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Imbalanced salivary electrolytes, COVID-19 severity, and dysgeusia

  • Hanadi Abdullah Alwafi1
  • Soad Shaker Ali2,3
  • Sunil Babu Kotha1,4,*,
  • Layla Waleed Abuljadayel5
  • Maha Ibrahim6
  • Ibrahim Rashad Noor Elahi7
  • Hebah Abdullah Alwafi8
  • Matthew D. Finkelman9
  • Nagla A. El-Shitany10,11,*,

1Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, 11681 Riyadh, Saudi Arabia

2Department of Histology and cell biology, Faculty of Medicine, Assiut University, 71515 Assiut, Egypt

3Department of Histology, Faculty of Medicine, Merit University, 82755 Sohag, Egypt

4Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), 4420004 Maharashtra, India

5Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, 21589 Jeddah, Saudi Arabia

6Department of Hematology, MSF for medical research and development, 22234 Jeddah, Saudi Arabia

7Consultant of Preventive Medicine and Public Health, Department of Public Health, Directorate of Health Affairs, 22230 Jeddah, Saudi Arabia

8General surgery resident, Security force hospital, 34628 Dammam, Saudi Arabia

9Division of Biostatistics and Experimental Design, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts 02111, USA

10Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, 31527 Tanta, Egypt

11Yousef Abdullatif Jameel Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, 21589 Jeddah, Saudi Arabia

DOI: 10.22514/sv.2023.005

Submitted: 04 August 2022 Accepted: 28 October 2022

Online publish date: 18 January 2023

*Corresponding Author(s): Sunil Babu Kotha E-mail:
*Corresponding Author(s): Nagla A. El-Shitany E-mail:


Early studies of patients who progressed to severe coronavirus disease 2019 (COVID-19) reported various serum electrolyte disturbances. Hyposalivation and dysgeusia are two of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection oral symptoms. This study investigated how SARS-CoV-2 infection affects saliva volume, pH, zinc, and inorganic components (sodium, potassium, calcium). The association between these salivary properties and dysgeusia was also investigated in patients with mild and severe COVID-19. Saliva volume, pH, zinc, sodium, potassium, and calcium were measured in 142 healthy persons (control) and 158 COVID-19 patients (72 mild and 86 severe). This study showed that saliva volume, pH, zinc, sodium, potassium, and calcium levels reduced dramatically during COVID-19. Likewise, these saliva characteristics were significantly lower in severe COVID-19 individuals than in mild COVID-19 cases. In addition, there was no correlation between dysgeusia and salivary composition, volume, or pH. All salivary indicators were reduced in the COVID-19 group reporting the loss of taste and smell and the group who perceived neither. These data suggested that COVID-19 is associated with many salivary abnormalities, including hyposalivation, decreased pH, and electrolyte imbalances. These were more pronounced in severe COVID-19 cases. According to the current study, saliva characteristics could be utilized for early diagnosis, quarantine, and therapy in COVID-19 patients. As a result, the virus transmission can be stopped, and the optimum therapeutic results might be obtained. COVID-19-associated dysgeusia was unrelated to the reduction of these changes.


COVID-19; Saliva; Electrolytes; Dysgeusia; Zinc; pH; Volume; Severity

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Hanadi Abdullah Alwafi,Soad Shaker Ali,Sunil Babu Kotha,Layla Waleed Abuljadayel,Maha Ibrahim,Ibrahim Rashad Noor Elahi,Hebah Abdullah Alwafi,Matthew D. Finkelman,Nagla A. El-Shitany. Imbalanced salivary electrolytes, COVID-19 severity, and dysgeusia. Signa Vitae. 2023.doi:10.22514/sv.2023.005.


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