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Sasso-Cerri E, Martinelli VD, de Oliveira SA, da Silva AAS, de Moraes JCG, Cerri PS. Submandibular Gland Pathogenesis Following SARS-CoV-2 Infection and Implications for Xerostomia. Int J Mol Sci 2024; 25:6820. [PMID: 38999930 PMCID: PMC11241347 DOI: 10.3390/ijms25136820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/10/2024] [Accepted: 06/15/2024] [Indexed: 07/14/2024] Open
Abstract
Although SARS-CoV-2 induces mucin hypersecretion in the respiratory tract, hyposalivation/xerostomia has been reported by COVID-19 patients. We evaluate the submandibular gland (SMGs) pathogenesis in SARS-CoV-2-infected K18-hACE2 mice, focusing on the impact of infection on the mucin production and structural integrity of acini, ductal system, myoepithelial cells (MECs) and telocytes. The spike protein, the nucleocapsid protein, hACE2, actin, EGF, TNF-α and IL-1β were detected by immunofluorescence, and the Egfr and Muc5b expression was evaluated. In the infected animals, significant acinar hypertrophy was observed in contrast to ductal atrophy. Nucleocapsid proteins and/or viral particles were detected in the SMG cells, mainly in the nuclear membrane-derived vesicles, confirming the nuclear role in the viral formation. The acinar cells showed intense TNF-α and IL-1β immunoexpression, and the EGF-EGFR signaling increased, together with Muc5b upregulation. This finding explains mucin hypersecretion and acinar hypertrophy, which compress the ducts. Dying MECs and actin reduction were also observed, indicating failure of contraction and acinar support, favoring acinar hypertrophy. Viral assembly was found in the dying telocytes, pointing to these intercommunicating cells as viral transmitters in SMGs. Therefore, EGF-EGFR-induced mucin hypersecretion was triggered by SARS-CoV-2 in acinar cells, likely mediated by cytokines. The damage to telocytes and MECs may have favored the acinar hypertrophy, leading to ductal obstruction, explaining xerostomia in COVID-19 patients. Thus, acinar cells, telocytes and MECs may be viral targets, which favor replication and cell-to-cell viral transmission in the SMG, corroborating the high viral load in saliva of infected individuals.
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Affiliation(s)
- Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School–São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (V.D.M.); (J.C.G.d.M.)
| | - Vitor Dallacqua Martinelli
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School–São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (V.D.M.); (J.C.G.d.M.)
| | - Salmo Azambuja de Oliveira
- Department of Morphology and Genetics, Federal University of São Paulo, São Paulo 04023-900, Brazil; (S.A.d.O.); (A.A.S.d.S.)
| | - André Acácio Souza da Silva
- Department of Morphology and Genetics, Federal University of São Paulo, São Paulo 04023-900, Brazil; (S.A.d.O.); (A.A.S.d.S.)
| | - Juliana Cerini Grassi de Moraes
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School–São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (V.D.M.); (J.C.G.d.M.)
| | - Paulo Sérgio Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School–São Paulo State University (UNESP), Araraquara 14801-903, Brazil; (V.D.M.); (J.C.G.d.M.)
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Castilho NL, Martelli DRB, Machado RA, Cunha ZA, dos Reis C, Queiroz PR, de Sá Silva D, Oliveira EA, Coletta RD, Martelli-Júnior H. Frequency of Oral Lesions, Olfactory, and Gustatory Disorders and Xerostomia in Patients with COVID-19. Dent J (Basel) 2024; 12:179. [PMID: 38920880 PMCID: PMC11203208 DOI: 10.3390/dj12060179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/18/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
COVID-19, a respiratory illness with a global impact on millions, has recently been linked to manifestations affecting various bodily systems, including the oral cavity. Studies highlight oral issues, like ulcers, blisters, and white patches, alongside olfactory and gustatory dysfunction, influencing an individual's quality of life. In this context, our study aimed to assess the frequency of oral lesions, olfactory and gustatory disorders, and xerostomia resulting from COVID-19. An observational study was conducted with 414 patients to evaluate the frequency of oral symptoms resulting from COVID-19. Patients were diagnosed with mild symptoms and evaluated through clinical examination of the oral cavity and a questionnaire to assess functional alterations. The findings showed that 139 out of 414 patients presented clinical manifestations, with oral lesions being the most prevalent (19.1%), followed by gustatory disorders (18.1%), xerostomia (14.2%), and olfactory dysfunction (14%). The most prevalent oral lesions were ulcerations (n = 51), candidiasis (n = 8), and erythema or red plaques (n = 7). Unfortunately, 50 (12.1%) patients died during this study. Therefore, oral lesions, olfactory and gustatory dysfunctions, and xerostomia are common symptoms associated with COVID-19.
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Affiliation(s)
- Natália Lopes Castilho
- Health Science/Primary Care Postgraduate Program, State University of Montes Claros (UNIMONTES), Montes Claros 39400-000, Brazil; (N.L.C.); (Z.A.C.)
| | - Daniella R. Barbosa Martelli
- Health Science/Primary Care Postgraduate Program, Department of Oral Medicine and Oral Pathology, Dental School, State University of Montes Claros (UNIMONTES), Montes Claros 39400-000, Brazil; (D.R.B.M.); (H.M.-J.)
| | - Renato Assis Machado
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-018, Brazil;
| | - Zêus Araujo Cunha
- Health Science/Primary Care Postgraduate Program, State University of Montes Claros (UNIMONTES), Montes Claros 39400-000, Brazil; (N.L.C.); (Z.A.C.)
| | - Claudiojanes dos Reis
- Mário Ribeiro Clinical Hospital, School of Medicine, Funorte University Center, Montes Claros 39401-222, Brazil; (C.d.R.); (P.R.Q.); (D.d.S.S.)
| | - Priscila Regina Queiroz
- Mário Ribeiro Clinical Hospital, School of Medicine, Funorte University Center, Montes Claros 39401-222, Brazil; (C.d.R.); (P.R.Q.); (D.d.S.S.)
| | - Dayane de Sá Silva
- Mário Ribeiro Clinical Hospital, School of Medicine, Funorte University Center, Montes Claros 39401-222, Brazil; (C.d.R.); (P.R.Q.); (D.d.S.S.)
| | - Eduardo Araujo Oliveira
- Health Sciences Postgraduate Program, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte 30310-580, Brazil;
- Department of Pediatrics, Rady Children’s Hospital, University of California, San Diego, CA 92093, USA
| | - Ricardo D. Coletta
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-018, Brazil;
| | - Hercílio Martelli-Júnior
- Health Science/Primary Care Postgraduate Program, Department of Oral Medicine and Oral Pathology, Dental School, State University of Montes Claros (UNIMONTES), Montes Claros 39400-000, Brazil; (D.R.B.M.); (H.M.-J.)
