child is going to get a serious infection?” Sethuraman said. “Children with COVID infections present much like other childhood viral infections. It is difficult for us as providers to decide which child is going to develop a serious COVID infection. So, then we thought about it, and said, ‘Let’s see if there are any changes in your cytokines, saliva or micro RNA that can help us decide who is going to develop serious infections.’ ”.

In non-invasive tests on 33 children who tested positive for COVID-19, Sethuraman and colleagues analyzed the presence of salivary miRNA. According to the summary, 29 tested positive for SARS-CoV-2 by RT PCR, four tested positive for antibody and six children had a severe infection.

The researchers compared the salivary miRNA levels of severely infected participants with those of children without severe infection and found that 63 miRNA expression was different, including 38 found at significantly lower levels in the saliva of severely infected children.

“We were very surprised to find that there is differential expression with miRNAs that are significantly different between severe and non-severe children,” says Sethuraman.

They also considered external factors, surveying the parents of all patients requesting income, housing status and access to medical care, among other factors.

“There are some adult studies that have shown that there are certain social and social factors that can affect outcomes in COVID in adults, so we are also looking at that,” says Sethuraman.

The study is ongoing. Sethuraman said she hopes to enroll as many as 400 children under the age of 18 who have experienced COVID-19. She also hopes that saliva is seriously considered as a way to assist doctors, particularly in emergency departments.

“If this [study] going through successfully, we hope we can get saliva from a child, put it into a machine, and share the prediction for who is going to get a serious disease, ”said Sethuraman. “That would be an amazing, incredible achievement, especially in the emergency department, where it can help us make decisions and start treatment earlier.”


A study seeking to find ways to predict COVID-19 severity risk in children. Published October 8, 2021. Accessed October 9, 2021.