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. 2022 Jul;85(1):86-89.
doi: 10.1016/j.jinf.2022.04.041. Epub 2022 Apr 29.

Differences in saliva ACE2 activity among infected and non-infected adult and pediatric population exposed to SARS-CoV-2

Daniel Jiménez  1 , Javier Martínez-Sanz  2 , Talía Sainz  3 , Cristina Calvo  3 , Ana Méndez-Echevarría  3 , Elena Moreno  1 , Daniel Blázquez-Gamero  4 , Pilar Vizcarra  1 , Mario Rodríguez  5 , Robert Jenkins  6 , Matilde Sánchez-Conde  1 , Raquel Ron  1 , Francesca Norman  1 , Santiago Moreno  1 , Manuel Ferrer  7 , Sergio Serrano-Villar  8
Affiliations

Differences in saliva ACE2 activity among infected and non-infected adult and pediatric population exposed to SARS-CoV-2

Daniel Jiménez et al. J Infect. 2022 Jul.

Abstract

Background: Variations in the ACE2 activity in saliva could explain the striking differences of susceptibility to infection and risk of severe disease.

Methods: We analyze the activity of ACE2 in saliva in different population groups across a wide age range and disease status during April to June 2020, before SARS-CoV-2 vaccine implementation, and we establish differences between infected people and participants considered resistant (highly exposed healthcare workers and children who cohabited with parents with COVID-19 without isolation and remain IgG negative).

Results: We included 74 adults, of which 47 (64%) were susceptible and 27 (36%) were resistant, and 79 children, of which 41 (52%) were susceptible and 38 (48%) were resistant. Resistant adults have significantly lower ACE2 activity in saliva than susceptible adults and non-significant higher values than susceptible and resistant children. ACE2 activity is similar in the susceptible and resistant pediatric population (p = 0.527). In contrast, we observe an increase in activity as the disease's severity increases among the adult population (mild disease vs. severe disease, 39 vs. 105 FU, p = 0.039; severe disease vs. resistant, 105 vs. 31 FU, p < 0.001).

Conclusions: using an enzymatic test, we show that ACE2 activity in saliva correlates with the susceptibility to SARS-Cov-2 infection and disease severity. Children and adults with low-susceptibility to SARS-Cov-2 infection showed the lowest ACE2 activity. These findings could inform future strategies to identify at-risk individuals.

Keywords: ACE2; SARS-CoV-2; Saliva; Severity; Susceptibility.

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Conflict of interest statement

Declaration of Competing Interest Outside the submitted work, S. S.-V. reports personal fees from ViiV Healthcare, Janssen Cilag, Gilead Sciences, and MSD as well as non-financial support from ViiV Healthcare and Gilead Sciences and research grants from MSD and Gilead Sciences. J.M.-S. reports non-financial support from ViiV Healthcare, Gilead Sciences, and Jannsen Cilag. S.M. reports personal fees and non-financial from ViiV Healthcare, Janssen, Gilead Sciences, and MSD, as well as grants from MSD, ViiV Healthcare, and Gilead Sciences.

Figures

Fig 1
Fig. 1
Comparison of ACE2 activity in saliva according to susceptibility and disease severity in adult and pediatric population". The graph is a box and whiskers plot showing all values as points. The groups were compared by one-way ANOVA followed by Tukey test. The adult resistant group was the reference category for the multiple comparisons. ** denotes a p value < 0.01 and > 0.001 **** denotes a p value < 0.0001.
See this image and copyright information in PMC

Comment in

  • Are SARS-CoV-2 viral loads in children lower than in adults?
    Bayhan Gİ, Özkubat Korkmaz I, Şahiner ES, Tekeli N, Akdağ AG, Uyan Erten AZ, Taşbaşı AB, Göre B, Doğru M, Kırca F, Dinç B. Bayhan Gİ, et al. J Infect. 2023 Jan;86(1):e13-e14. doi: 10.1016/j.jinf.2022.08.025. Epub 2022 Aug 24. J Infect. 2023. PMID: 36029921 Free PMC article. No abstract available.

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