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Alkharobi HE. Oral symptoms potentially associated with mild-to-moderate COVID-19 in tobacco users. Tob Induc Dis 2024; 22:TID-22-75. [PMID: 38742218 PMCID: PMC11089344 DOI: 10.18332/tid/186531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Coronavirus disease (COVID-19) is a worldwide infection characterized by various symptoms. Few studies have examined its oral manifestations. However, there is insufficient information on the oral manifestations of patients with COVID-19 who use tobacco products. Therefore, this cross-sectional study investigated oral symptoms of tobacco-using patients with mild-to-moderate COVID-19. METHODS This study used a convenience sample of non-hospitalized patients (aged ≥18 years) with mild-to-moderate COVID-19 diagnosed by polymerized chain reaction (PCR). This study excluded pregnant or lactating women or patients with serious COVID-19 complications, including those who required hospitalization or were on specific medications (antiviral, corticosteroid, antimicrobial, or immunosuppressive). Oral examinations were performed, including labial, buccal, and gingival mucosa, tongue, floor of the mouth, and palate, for any newly developed lesions associated with the onset of COVID-19. The salivary flow was determined using the passive drool collection technique. RESULTS Lip dryness, gingivitis, tongue lesions, and taste loss were the most commonly reported oral symptoms in patients with mild-to-moderate COVID-19. The most common general symptoms were tiredness and headache (63.9%), followed by dry cough, myalgia, sore throat, and fever. This study found 139 occurrences of oral symptoms, of which 52 were dry lips (27 tobacco non-users, and 25 tobacco users), and 11 were gingivitis (five non-users, and six tobacco users), and 12 tongue changes (eight non-users, and four tobacco users). Ageusia, or loss of taste sensation, was most commonly reported with or without other oral COVID-19 symptoms (55 occurrences: 36 non-users and 19 tobacco users). No significant differences were found in oral symptoms between tobacco non-users and tobacco users. CONCLUSIONS There is a need to expand the routine examination protocol for patients during future respiratory pandemics, as monitoring oral health allows dentists to improve the management of oral sequelae during a pandemic.
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Affiliation(s)
- Hanaa E. Alkharobi
- Department of Oral Biology, College of Dentistry, King Abdul-Aziz University, Jeddah, Saudi Arabia
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Kritika S, Mahalaxmi S, Srinivasan N, Krithikadatta J. Deciphering the role of Saliva in COVID 19: A global cross-sectional study on the knowledge, awareness and perception among dentists. BMC Oral Health 2023; 23:424. [PMID: 37365550 DOI: 10.1186/s12903-023-03152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVES The global pandemic outbreak of the coronavirus has instilled the quest amongst researchers on the expedited need for the early detection of viral load. Saliva is a complex oral biological fluid which not only causes the disease transmission but can be an effective alternative sample for detection of SARS-CoV2. This provides an ideal opportunity for dentists to be the frontline healthcare professionals who can collect the salivary samples; however the awareness of this amongst dentists is uncertain. Hence the aim of this survey was to evaluate the knowledge, perception and awareness of the role of saliva in detecting the SARS-CoV2 among dentists worldwide. METHODS The online questionnaire comprising of 19 questions was shared to 1100 dentists worldwide and a total of 720 responses was collected. The data was tabulated, statistically analysed using the non- parametric Kruskal-Wallis test (p < 0.05). Based on the principal component analysis, 4 components (knowledge about virus transmission, perception about SARS-CoV2 virus, awareness on the sample collection and knowledge about prevention of the virus) were obtained which was compared with the 3 independent variables (years of clinical experience, occupation and region). RESULTS A statistically significant difference was observed in the awareness quotient amongst the dentists with 0-5 years and greater than 20 years of clinical experience. In terms of the occupation, a significant difference was noted when comparing the postgraduate students to practitioners knowledge about the virus transmission. A highly significant difference was seen on comparing academicians and postgraduate students and also between academicians and practitioners. No significant difference was evidenced amongst the different regions, however the mean score was in the range of 3-3.44. CONCLUSION This survey highlights the deficiency in the knowledge, perception and awareness among dentists worldwide.
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Affiliation(s)
- Selvakumar Kritika
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Ramapuram, SRM Institute of Science & Technology, Ramapuram Campus, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, 600089, India.
| | - Sekar Mahalaxmi
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Ramapuram, SRM Institute of Science & Technology, Ramapuram Campus, Bharathi Salai, Ramapuram, Chennai, Tamil Nadu, 600089, India
| | - N Srinivasan
- Specialist Endodontist, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
| | - Jogikalmat Krithikadatta
- Department of Cariology and Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, 600077, India
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Tsuchiya H. Treatments of COVID-19-Associated Taste and Saliva Secretory Disorders. Dent J (Basel) 2023; 11:140. [PMID: 37366663 DOI: 10.3390/dj11060140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, treating taste and saliva secretory disorders associated with coronavirus disease 2019 (COVID-19) has become a critical issue. The aim of the present study was to update information on treatments applicable to such oral symptoms and discuss their pathogenic mechanisms. The literature search indicated that different treatments using tetracycline, corticosteroids, zinc, stellate ganglion block, phytochemical curcumin, traditional herbal medicine, nutraceutical vitamin D, photobiomodulation, antiviral drugs, malic acid sialagogue, chewing gum, acupuncture, and/or moxibustion have potential effects on COVID-19-associated ageusia/dysgeusia/hypogeusia and xerostomia/dry mouth/hyposalivation. These treatments have multiple modes of action on viral cellular entry and replication, cell proliferation and differentiation, immunity, and/or SARS-CoV-2 infection-induced pathological conditions such as inflammation, cytokine storm, pyroptosis, neuropathy, zinc dyshomeostasis, and dysautonomia. An understanding of currently available treatment options is required for dental professionals because they may treat patients who were infected with SARS-CoV-2 or who recovered from COVID-19, and become aware of their abnormal taste and salivary secretion. By doing so, dentists and dental hygienists could play a crucial role in managing COVID-19 oral symptoms and contribute to improving the oral health-related quality of life of the relevant patients.
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Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu 501-0296, Japan
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Hussein RR, Ahmed E, Abou-Bakr A, El-Gawish AA, Ras ABE, Ghalwash DM. Oral Changes in Hospitalized COVID-19 Patients: A Cross-Sectional Multicentric Study. Int J Dent 2023; 2023:3002034. [PMID: 37223395 PMCID: PMC10202601 DOI: 10.1155/2023/3002034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 05/25/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has rapidly spread over the globe, and several oral symptoms have been documented. However, it is unclear whether these lesions are the result of coronavirus infection or are secondary symptoms of the patient's systemic illness. The aim of this study was to collect data from various hospitals on COVID-19 patients with oral involvement in order to highlight different oral changes that may be manifested in those patients. Methods This observational cross-sectional multicenter study used an online questionnaire covering oral signs and symptoms that were believed to be related to COVID-19 patients who were hospitalized in different hospitals in Egypt. Results 94.3% of the 210 patients who participated in the current study developed oral symptoms. Altered taste sensation (56.2%), burning sensation (43.3%), and oral candidiasis (40%) were the most prevalent oral symptoms (34.4%) that were found in the studied sample. Conclusions COVID-19 has a major influence on the oral cavity, with numerous oral symptoms that may impair quality of life. Thus, considering the need for support, pain control, and management for a better prognosis, the clinical dental evaluation of hospitalized patients with infectious diseases like COVID-19 should be addressed.
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Affiliation(s)
- Radwa R. Hussein
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Enji Ahmed
- Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Giza, Egypt
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Asmaa Abou-Bakr
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Ayman A. El-Gawish
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Abou-Bakr E. Ras
- Otolaryngology Department, Faculty of Medicine, Benha University, Qalyoubya, Egypt
| | - Dalia M. Ghalwash
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
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Saleem MK, Lal A, Ahmed N, Abbasi MS, Vohra F, Abduljabbar T. Oral health related quality of life and the prevalence of ageusia and xerostomia in active and recovered COVID-19 Patients. PeerJ 2023; 11:e14860. [PMID: 36908817 PMCID: PMC9997189 DOI: 10.7717/peerj.14860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background Salivary disturbance is associated with patients who either have an active coronavirus disease 2019 (COVID-19) or have recovered from coronavirus infection along with loss of taste sensation. In addition, COVID-19 infection can drastically compromise quality of life of individuals. Objective This study aimed to analyze xerostomia, ageusia and the oral health impact in coronavirus disease-19 patients utilizing the Xerostomia Inventory scale-(XI) and the Oral Health Impact Profile-14. Methods In this cross-sectional survey-based study, data was collected from 301 patients who suffered and recovered from COVID-19. Using Google Forms, a questionnaire was developed and circulated amongst those who were infected and recovered from coronavirus infection. The Xerostomia Inventory (XI) and Oral Health Impact Profile-14 were used to assess the degree and quality of life. A paired T-test and Chi-square test were used to analyze the effect on xerostomia inventory scale-(XI) and OHIP-14 scale scores. A p-value of 0.05 was considered as statistically significant. Results Among 301 participants, 54.8% were females. The prevalence of xerostomia in participants with active COVID-19 disease was 39.53% and after recovery 34.88%. The total OHIP-14 scores for patients in the active phase of infection was 12.09, while 12.68 in recovered patients. A significant difference was found between the mean scores of the xerostomia inventory scale-11 and OHIP-14 in active and recovered COVID patients. Conclusion A higher prevalence of xerostomia was found in COVID-19 infected patients (39.53%) compared to recovered patients (34.88%). In addition, more than 70% reported aguesia. COVID-19 had a significantly higher compromising impact on oral function of active infected patients compared to recovered patients.
