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Infection of the oral cavity with SARS-CoV-2 variants: Scope of salivary diagnostics

Coronaviruses, including #SARSCoV2, have caused pandemics in the past two decades. The most prevalent SARS-CoV-2 variants of concern can re-infect individuals who have been previously infected with other variants or had protection from vaccines targeting the original SARS-CoV-2 variant. Given the high risk of transmission of coronavirus via aerosols produced during dental procedures, it is important to understand the future risk of coronavirus infection for oral health professionals and to diagnose quickly early stages of outbreaks. Testing of saliva for #coronavirus may be the least invasive and most convenient method for following the outbreak at the individual and community level. This review will describe strategies for diagnosis of coronavirus in saliva.


Introduction

The Coronavirus disease 19 (COVID-19) pandemic, caused by infection with the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has killed more than 6 million individuals globally as of July 2022 (1). The symptoms of infection range from asymptomatic; to coughs, fever, and fatigue in moderate disease; to severe pulmonary pathology requiring hospitalization and ventilators. Persons with underlying co-morbidities are at a higher risk for severe disease. Though the patients with mild to moderate disease recover quickly, some report post-COVID-19 symptoms months to years after infection, even in individuals who experienced mild symptoms. For those who suffered a severe infection, it is possible for lung and cardiac function to be impaired permanently leading, to an increased risk for other complications in the future (2).

The first modern coronavirus pandemic occurred in 2002 in China and the disease was named the Severe Acute Respiratory Syndrome (SARS). In 2012, a pandemic caused by another coronavirus emerged in the middle east and was named the Middle East Respiratory Syndrome (MERS-CoV).

SARS-CoV-2 is the fifth recent coronavirus to infect humans on a wide scale, and as the mutations continue to evolve rapidly, it is crucial to understand the mechanics of prevention, genomics, and pathogenesis of the new mutations (3). The virus responsible for this pandemic has a higher rate of transmissibility and infectivity compared to the previous pandemic coronaviruses, SARS-CoV and MERS-CoV (4).


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