Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;83(3):775-782.
doi: 10.1007/s12020-023-03597-z. Epub 2023 Nov 22.

Heat inactivation of SARS-CoV 2 enabled the measurement of salivary cortisol during COVID-19 pandemic

Giacomo Voltan  1   2 , Giorgia Antonelli  1   3 , Alessandro Mondin  1   2 , Irene Tizianel  1   2 , Chiara Sabbadin  1   2 , Mattia Barbot  1   2 , Daniela Basso  1   3 , Carla Scaroni  1   2 , Filippo Ceccato  4   5
Affiliations

Heat inactivation of SARS-CoV 2 enabled the measurement of salivary cortisol during COVID-19 pandemic

Giacomo Voltan et al. Endocrine. 2024 Mar.

Abstract

Background and aim: Salivary cortisol has become an essential tool in the management of cortisol-related disease. In 2020 the sudden outbreak of COVID-19 pandemic caused several concerns about the use of saliva, due to the risk of contamination, and a European consensus further discourage using salivary cortisol. To decrease infectious risk, we handled specimens by applying a heat treatment to inactivate viral particles, further evaluating the impact of the COVID-19 pandemic on the use of salivary cortisol in clinical practice.

Material and methods: Saliva samples were exposed for 10 min at 70 °C, then cortisol was measured using LC-MS/MS. The number of salivary cortisol examinations from 2013 to 2022 was extracted from the local electronic database: those performed in 2019, 2020, and 2021 were analyzed and compared with the historical data.

Results: During 2020 we observed a decrease of 408 (-20%) examinations (p = 0.05) compared to 2019; especially in salivary cortisol daily rhythm and salivary cortisol/cortisone ratio (respectively reduction of 47% and 88%, p = 0.003 and p = 0.001). Analyzing year 2021 compared with 2020 we reported an increase of 420 examinations (+20%, p = 0.01), with a complete recovery of salivary cortisol measurement (considering 2019: p = 0.71). Major differences were observed between morning salivary cortisol (-20%, p = 0.017), LNSC (-21%, p = 0.012) and salivary cortisol rhythm (-22%, p = 0.056). No Sars-Cov2 infections related to working exposure were reported among laboratory's employers.

Conclusions: We speculate that the adoption of an appropriate technique to inactivate viral particles in saliva specimens allowed the safety maintenance of salivary collections, also during the Sars-CoV-2 outbreak.

Keywords: COVID-19; Cortisone; Cushing; Pandemic; Salivary cortisol; Sars-Cov2.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot with Passing Bablok regression. Regression line (black) with confidence intervals (dotted) and line of best fit (gray) between standard procedure and heat inactivation addition for sF (A: y = 1.01x − 0.04) and for sE (B: y = 1.01x-0.33)
Fig. 2
Fig. 2
Total number of salivary cortisol assessments sorted by year from 2013
Fig. 3
Fig. 3
Distribution of salivary cortisol examination in the years 2019, 2020 and 2021
See this image and copyright information in PMC

References

    1. Carrasco CA, Coste J, Guignat L, et al. Midnight salivary cortisol determination for assessing the outcome of transsphenoidal surgery in Cushing’s disease. J. Clin. Endocrinol. Metab. 2008;93(12):4728–4734. doi: 10.1210/jc.2008-1171. - DOI - PubMed
    1. Fleseriu M, Auchus R, Bancos I, et al. Consensus on diagnosis and management of Cushing’s disease: a guideline update. Lancet Diabetes Endocrinol. 2021;9(12):847–875. doi: 10.1016/S2213-8587(21)00235-7. - DOI - PMC - PubMed
    1. Newell-Price J, Pivonello R, Tabarin A, et al. Use of late-night salivary cortisol to monitor response to medical treatment in Cushing’s disease. Eur. J. Endocrinol. 2020;182(2):207–217. doi: 10.1530/EJE-19-0695. - DOI - PMC - PubMed
    1. S.R. Bornstein, B. Allolio, W. Arlt et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab Published online (2016). 10.1210/jc.2015-1710 - PMC - PubMed
    1. Ceccato F, Scaroni C. Central adrenal insufficiency: open issues regarding diagnosis and glucocorticoid treatment. Clin. Chem. Lab Med. 2019;57(8):1125–1135. doi: 10.1515/cclm-2018-0824. - DOI - PubMed