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Affiliation(s)
- Mahnoor K.M. Saleem
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Abhishek Lal
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Naseer Ahmed
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
- Prosthodontics Department, University Sains Malaysia, Kelantan, Malaysia
| | - Maria S. Abbasi
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Fahim Vohra
- Prosthetic Dental Sceinces, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Prosthetic Dental Sceinces, King Saud University, Riyadh, Saudi Arabia
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Lin W, Gao F, Wang X, Qin N, Chen X, Tam KY, Zhang C, Zhang M, Sha O. The oral manifestations and related mechanisms of COVID-19 caused by SARS-CoV-2 infection. Front Cell Neurosci 2023; 16:1006977. [PMID: 36687524 PMCID: PMC9846147 DOI: 10.3389/fncel.2022.1006977] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) was reported to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and patients present mostly with respiratory symptoms. There have been an increasing number of reports on oral manifestations, and some of these signs are informative in terms of identifying SARS-CoV-2 infection. The goal of present study was to review and synthesize the clinical characteristics and underlying mechanisms of COVID-19 oral manifestations, as well as to evaluate the factors influencing SARS-CoV-2 infectivity, in order to conduct further in-depth investigations and help clinicians diagnose COVID-19 patients exhibiting oral symptoms.
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Affiliation(s)
- Weiming Lin
- Shenzhen University Medical School, Shenzhen, China
| | - Feng Gao
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China
| | - Xia Wang
- Shenzhen University Medical School, Shenzhen, China
| | - Nianhong Qin
- Shenzhen University Medical School, Shenzhen, China
| | - Xianxiong Chen
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China
| | - Kin Yip Tam
- Faculty of Health Sciences, University of Macau, Macau, Macau SAR, China
| | - Chengfei Zhang
- Shenzhen University Medical School, Shenzhen, China,School of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mingxia Zhang
- The Third People’s Hospital of Shenzhen, Shenzhen, China,Mingxia Zhang,
| | - Ou Sha
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China,*Correspondence: Ou Sha,
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Shang YF, Shen YY, Zhang MC, Lv MC, Wang TY, Chen XQ, Lin J. Progress in salivary glands: Endocrine glands with immune functions. Front Endocrinol (Lausanne) 2023; 14:1061235. [PMID: 36817607 PMCID: PMC9935576 DOI: 10.3389/fendo.2023.1061235] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
The production and secretion of saliva is an essential function of the salivary glands. Saliva is a complicated liquid with different functions, including moistening, digestion, mineralization, lubrication, and mucosal protection. This review focuses on the mechanism and neural regulation of salivary secretion, and saliva is secreted in response to various stimuli, including odor, taste, vision, and mastication. The chemical and physical properties of saliva change dynamically during physiological and pathophysiological processes. Moreover, the central nervous system modulates salivary secretion and function via various neurotransmitters and neuroreceptors. Smell, vision, and taste have been investigated for the connection between salivation and brain function. The immune and endocrine functions of the salivary glands have been explored recently. Salivary glands play an essential role in innate and adaptive immunity and protection. Various immune cells such as B cells, T cells, macrophages, and dendritic cells, as well as immunoglobins like IgA and IgG have been found in salivary glands. Evidence supports the synthesis of corticosterone, testosterone, and melatonin in salivary glands. Saliva contains many potential biomarkers derived from epithelial cells, gingival crevicular fluid, and serum. High level of matrix metalloproteinases and cytokines are potential markers for oral carcinoma, infectious disease in the oral cavity, and systemic disease. Further research is required to monitor and predict potential salivary biomarkers for health and disease in clinical practice and precision medicine.
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Affiliation(s)
- Yu Feng Shang
- Department of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang University School of Stomatology, Hangzhou, China
| | - Yi Yang Shen
- Department of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang University School of Stomatology, Hangzhou, China
| | - Meng Chen Zhang
- National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| | - Min Chao Lv
- Department of Orthopedics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Tong Ying Wang
- National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
- Department of Neurobiology, Department of Neurology of the Second Affiliated Hospital, School of Brain Science and Brain Medicine, Hangzhou, China
| | - Xue Qun Chen
- National Health Commission and Chinese Academy of Medical Sciences Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
- Department of Neurobiology, Department of Neurology of the Second Affiliated Hospital, School of Brain Science and Brain Medicine, Hangzhou, China
| | - Jun Lin
- Department of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang University School of Stomatology, Hangzhou, China
- *Correspondence: Jun Lin,
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Maegawa K, Nishioka H. COVID-19-associated parotitis and sublingual gland sialadenitis. BMJ Case Rep 2022; 15:15/12/e251730. [PMID: 36535731 PMCID: PMC9764613 DOI: 10.1136/bcr-2022-251730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 mainly affects the respiratory system; however, a variety of atypical manifestations of this disease have been also reported. Herein, we report a case of a man in his late 50s with severe COVID-19 presenting with parotitis and sublingual gland sialadenitis. Six days after admission, swelling in the bilateral preauricular and lower jaw areas developed. CT demonstrated parotid and sublingual gland enlargement with surrounding fat stranding, indicating sialadenitis. This case suggests that, in the present COVID-19 pandemic, COVID-19 should be included in the differential diagnosis of sialadenitis and prompt isolation should be considered to reduce the spread of infection.
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Affiliation(s)
- Kazuki Maegawa
- General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hiroaki Nishioka
- General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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Gutierrez-Camacho JR, Avila-Carrasco L, Martinez-Vazquez MC, Garza-Veloz I, Zorrilla-Alfaro SM, Gutierrez-Camacho V, Martinez-Fierro ML. Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11383. [PMID: 36141654 PMCID: PMC9517300 DOI: 10.3390/ijerph191811383] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Some oral lesions have been described in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the possibility has been raised that the buccal lesions observed in patients with the coronavirus disease 2019 (COVID-19) are due to this virus and the patient's systemic condition. The aim of this review was to integrate the knowledge related to the oral lesions associated with COVID-19 and the participation of the buccal cavity in the establishment of immunity against SARS-CoV-2. METHODS A literature search on the manifestations of buccal lesions from the beginning of the pandemic until October 2021 was carried out by using the PubMed database. A total of 157 scientific articles were selected from the library, which included case reports and reports of lesions appearing in patients with COVID-19. RESULTS Oral lesions included erosions, ulcers, vesicles, pustules, plaques, depapillated tongue, and pigmentations, among others. The oral cavity is a conducive environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, immunodeficiencies, and autoimmunity primarily. CONCLUSIONS The oral cavity is an accessible and privileged environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; the direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, in particular those related to immunodeficiencies and autoimmunity.
