The importance of combining serological testing with RT-PCR assays for efficient detection of COVID-19 and higher diagnostic accuracy.

Misdiagnosing suspected COVID-19 individuals could largely contribute to the viruses transmission, therefore, making an accurate diagnosis of infected subjects vital in minimizing and containing the disease. Although RT-PCR is the standard method in detecting COVID-19, it is associated with some limitations, including possible false negative results. Therefore, serological testing has been suggested as a complement assay to RT-PCR to support the diagnosis of acute infections. In this study, 15 out of 639 unvaccinated healthcare workers (HCWs) were tested negative for COVID-19 by RT-PCR and were found seropositive for SARS-CoV-2 nucleocapsid protein-specific IgM and IgG antibodies. These participants underwent additional confirmatory RT-PCR and SARS-CoV-2 spike-specific ELISA tests. Of the 15 individuals, nine participants were found negative by second RT-PCR but seropositive for anti-spike IgM and IgG antibodies and neutralizing antibodies confirming their acute infection. At the time of collection, these nine individuals were in close contact with COVID-19-confirmed patients, with 77.7% reporting COVID-19-related symptoms. These results indicate that including serological tests in the current testing profile can provide better outcomes and help contain the spread of the virus by increasing diagnostic accuracy to prevent future outbreaks rapidly.

The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study.

Several investigations evaluated the possibility of different types of mouth wash rinse in minimizing the SARS-CoV-2 load. However, results still controversial. The study aim is to assess the short-term efficiency of several over-the-counter mouth rinses and lozenges in minimizing the salivary viral load for SARS-CoV-2 in patients with confirmed COVID-19 in comparison to saline. This is a randomized controlled clinical trial with 4 arms. The recruited cases were randomized using a simple randomization technique and were assigned to chlorhexidine digluconate mouth rinse (CHX mouth rinse), 2 mg of chlorhexidine digluconate lozenges (CHX lozenges), povidone iodine mouth rinse (PVP-I mouth rinse) or saline as a control group. Saliva were collected from all study subjects by passive drool technique at two time points. First, prior to intervention with mouth rinse or the lozenges, the baseline saliva sample was collected. Second saliva samples were collected immediately after the mouth rinse. Real time PCR was conducted and the value threshold cycle (Ct) for each sample was recorded. Majority of the participants had an education level of high school or less (60%), were married (68.3), males (58.3%), and non-smokers (58.5%). No statistically significant differences between groups at the two times test (P > .05). However, a significant decrease of salivary viral load in all four groups combined (P-value for E genes = .027, and for S genes = .006), and in PVP-I mouth rinse specifically (P = .003 and P = .045, respectively). Povidone iodine mouth rinse showed a potential influence on the reduction of the viral load on a short-term basis. However, longer-term studies of the effect of these products should be conducted.

Can periodontal pockets and caries lesions act as reservoirs for coronavirus?

The periodontal pocket and likely caries lesions may act as a reservoir and source of dissemination and development of systemic infections. While periodontal pockets have been found to harbor several viral species, there is no information on its ability to serve as a reservoir for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have used a real-time polymerase chain reaction (RT-PCR) approach to evaluate SARS-CoV-2 in periodontal pockets and cavitated caries lesions in a cross-sectional study of 72 participants who were divided into six groups: symptomatic positive COVID-19 cases with periodontal pockets, symptomatic positive with cavitated caries lesions, asymptomatic positive with periodontal pockets, asymptomatic positive with cavitated caries lesions, positive control, and negative control. A total of 180 samples were interrogated by RT-PCR to amplify the SARS-CoV-2 E and S genes. SARS-CoV-2 was present in 41.7% of symptomatic positive COVID-19 cases with periodontal pockets and 16.7% of symptomatic positive with cavitated caries lesions. The mean Ct value of E and S genes in periodontal pockets patients were 36.06±0.46 and 30.06±6.73, respectively, and the mean Ct value for both genes in caries lesions patients were 35.73±4.14, and 34.78±1.93, respectively. The sensitivity, specificity, and accuracy to detect SARS-CoV-2 among periodontal pockets were 20.8% (95% CI 7.13-42.15), 100% (95% CI 73.54-100.0), and 47.2% (95% CI 30.22-64.51), respectively. Among cavitated caries lesions patients, they were 8.3% (95% CI 1.03-27.0), 100% (95% CI 73.54-100.0), and 38.9% (95% CI 23.14-56.54), respectively. SARS-CoV-2 can be detected in periodontal pockets and caries lesions, and these sites may act as reservoirs for the virus. However, the sensitivity of SARS-CoV-2 detection is low compared with other methods. To our knowledge, this report is the first to investigate the relationship between SARS-CoV-2 and periodontal pockets and caries.

