Saliva could be used to predict COVID-19 severity in kids, early analysis finds – Healio

October 09, 2021

2 min read

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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 & Exhibition.

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

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

Sethuraman said in an interview with Healio that the inspiration for the study came from the work of presenting author Steven Hicks, MD, PhD, a Penn State professor and pediatrician who was examining the role of micro RNA (miRNA) — a form of non-coding RNA — in concussions.

“That led me to thinking, Why not apply this to the COVID situation to help us determine which kid is going to have a severe infection?” Sethuraman said. “Children who have COVID infections present very similar to other childhood viral infections. It’s difficult for us as providers to determine which child’s going to go onto develop severe COVID infection. So, then we thought about it, and said, ‘Let’s just see if there are any changes in your cytokines, in the saliva or micro RNA that can help us decide who’s going to develop severe 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 abstract, 29 tested positive for SARS-CoV-2 via RT PCR, four had a positive antibody test and six children had severe infection.

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

“We were quite surprised to see that there is a differential expression with miRNAs that is significantly different between severe and non-severe children,” Sethuraman said.

They also took outside factors into consideration, giving each patient’s parents a survey asking about income, house status and access to medical care, among other factors.

“There are some adult studies that have shown that there are specific social and societal factors that can impact outcomes in COVID in adults, so we’re also looking at that,” Sethuraman said.

The study is ongoing. Sethuraman said she hopes to enroll as many as 400 children under 18 who experienced COVID-19. She also hopes that saliva is seriously considered as a way to assist doctors, specifically in EDs.

“If this [study] goes through successfully, our hope is that we’re able to get saliva from a child, put it into a machine, and it spits out the prediction for who’s going to have a severe disease,” Sethuraman said. “That would be an awesome, awesome achievement, especially in the emergency department, where it can help us make decisions and start treatment earlier.”


Study seeks to find ways to predict COVID-19 severity risk in children. Published Oct. 8, 2021. Accessed Oct. 9, 2021.