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12
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Hao M, Wang D, Xia Q, Kan S, Chang L, Liu H, Yang Z, Liu W. Pathogenic Mechanism and Multi-omics Analysis of Oral Manifestations in COVID-19. Front Immunol 2022; 13:879792. [PMID: 35860279 PMCID: PMC9290522 DOI: 10.3389/fimmu.2022.879792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease that seriously threatens human life. The clinical manifestations of severe COVID-19 include acute respiratory distress syndrome and multiple organ failure. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of COVID-19, spreads through contaminated droplets. SARS-CoV-2 particles have been detected in the saliva of COVID-19 patients, implying that the virus can infect and damage the oral cavity. The oral manifestations of COVID-19 include xerostomia and gustatory dysfunction. Numerous studies showed that the four structural proteins of SARS-CoV-2 are its potential pathogenic factors, especially the S protein, which binds to human ACE2 receptors facilitating the entry of the virus into the host cells. Usually, upon entry into the host cell, a pathogen triggers the host’s immune response. However, a mount of multi-omics and immunological analyses revealed that COVID-19 is caused by immune dysregulation. A decrease in the number and phenotypes of immune cells, IFN-1 production and excessive release of certain cytokines have also been reported. In conclusion, this review summarizes the oral manifestations of COVID-19 and multi-omics analysis of SARS-CoV-2 infection.
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Affiliation(s)
- Ming Hao
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Dongxu Wang
- Laboratory Animal Center, College of Animal Science, Jilin University, Changchun, China
| | - Qianyun Xia
- Laboratory Animal Center, College of Animal Science, Jilin University, Changchun, China
| | - Shaoning Kan
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Lu Chang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Huimin Liu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Zhijing Yang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - Weiwei Liu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
- *Correspondence: Weiwei Liu,
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13
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Irani S. Immune Responses in SARS-CoV-2, SARS-CoV, and MERS-CoV Infections: A Comparative Review. Int J Prev Med 2022; 13:45. [PMID: 35529506 PMCID: PMC9069147 DOI: 10.4103/ijpvm.ijpvm_429_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/21/2021] [Indexed: 12/04/2022] Open
Abstract
Coronavirus, discovered in the 1960s, is able to infect human hosts and causes mild to serious respiratory problems. In the last two decades, the severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been recognized. It has long been demonstrated that MERS-CoV binds to dipeptidyl peptidase 4 and SARS-CoV binds to angiotensin-converting enzyme 2. A "cytokine storm" is the main pathophysiology of aforementioned viruses. Infiltration of neutrophils at the site of the infection is a risk factor for the development of acute respiratory distress syndrome and death. The new coronavirus, SARS-CoV-2, has infected more people than SARS-Cov and MERS-CoV as it can easily be transmitted from person to person. Epidemiological studies indicate that majority of individuals are asymptomatic; therefore, an effective and an efficient tool is required for rapid testing. Identification of various cytokine and inflammatory factor expression levels can help in outcome prediction. In this study we reviewed immune responses in SARS-CoV, Mers-CoV, and SARS-COV-2 infections and the role of inflammatory cells.
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Affiliation(s)
- Soussan Irani
- Dental Research Centre, Oral Pathology Department, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
- Pathology Department of Faculty of Medicine, Griffith University, Gold Coast, Australia
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14
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Ember K, Daoust F, Mahfoud M, Dallaire F, Ahmad EZ, Tran T, Plante A, Diop MK, Nguyen T, St-Georges-Robillard A, Ksantini N, Lanthier J, Filiatrault A, Sheehy G, Beaudoin G, Quach C, Trudel D, Leblond F. Saliva-based detection of COVID-19 infection in a real-world setting using reagent-free Raman spectroscopy and machine learning. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:JBO-210270RR. [PMID: 35142113 PMCID: PMC8825664 DOI: 10.1117/1.jbo.27.2.025002] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/20/2022] [Indexed: 05/31/2023]
Abstract
SIGNIFICANCE The primary method of COVID-19 detection is reverse transcription polymerase chain reaction (RT-PCR) testing. PCR test sensitivity may decrease as more variants of concern arise and reagents may become less specific to the virus. AIM We aimed to develop a reagent-free way to detect COVID-19 in a real-world setting with minimal constraints on sample acquisition. The machine learning (ML) models involved could be frequently updated to include spectral information about variants without needing to develop new reagents. APPROACH We present a workflow for collecting, preparing, and imaging dried saliva supernatant droplets using a non-invasive, label-free technique-Raman spectroscopy-to detect changes in the molecular profile of saliva associated with COVID-19 infection. RESULTS We used an innovative multiple instance learning-based ML approach and droplet segmentation to analyze droplets. Amongst all confounding factors, we discriminated between COVID-positive and COVID-negative individuals yielding receiver operating coefficient curves with an area under curve (AUC) of 0.8 in both males (79% sensitivity and 75% specificity) and females (84% sensitivity and 64% specificity). Taking the sex of the saliva donor into account increased the AUC by 5%. CONCLUSION These findings may pave the way for new rapid Raman spectroscopic screening tools for COVID-19 and other infectious diseases.
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Affiliation(s)
- Katherine Ember
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - François Daoust
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Myriam Mahfoud
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Frédérick Dallaire
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Esmat Zamani Ahmad
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
- Institut du cancer de Montréal, Montreal, Canada
| | - Trang Tran
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Arthur Plante
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Mame-Kany Diop
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
- Institut du cancer de Montréal, Montreal, Canada
| | - Tien Nguyen
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
- Institut du cancer de Montréal, Montreal, Canada
| | - Amélie St-Georges-Robillard
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Nassim Ksantini
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Julie Lanthier
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Antoine Filiatrault
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Guillaume Sheehy
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Gabriel Beaudoin
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
| | - Caroline Quach
- Research Center, CHU Sainte-Justine, Montreal, Canada
- University of Montreal, Faculty of Medicine, Montreal, Quebec, Canada
| | - Dominique Trudel
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
- Institut du cancer de Montréal, Montreal, Canada
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
- Center Hospitalier de l’Université de Montréal, Department of Pathology, Montreal, Quebec, Canada
| | - Frédéric Leblond
- Polytechnique Montréal, Montreal, Canada
- Center de recherche du Center hospitalier de l’Université de Montréal, Montreal, Canada
- Institut du cancer de Montréal, Montreal, Canada
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15
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Endriyana J, Bachtiar E. Review of using saliva for COVID-19 testing. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_100_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Tsuchiya H. Characterization and Pathogenic Speculation of Xerostomia Associated with COVID-19: A Narrative Review. Dent J (Basel) 2021; 9:dj9110130. [PMID: 34821594 PMCID: PMC8625834 DOI: 10.3390/dj9110130] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022] Open
Abstract
Patients with coronavirus disease 2019 (COVID-19) have become known to present with different oral symptoms. However, xerostomia remains poorly recognized compared with taste dysfunction. For better understanding of COVID-19 symptomatology, xerostomia associated withCOVID-19 was characterized and its possible pathogenesis was speculated by a narrative literature review. Scientific articles were retrieved by searching PubMed, LitCovid, ProQuest, Google Scholar, medRxiv and bioRxiv from 1 April 2020 with a cutoff date of 30 September 2021. Results of the literature search indicated that xerostomia is one of prevalent and persistent oral symptoms associated with COVID-19. In contrast to taste dysfunction, the prevalence and persistence of xerostomia do not necessarily depend on ethnicity, age, gender and disease severity of patients. COVID-19 xerostomia is pathogenically related to viral cellular entry-relevant protein expression, renin-angiotensin system disturbance, salivary gland inflammation, zinc deficiency, cranial neuropathy, intercurrent taste dysfunction, comorbidities and medications. Despite a close association with COVID-19, xerostomia, dry mouth and hyposalivation tend to be overlooked unlike ageusia, dysgeusia and hypogeusia. Although mouth dryness per se is not life-threating, it has an impact on the oral health-related quality of life. More attention should be paid to xerostomia in COVID-19 patients and survivors.