Characteristics of Oral Manifestations in Symptomatic Non-Hospitalized COVID-19 Patients: A Cross-Sectional Study on a Sample of the Saudi Population.

PURPOSE: Few case reports and letters to the editor have been published regarding oral signs and symptoms in COVID-19 patients. The aim of the study therefore is to investigate different types of oral manifestations in COVID-19 patients as well as their prevalence. PATIENTS AND METHODS: The study is a cross-sectional study from a single medical center. A convenience sample was taken from all patients who were COVID-19 confirmed, symptomatic, and non-hospitalized. Demographic information, medical and travel history, general symptoms, and clinical examination results of the oral cavity were collected. RESULTS: This study included a total of 109 patients. Loss of taste was the most common oral manifestation of COVID-19 (43.4%), followed by erythema/desquamated gingivitis and coated tongue (7.3% each) and ulcers/blisters (6.4%). Loss of taste was the only symptom persisting for 10 days. Oral manifestations appeared as a single symptom (79.3%), and dorsum of tongue was the most common oral location (72.4%). CONCLUSION: Loss of taste was the most prevalent specific reported oral manifestation. Other nonspecific oral lesions/symptoms are controversial. It has been suggested that oral examinations of COVID-19 patients should be conducted as part of routine examinations to investigate any possible correlation between the disease and the oral cavity.

Factors associated with a late visit to dentists by children: A cross-sectional community-based study in Saudi Arabia.

OBJECTIVES: This cross-sectional study aims to determine children's age at their first visit to dentists and factors associated with these visits. METHODS: This cross-sectional community survey-based study was conducted in 2019 during the events of the 10th Gulf Oral Health Week in Jeddah, Saudi Arabia. All participants including visitors and dentists, with current or previous experience in caring for children aged six months to ten years, provided their consents for the study. RESULTS: Among the visitors, 348 participated in the survey. Most children, aged three to ten years, first visited the dentist with complaints of pain and dental cavities. The risk of a late visit to the dentist increased (OR: 2.28; CI 95%: 1.01-5.14) among caregivers who did not help their children brush their teeth. Using the Internet for accessing health information negatively impacted the visits (OR: 27.00; CI 95% 1.26-57.35). While employed mothers took their children to the dentist at an earlier age (OR: 2.284; CI 95% 1.08-4.79), early visits were mostly missed by mothers with smaller families (OR: 0.043; CI 95% 0.48-0.98). CONCLUSION: The results of our study show that the caregiver's attitude, source of health information, employment, age, and number of children are risk factors associated with late visits to dentists.

Willingness of general dental practices in South East London to engage with research.

This study assessed the willingness of general dental practices (GDPs) to participate in research. All 263 GDPs in South East London that provide dental care under National Health Service (NHS) contracts were invited. The survey instrument was adapted from previous studies and piloted before administration. Geographical factors and practice characteristics associated with willingness to participate in research were explored in logistic regression models. A total of 77 responses were received (response rate: 29%). Of them, 40 (53%) expressed interest in being involved in primary care research. They saw their main role as collecting data and facilitating access to patients. Time, bureaucracy and lack of energy were the main reasons behind a decision not to engage with research. Those spending more time in NHS services were more likely to be willing to participate in research. Other possible indicators were single-handed GDPs, participation in the dental foundation training programme and location in more affluent areas.