Cytopathology of Saliva in COVID-19 Patients: Preliminary Study on Five Patients of COVID-19

BACKGROUND: Coronavirus disease (COVID-19) is caused by a SARS-CoV-2 virus. The virus is currently known to possess single-stranded and positive-sense RNA genomes. The replication of this virus does not occur in the nucleus but in the cytoplasm of the host cell. This rapid replication can lead to impairment of host cell. Without cytoplasm, the host cell will lose its shape and may be damaged. AIM: This study aims to find out the histopathology of exfoliated epithelial cells in saliva of COVID-19 patients. METHODS: This was an observational study with a laboratory-based cross-sectional design. The specimens of saliva were collected from five positive people of COVID-19 and four people as negative controls of COVID-19. The determination of positive and negative infections of COVID-19 was based on the results of the real-time reverse transcription–polymerase chain reaction on nasopharyngeal swabs, oropharyngeal swabs, and sputum. The cytopathology of saliva was examined by Smear test and it was then stained by Papanicolaou method. The morphology of exfoliative epithelial cells in saliva was observed using a light microscope with magnification of ×10 and ×40. The damage of epithelial cells was observed from the integrity of the epithelial cell membrane and the shape of the damaged epithelial cells. In addition to morphologic findings, the number of cells with no nucleus was also calculated. RESULTS: From five samples of saliva from patients of positive COVID-19, microscopically the membrane of epithelial cells was intact and the contents of the cells were scattered about. The damaged epithelial cells with nuclei were in place, which were also found, but the morphology was not normal. More cells without nuclei were frequently observed in the saliva of COVID-19 patients. CONCLUSION: The damage to membrane and organelles of epithelial cells was found in the saliva of COVID-19 patients.