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17
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Bobamuratova DT, Boymuradov SA, Dar-Odeh NS, Kurbanov YK, Umarov RZ. Impact of COVID-19 disease and its treatment on the development of maxillofacial complications. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [PMCID: PMC8434691 DOI: 10.1016/j.adoms.2021.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The novel coronavirus spread worldwide in 2020, causing millions of deaths and disabilities. Even though the virus was considered a respiratory virus, its adverse effects can be detected in several body systems. The article describes COVID-19 disease and its complications in the maxillofacial area. Several complications develop either in response to therapeutic modalities used to treat the underlying disease, or due to overuse of particular medications namely glucocorticoids, antirheumatic agents, interleukin 6-inhibitors, and antibiotics. This article will describe a number of complications ranging from mild complications to severe ones such as osteonecrosis of the upper jaw and facial bones, ophthalmologic and neurological complications. It will also summarize recommendations that will help prevent or minimize these complications.
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18
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El Kady DM, Gomaa EA, Abdella WS, Ashraf Hussien R, Abd ElAziz RH, Khater AGA. Oral manifestations of COVID-19 patients: An online survey of the Egyptian population. Clin Exp Dent Res 2021; 7:852-860. [PMID: 33931952 PMCID: PMC8239795 DOI: 10.1002/cre2.429] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This pilot survey aims to study the oral manifestations associated with COVID-19 infection and report the prevalence of oral signs and symptoms in COVID-19 patients. MATERIALS AND METHODS From May 15 to June 10, 2020, we used an online questionnaire containing the oral manifestations that are expected to be associated with the COVID-19 infection. Adults in our survey who have been diagnosed with COVID-19 positive were confirmed with reverse transcriptase PCR (RT-PCR), and isolated in various hospitals in Cairo, Egypt. RESULTS This pilot study included 58 (53.4% males and 46.6% females) COVID-19 patients ages 18-46 years, and 13 (22.4%) were healthcare workers. Our results showed that 67.2% of the patients had at least one manifestation related to the oral cavity and salivary glands, and 32.8% (n = 19) did not have any symptoms associated with the oral cavity. The highest prevalence symptoms were dry mouth 39.7% (n = 23), gustatory dysfunction as 34.5% (n = 20) loss of salt sensation, 29.3% (n = 17) loss of sweet sensation, and 25.9% (n = 15) altered food taste, while the least prevalent symptoms were tongue redness 8.8% (n = 5), and gingival bleeding 7% (n = 4). The most frequently associated symptoms were loss of salt and sweetness, as reported by 27.6% of the participants. However, there was no significant association between the incidence of oral symptoms and demographic data (age, gender, or job) of the patients (p > 0.05). CONCLUSIONS Based on limited data, COVID-19 significantly impacts the oral cavity and salivary glands, as salivary gland-related symptoms and taste disorders are highly prevalent in COVID-19 patients.
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19
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Zhu F, Zhong Y, Ji H, Ge R, Guo L, Song H, Wu H, Jiao P, Li S, Wang C, Du H. ACE2 and TMPRSS2 in human saliva can adsorb to the oral mucosal epithelium. J Anat 2021; 240:398-409. [PMID: 34590312 PMCID: PMC8662096 DOI: 10.1111/joa.13560] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 08/19/2021] [Accepted: 09/15/2021] [Indexed: 01/21/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is primarily transmitted through droplets. All human tissues with the angiotensin‐converting enzyme 2 (ACE2) and transmembrane protease serines 2 (TRMPRSS2) are potential targets of SARS‐CoV‐2. The role of saliva in SARS‐CoV‐2 transmission remains obscure. In this study, we attempted to reveal ACE2 and TRMPRSS2 protein expression in human parotid, submandibular, and sublingual glands (three major salivary glands). Then, the binding function of spike protein to ACE2 in three major salivary glands was detected. The expression of ACE2 and TMPRSS2 in human saliva from parotid glands were both examined. Exogenous recombined ACE2 and TMPRSS2 anchoring and fusing to oral mucosal epithelial cells in vitro were also unraveled. ACE2 and TMPRSS2 were found mainly to be expressed in the cytomembrane and cytoplasm of epithelial cells in the serous acinus cells in parotid and submandibular glands. Our research also discovered that the spike protein of SARS‐CoV‐2 binds to ACE2 in salivary glands in vitro. Furthermore, exogenous ACE2 and TMPRSS2 can anchor and fuse to oral mucosa in vitro. Thus, the expression of ACE2 and TMPRSS2 in human saliva might have implications for SARS‐CoV‐2 infection.
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Affiliation(s)
- Fucun Zhu
- Department of Pathology, Fuzhou Children's Hospital of Fujian Province, Fuzhou, Fujian Province, P.R. China
| | - Yi Zhong
- Department of General Dentistry, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Huan Ji
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Ran Ge
- Department of Nuclear Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, P.R. China
| | - Lu Guo
- Department of Pathology, Fuzhou Children's Hospital of Fujian Province, Fuzhou, Fujian Province, P.R. China
| | - Haiyang Song
- Department of General Dentistry, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Heming Wu
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Pengfei Jiao
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Sheng Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Chenxing Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Hongming Du
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.,Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
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20
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Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC. An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings? Int J Dermatol 2021; 61:278-290. [PMID: 34541674 PMCID: PMC8653326 DOI: 10.1111/ijd.15881] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/01/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
We conducted an integrative review on oral manifestations in patients with COVID‐19 based on the current available literature evidence. A bibliographic search was carried out on March 11, 2021, among published studies in the years 2019–2021 in the PubMed database and based on the search strategy (“COVID‐19” AND “oral lesions” OR “oral mucositis” OR “oral manifestation”). After applying the inclusion and exclusion criteria, 29 articles were considered suitable for this review. A total of 110 cases of patients with COVID‐19 who had oral manifestations were reported. The presence of ulcerated lesions was the most common finding, having a herpetiform and aphthous clinical pattern observed in most cases. Macules, petechiae, hemorrhagic blisters, pustular enanthem, mucositis, and halitosis were also among the most frequently described oral manifestations. The tongue was the most commonly affected site, followed by the palate and lip. Most of the reported cases were diagnosed only by the clinical aspect of the lesion associated with a positive SARS‐CoV‐2 test or the presence of other COVID‐19 symptoms. Current scientific evidence still could not affirm that most of the oral lesions observed in patients with COVID‐19 are related to the virus's direct or indirect action on the oral mucosa. To confirm this association, prospective and longitudinal studies are further needed, together with a larger number of patients, complemented by histopathological examination of these lesions. Additionally, molecular techniques, such as immunohistochemistry and in situ hybridization, may be necessary to perform the differential diagnosis with other oral lesions.
