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