Proposal of Research Model for the Detection of COVID-19 among Asymptomatic Carriers

Rajendra Santosh, Arvind Babu; Krishnamurthy, Kandamaran; Baddam, Venkat Ramana Reddy

doi:10.1055/s-0040-1712936

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International Archives of Otorhinolaryngology

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Opinion Article, Special Article COVID-19 • Int. Arch. Otorhinolaryngol. 24 (3) • Jul-Sep 2020 • https://doi.org/10.1055/s-0040-1712936 copy

Proposal of Research Model for the Detection of COVID-19 among Asymptomatic Carriers

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic and rapidly progressing infectious disease that represents a global health care emergency due to severe acute respiratory syndrome. Rapid tests detect antigen or antibody presence, which is useful for patient care and for assisting in disease surveillance and epidemiological research. The complicating aspect of the COVID-19 spread may be due to asymptomatic individuals. Unfortunately, asymptomatic individuals are not detected in the early stages of infection, which could help to prevent community spread. The present paper shares an opinion through the proposal of a research model for detecting COVID-19 among asymptomatic carriers.

Keywords
COVID-19; asymptomatic; PCR; diagnosis; epidemiology; saliva

No.	Study hypothesis	Study findings/ conclusion	Author and year of publication
1	Salivary testing from suspected COVID-19 patients based on clinical and epidemiological criteria.	nCoV was detected in the self-collected saliva of 91.7% of patients.	To et al 2020⁵5 To KK, Tsang OT, Chik-Yan Yip C, et al. Consistent detection of 2019 novel coronavirus in saliva [published online ahead of print, 2020 Feb 12]. Clin Infect Dis 2020:ciaa149. Doi: 10.1093/cid/ciaa149 https://doi.org/10.1093/cid/ciaa149...
2	Ferret model of SARS-COV-2 study employed to understand the infection and transmission that recapitulates aspects of human disease.	SARS COV-2 infected ferrets showed the presence of the virus in nasal washes and saliva up to 8 days postinfection.	Kim et al 2020⁸8 Kim YI, Kim SG, Kim SM, et al. Infection and Rapid Transmission of SARS-CoV-2 in Ferrets [published online ahead of print, 2020 Apr 5]. Cell Host Microbe 2020;S1931-3128(20)30187-6. Doi: 10.1016/j.chom.2020.03.023 https://doi.org/10.1016/j.chom.2020.03.0...
3	Analysis of COVID-19 from salivary samples of patients with known clinical and laboratory data. Samples were collected from patients with severe to very severe COVID-19 symptoms.	All the samples tested positive for nCoV. Interestingly, two patients showed positive salivary results while nasal swabs were negative.	Azzi et al 2020⁹9 Azzi L, Carcano G, Gianfagna F, et al. Saliva is a reliable tool to detect SARS-CoV-2. J Infect 2020;•••:S0163-S4453
4	Prediction of intrinsic disorder in MERS-CoV/HCoV-EMC supports a high oral-fecal transmission.	Oral-saliva and oral-urine routes are also a possibility for viral transmission.	Goh et al 2013¹⁰10 Goh GK, Dunker AK, Uversky V. Prediction of Intrinsic Disorder in MERS-CoV/HCoV-EMC Supports a High Oral-Fecal Transmission. PLoS Curr 2013;5: ecurrents.outbreaks.22254b58675cdebc256dbe3c5aa6498b. Published 2013 Nov 13. Doi: 10.1371/currents.outbreaks.22254b58675cdebc256dbe3c5aa6498b https://doi.org/10.1371/currents.outbrea...
5	Viral replication in the upper respiratory tract may contribute to the rapid viral shedding into saliva droplets.	Demonstrated for the first time in the literature that the ACE2 epithelial cells of the salivary gland ducts are early targets of SARS-CoV infection. The findings provide evidence that salivary gland epithelial cells can be infected in vivo soon after infection, thus providing source of virus in saliva, particularly in early infection.	Liu et al 2011⁴4 Liu L, Wei Q, Alvarez X, et al. Epithelial cells lining salivary glandducts are early target cells of severe acute respiratory syndrome coronavirus infection in the upper respiratory tracts of rhesus macaques. J Virol 2011;85(08):4025-4030. Doi: 10.1128/JVI.02292-10 https://doi.org/10.1128/JVI.02292-10...

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[1] Address for correspondence Arvind Babu RS, Oral and Maxillofacial Pathologist, Senior Lecturer, School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Jamaica (e-mail: arvindbabu2001@gmail.com).