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Affiliation(s)
- Vanessa Paiva Reis
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Polyclinic of Cascadura (Policlínica da Polícia Militar de Cascadura), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Adriana Raymundo Bezerra
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Central Dental Clinic (Odontoclínica Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Adriane Batista Pires Maia
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Central Hospital (Hospital Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Letícia Côgo Marques
- Dentistry Sector, Healthcare and Social Assistance Section of The Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.,Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Danielle Castex Conde
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil.,Oral Maxillofacial Surgery and Traumatology Service and Anatomical Pathology Service, Military Police Central Hospital (Hospital Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
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21
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Omezli MM, Torul D. Evaluation of the xerostomia, taste and smell impairments after Covid-19. Med Oral Patol Oral Cir Bucal 2021; 26:e568-e575. [PMID: 33772565 PMCID: PMC8412452 DOI: 10.4317/medoral.24510] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/01/2021] [Indexed: 12/15/2022] Open
Abstract
Background The purpose of this study was to explore the effects of coronavirus disease 19 (Covid-19) on the oral cavity by evaluating the oral findings in the patients who recovered after treatment. Material and Methods This study involved confirmed Covid-19 patients whose treatment completed at least two weeks ago. A questionnaire consist of eight parts was applied to explore the oral findings after Covid-19. Also stimulated salivary flow rate was evaluated with a salivary flow test. Results 177 patients reached and 107 of them participate in the study. Regarding gender significant differences were found in terms of the presence of taste impairment after treatment (p=0.007), the degree of taste (p=0.021) and smell (p=0.010) impairment. 18 % (5/27) of the patients evaluated were showed hyposalivation. No significant differences were observed regarding salivary flow between males (mean±SD: 1.14±0.65) and females (mean±SD: 1.12±0.43), (p=0.928); among the patients having treatment at home (mean±SD: 1.03±0.48) or hospital (mean±SD: 1.33±0.65), (p=0.187). In some of the patients’ taste [15], smell [23] impairment, and xerostomia [43] still observed at least two weeks after the treatment is completed. Conclusions The most frequent finding in patients after the treatment was xerostomia. Taste and smell impairments were more frequently observed in females. Key words:Saliva, oral findings, hyposalivation, Covid-19.
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Affiliation(s)
- M-M Omezli
- Ordu University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Altınordu/Ordu, 52200, Turkey
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22
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Whale AS, von der Heide EK, Kohlenberg M, Brinckmann A, Baedker S, Karalay O, Fernandez-Gonzalez A, Busby EJ, Bustin SA, Hauser H, Missel A, O'Sullivan DM, Huggett JF, Pfaffl MW, Nolan T. Digital PCR can augment the interpretation of RT-qPCR Cq values for SARS-CoV-2 diagnostics. Methods 2021; 201:5-14. [PMID: 34454016 PMCID: PMC8387146 DOI: 10.1016/j.ymeth.2021.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 12/19/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious, acute respiratory disease caused mainly by person-to-person transmission of the coronavirus SARS-CoV-2. Its emergence has caused a world-wide acute health crisis, intensified by the challenge of reliably identifying individuals likely to transmit the disease. Diagnosis is hampered by the many unknowns surrounding this disease, including those relating to infectious viral burden. This uncertainty is exacerbated by disagreement surrounding the clinical relevance of molecular testing using reverse transcription quantitative PCR (RT-qPCR) for the presence of viral RNA, most often based on the reporting of quantification cycles (Cq), which is also termed the cycle threshold (Ct) or crossing point (Cp). Despite it being common knowledge that Cqs are relative values varying according to a wide range of different parameters, there have been efforts to use them as though they were absolute units, with Cqs below an arbitrarily determined value, deemed to signify a positive result and those above, a negative one. Our results investigated the effects of a range of common variables on Cq values. These data include a detailed analysis of the effect of different carrier molecules on RNA extraction. The impact of sample matrix of buccal swabs and saliva on RNA extraction efficiency was demonstrated in RT-qPCR and the impact of potentially inhibiting compounds in urine along with bile salts were investigated in RT-digital PCR (RT-dPCR). The latter studies were performed such that the impact on the RT step could be separated from the PCR step. In this way, the RT was shown to be more susceptible to inhibitors than the PCR. Together, these studies demonstrate that the consequent variability of test results makes subjective Cq cut-off values unsuitable for the identification of infectious individuals. We also discuss the importance of using reliable control materials for accurate quantification and highlight the substantial role played by dPCR as a method for their development.
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Affiliation(s)
- Alexandra S Whale
- National Measurement Laboratory, LGC, Queens Road, Teddington, Middlesex TW11 0LY, UK.
| | - Eva K von der Heide
- LGC Genomics GmbH, Research and Development, TGS Haus 8, Ostendstraße 25, 12459 Berlin, Germany.
| | - Max Kohlenberg
- LGC Genomics GmbH, Research and Development, TGS Haus 8, Ostendstraße 25, 12459 Berlin, Germany.
| | - Anja Brinckmann
- LGC Genomics GmbH, Research and Development, TGS Haus 8, Ostendstraße 25, 12459 Berlin, Germany.
| | - Silke Baedker
- QIAGEN GmbH, Research and Development, QIAGEN Strasse 1, 40724 Hilden, Germany.
| | - Oezlem Karalay
- QIAGEN GmbH, Research and Development, QIAGEN Strasse 1, 40724 Hilden, Germany.
| | | | - Eloise J Busby
- National Measurement Laboratory, LGC, Queens Road, Teddington, Middlesex TW11 0LY, UK.
| | - Stephen A Bustin
- Molecular Diagnostics Unit, Medical Technology Research Centre, Anglia Ruskin University, UK.
| | - Heiko Hauser
- LGC Genomics GmbH, Research and Development, TGS Haus 8, Ostendstraße 25, 12459 Berlin, Germany.
| | - Andreas Missel
- QIAGEN GmbH, Research and Development, QIAGEN Strasse 1, 40724 Hilden, Germany.
| | - Denise M O'Sullivan
- National Measurement Laboratory, LGC, Queens Road, Teddington, Middlesex TW11 0LY, UK.
| | - Jim F Huggett
- National Measurement Laboratory, LGC, Queens Road, Teddington, Middlesex TW11 0LY, UK; School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK.
| | - Michael W Pfaffl
- Division of Animal Physiology and Immunology, School of Life Sciences Weihenstephan, Technical University of Munich, Munich, Germany.
| | - Tania Nolan
- LGC Genomics GmbH, Research and Development, TGS Haus 8, Ostendstraße 25, 12459 Berlin, Germany; Molecular Diagnostics Unit, Medical Technology Research Centre, Anglia Ruskin University, UK.
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23
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Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca Canto G, Sugaya N, Santos-Silva AR, Guerra ENS. Oral Manifestations in Patients with COVID-19: A 6-Month Update. J Dent Res 2021; 100:1321-1329. [PMID: 34324825 DOI: 10.1177/00220345211029637] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This is the first update of the previously published living systematic review that summarized evidence on the prevalence of oral signs and symptoms in patients with COVID-19. Hitherto, 183 studies were included, reporting data from 64,876 patients with COVID-19 worldwide. The overall prevalence of taste disorders was 38% (95% CI = 22% to 56%, I2 = 98%). Hypogeusia, dysgeusia, and ageusia were also evaluated by a meta-analysis, and the pooled prevalence was 34% for hypogeusia, 33% for dysgeusia, and 26% for ageusia. Taste disorders were associated with a positive COVID-19 test (odds ratio [OR] = 7.54, 95% CI = 5.24 to 10.86, I2 = 93%, P < 0.00001), showing high certainty of evidence. However, the association between taste disorders and mild/moderate severity of COVID-19 (OR = 1.63, 95% CI = 1.33 to 1.99, I2 = 69%, P < 0.0001) and female patients with COVID-19 (OR = 1.77, 95% CI = 1.26 to 2.48, I2 = 79%, P = 0.001) presented low certainty of evidence. Xerostomia was a new feature of this update, and the pooled data demonstrated a prevalence of 43% (95% CI = 36% to 50%, I2 = 71%) in patients with COVID-19. Regarding oral mucosal lesions, the most common clinical pattern was aphthous like, followed by herpes-like lesions, candidiasis, glossitis/depapillation/geographic tongue, parotitis, and angular cheilitis. Oral lesions were more frequent in the tongue, lips, and palate, presenting miscellaneous clinical aspects that are more likely to represent coinfections. Therefore, the reanalysis of current evidence suggests the triad xerostomia, taste dysfunction, and oral mucosal lesions as common manifestations in patients with COVID-19. However, these outcomes are under discussion, and more studies will be necessary to confirm their association with direct SARS-CoV-2 infection in the oral cavity.
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Affiliation(s)
- J Amorim Dos Santos
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - A G C Normando
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil.,Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - R L Carvalho da Silva
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - A C Acevedo
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - G De Luca Canto
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - N Sugaya
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - A R Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - E N S Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
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24
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Optimization and Standardization of Human Saliva Collection for MALDI-TOF MS. Diagnostics (Basel) 2021; 11:diagnostics11081304. [PMID: 34441239 PMCID: PMC8392517 DOI: 10.3390/diagnostics11081304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 12/14/2022] Open
Abstract
SARS-CoV-2 outbreak led to unprecedented innovative scientific research to preclude the virus dissemination and limit its impact on life expectancy. Waiting for the collective immunity by vaccination, mass-testing, and isolation of positive cases remain essential. The development of a diagnosis method requiring a simple and non-invasive sampling with a quick and low-cost approach is on demand. We hypothesized that the combination of saliva specimens with MALDI-TOF MS profiling analyses could be the winning duo. Before characterizing MS saliva signatures associated with SARS-CoV-2 infection, optimization and standardization of sample collection, preparation and storage up to MS analyses appeared compulsory. In this view, successive experiments were performed on saliva from healthy healthcare workers. Specimen sampling with a roll cotton of Salivette® devices appeared the most appropriate collection mode. Saliva protein precipitation with organic buffers did not improved MS spectra profiles compared to a direct loading of samples mixed with acetonitrile/formic acid buffer onto MS plate. The assessment of sample storage conditions and duration revealed that saliva should be stored on ice until MS analysis, which should occur on the day of sampling. Kinetic collection of saliva highlighted reproducibility of saliva MS profiles over four successive days and also at two-week intervals. The intra-individual stability of saliva MS profiles should be a key factor in the future investigation for biomarkers associated with SARS-CoV-2 infection. However, the singularity of MS profiles between individuals will require the development of sophisticated bio-statistical analyses such as machine learning approaches. MALDI-TOF MS profiling of saliva could be a promising PCR-free tool for SARS-CoV-2 screening.
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25
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Surboyo MD, Ernawati DS, Budi HS. Oral mucosal lesions and oral symptoms of the SARS-CoV-2 infection. Minerva Dent Oral Sci 2021; 70:161-168. [PMID: 34269548 DOI: 10.23736/s2724-6329.21.04493-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION SARS-CoV-2 develops well in the oral mucosa because, it is the first contact area with the virus. The oral mucosa is highly expressed with angiotensin-converting enzyme 2 (ACE2) and makes the virus replicated in the epithelial cells and produce both oral lesions and oral symptoms. This review aimed to describe the oral mucosal symptoms and lesions related to SARS-CoV-2-infected patients that have been reported around the world. EVIDENCE ACQUISITION A literature search was performed on PubMed, ScienceDirect and Google Scholar, from February to October 5, 2020, focusing on COVID-19 (SARS-CoV-2) oral lesions and oral symptoms. EVIDENCE SYNTHESIS Eighteen studies were identified with a total of 25 cases describing the oral symptoms and oral mucosal lesions of the SARS-CoV-2 infection. The oral symptoms related to the SARS-CoV-2 infection included dysgeusia, ageusia, a burning mouth sensation, a dry mouth and severe halitosis. The oral mucosal lesions varied from ulceration and depapilation to pseudomembranous, maculae, nodules and plaque. The mucosal lesions related to the skin lesions were in the form of crusty lips, multiple ulcerations and rashes, targeted lesions, blisters and vesiculobullous lesions. CONCLUSIONS The manifestations of the SARS-CoV-2 infection in the oral cavity are non-specific. The oral mucosal lesions that occur mimic the Herpes zoster virus infection, the Herpes simplex virus infection, Varicella and hand, foot and mouth disease, and the oral mucosal lesions with the skin manifestations (e.g. erythema multiforme).
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Affiliation(s)
- Meircurius D Surboyo
- Department of Oral Medicine, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia - .,Research Center, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia -
| | - Diah S Ernawati
- Department of Oral Medicine, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Hendrik S Budi
- Research Center, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia.,Department of Oral Biology, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
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26
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Gaffuri M, Libonati A, Ettori J, Torretta S, Pignataro L, Capaccio P. COVID-19 isolation drape for sialendoscopy-assisted transfacial approach to parotid gland. Clin Case Rep 2021; 9:e04197. [PMID: 34322234 PMCID: PMC8296138 DOI: 10.1002/ccr3.4197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 04/02/2021] [Indexed: 11/22/2022] Open
Abstract
Surgical procedures requiring close contact with saliva, such as salivary gland surgery, may determine the risk of spreading the SARS-CoV-2 infection. The use of PPE and isolation settings are mandatory to protect health workers.
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Affiliation(s)
- Michele Gaffuri
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Otolaryngology and Head and Neck SurgeryMilanItaly
- Università degli Studi di MilanoDepartment of Clinical Sciences and Community HealthMilanItaly
| | - Antonio Libonati
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Otolaryngology and Head and Neck SurgeryMilanItaly
- Università degli Studi di MilanoDepartment of Clinical Sciences and Community HealthMilanItaly
| | - Jacopo Ettori
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Otolaryngology and Head and Neck SurgeryMilanItaly
- Università degli Studi di MilanoDepartment of Clinical Sciences and Community HealthMilanItaly
| | - Sara Torretta
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Otolaryngology and Head and Neck SurgeryMilanItaly
- Università degli Studi di MilanoDepartment of Clinical Sciences and Community HealthMilanItaly
| | - Lorenzo Pignataro
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Otolaryngology and Head and Neck SurgeryMilanItaly
- Università degli Studi di MilanoDepartment of Clinical Sciences and Community HealthMilanItaly
| | - Pasquale Capaccio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoDepartment of Otolaryngology and Head and Neck SurgeryMilanItaly
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesMilanItaly
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27
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Riofrio G, Castillo S, Salcedo G, Alvitez-Temoche D, Watanabe R, Mayta-Tovalino F. Future Challenges of Covid-19 and Oral Manifestations in Daily Dental Practice: A Literature Review. J Int Soc Prev Community Dent 2021; 11:242-247. [PMID: 34268185 PMCID: PMC8257013 DOI: 10.4103/jispcd.jispcd_21_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/25/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Some patients reportedly present with oral manifestations of coronavirus disease 2019 (Covid-19). It is unknown if this is due to the virus itself or a side effect of treatment; however, severe acute respiratory syndrome coronavirus 2 has been shown to have a predilection for angiotensin-converting enzyme receptors that are present in the respiratory tract, oral mucosa, tongue, and salivary glands, causing alterations in taste and smell. Therefore, the objective of this review was to present the future challenges of Covid-19 and oral manifestations in daily dental practice through a literature review. MATERIALS AND METHODS Scientific evidence in the databases Scopus and PubMed was searched using the Boolean operators. Articles published in Spanish and English between January and December 2020 were included. RESULTS Of the 89 articles found in Scopus, 69 were of the open access type and 20 were in the "others" category; only 22 scientific articles were found in PubMed. CONCLUSION It is important to take into account these clinical manifestations such as loss of taste and smell in order to detect the disease. Good oral hygiene is also recommended as a preventive measure to reduce viral load, which considerably reduces the probability of infecting other people who are in contact with the infected patient.
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Affiliation(s)
- Grecia Riofrio
- Academic Department, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Stephanny Castillo
- Academic Department, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Gabriela Salcedo
- Academic Department, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Romel Watanabe
- Department of Rehabilitative Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Frank Mayta-Tovalino
- CHANGE Research Working Group, Postgraduate Department, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
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28
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Melo Costa M, Benoit N, Dormoi J, Amalvict R, Gomez N, Tissot-Dupont H, Million M, Pradines B, Granjeaud S, Almeras L. Salivette, a relevant saliva sampling device for SARS-CoV-2 detection. J Oral Microbiol 2021; 13:1920226. [PMID: 33986939 PMCID: PMC8098750 DOI: 10.1080/20002297.2021.1920226] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022] Open
Abstract
Background: The gold standard for COVID-19 diagnosis relies on quantitative reverse-transcriptase polymerase-chain reaction (RT-qPCR) from nasopharyngeal swab (NPS) specimens, but NPSs present several limitations. The simplicity, low invasive and possibility of self-collection of saliva imposed these specimens as a relevant alternative for SARS-CoV-2 detection. However, the discrepancy of saliva test results compared to NPSs made of its use controversial. Here, we assessed Salivettes®, as a standardized saliva collection device, and compared SARS-CoV-2 positivity on paired NPS and saliva specimens. Methods: A total of 303 individuals randomly selected among those investigated for SARS-CoV-2 were enrolled, including 30 (9.9%) patients previously positively tested using NPS (follow-up group), 90 (29.7%) mildly symptomatic and 183 (60.4%) asymptomatic. Results: The RT-qPCR revealed a positive rate of 11.6% (n = 35) and 17.2% (n = 52) for NPSs and saliva samples, respectively. The sensitivity and specificity of saliva samples were 82.9% and 91.4%, respectively, using NPS as reference. The highest proportion of discordant results concerned the follow-up group (33.3%). Although the agreement exceeded 90.0% in the symptomatic and asymptomatic groups, 17 individuals were detected positive only in saliva samples, with consistent medical arguments. Conclusion Saliva collected with Salivette® was more sensitive for detecting symptomatic and pre-symptomatic infections.
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Affiliation(s)
- Monique Melo Costa
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Nicolas Benoit
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
- Centre National De Référence Du Paludisme, Marseille, France
| | - Jerome Dormoi
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Remy Amalvict
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
- Centre National De Référence Du Paludisme, Marseille, France
| | - Nicolas Gomez
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Hervé Tissot-Dupont
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Matthieu Million
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Bruno Pradines
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
- Centre National De Référence Du Paludisme, Marseille, France
| | - Samuel Granjeaud
- CRCM Integrative Bioinformatics Platform, Centre De Recherche En Cancérologie De Marseille, INSERM, U1068, Institut Paoli-Calmettes, CNRS, UMR7258, Aix-Marseille Université UM 105, Marseille, France
| | - Lionel Almeras
- Unité Parasitologie Et Entomologie, Département Microbiologie Et Maladies Infectieuses, Institut De Recherche Biomédicale Des Armées, Marseille, France
- Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, Marseille, France
- IHU Méditerranée Infection, Marseille, France
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29
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Lim ZY, Ang AX, Cross GB. COVID-19 associated parotitis. IDCases 2021; 24:e01122. [PMID: 33898261 PMCID: PMC8053412 DOI: 10.1016/j.idcr.2021.e01122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/05/2021] [Accepted: 04/05/2021] [Indexed: 12/15/2022] Open
Abstract
While Coronavirus 2019 (COVID-19) typically presents with respiratory tract symptoms, atypical manifestations have been reported. We present a case of a 46-year-old man who presented with fever but no respiratory tract symptoms, and later develops bilateral parotitis. We review the literature for all other reported cases of parotitis and describe common features of these cases. It is important to consider COVID-19 in cases of parotitis, as this impacts patient management and ensures important infection control measures are undertaken.
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Affiliation(s)
- Zhen Yu Lim
- Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Alicia X.Y. Ang
- Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Gail B. Cross
- Department of Medicine, National University Hospital, National University Health System, Singapore
- Department of Medicine, National University of Singapore, Singapore
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30
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Casillas Santana MA, Dipp Velázquez FA, Sámano Valencia C, Martínez Zumarán A, Zavala Alonso NV, Martínez Rider R, Salas Orozco MF. Saliva: What Dental Practitioners Should Know about the Role of This Biofluid in the Transmission and Diagnostic of SARS-CoV-2. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:349. [PMID: 33917276 PMCID: PMC8067428 DOI: 10.3390/medicina57040349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has become a global ongoing pandemic. This pandemic represents a great work risk for all health professionals, it includes dental professionals who are in constant contact with saliva, which represents one of the main routes of transmission of the disease. This is due to the fact that a wide variety of oral tissues and cells are susceptible to infection by SARS-CoV-2 and that they express the ACE2 receptor, which is the main route of entry of the virus into cells, as well as the proteins TMPRSS and furin that contributes to the binding of the virus to the host cells. According to recent studies, some of the oral cells most susceptible to infection by SARS-CoV-2 are the epithelial cells of the salivary glands. This explains the presence of the virus in the saliva of infected patients and provides scientific evidence that supports the use of saliva as a biofluid that offers the opportunity to develop new detection and diagnostic techniques. This is because saliva is much easier to collect compared to nasopharyngeal swab. However, the presence of the virus in saliva, also represents a great source of transmission, since the main form of infection is through microscopic drops that are generated when infected people cough or sneeze. Likewise, health professionals, such as dentists are exposed to contagion through saliva. The objective of this review article is to provide a perspective on the main cells and tissues that can be affected by the virus, the risk of contagion that the presence of the virus in saliva represents for dentists; and the new techniques developed from saliva samples for the diagnosis and surveillance of SARS-CoV-2 infection. This review is expected to contribute to the knowledge of oral health professionals about the risk of saliva in the spread of SARS-CoV-2, but also its advantages as a diagnostic tool for pandemic control. In conclusion, the authors can mention that information that provides more scientific evidence of the mechanisms of infection of the coronavirus in oral cells and tissues is being published continually. This also explains the presence of the virus in the saliva of infected people and the risk of contagion that this means. It also provides scientific evidence of the use of saliva as a biofluid for the detection, diagnosis, monitoring, and control of the spread of the virus.
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Affiliation(s)
- Miguel Angel Casillas Santana
- Maestría en Estomatología con Opción Terminal en Ortodoncia, Facultad de Estomatología, Benemérita Universidad Autónoma de Puebla, Puebla, Pue. 72410, Mexico; (F.A.D.V.); (C.S.V.)
| | - Farid Alonso Dipp Velázquez
- Maestría en Estomatología con Opción Terminal en Ortodoncia, Facultad de Estomatología, Benemérita Universidad Autónoma de Puebla, Puebla, Pue. 72410, Mexico; (F.A.D.V.); (C.S.V.)
| | - Carolina Sámano Valencia
- Maestría en Estomatología con Opción Terminal en Ortodoncia, Facultad de Estomatología, Benemérita Universidad Autónoma de Puebla, Puebla, Pue. 72410, Mexico; (F.A.D.V.); (C.S.V.)
| | - Alan Martínez Zumarán
- Especialidad en Ortodoncia, Facultad de Estomatología, Univesidad Autónoma de San Luis Potosí, San Luis Potosí, S.L.P. 78290, Mexico; (A.M.Z.); (N.V.Z.A.); (R.M.R.)
| | - Norma Verónica Zavala Alonso
- Especialidad en Ortodoncia, Facultad de Estomatología, Univesidad Autónoma de San Luis Potosí, San Luis Potosí, S.L.P. 78290, Mexico; (A.M.Z.); (N.V.Z.A.); (R.M.R.)
| | - Ricardo Martínez Rider
- Especialidad en Ortodoncia, Facultad de Estomatología, Univesidad Autónoma de San Luis Potosí, San Luis Potosí, S.L.P. 78290, Mexico; (A.M.Z.); (N.V.Z.A.); (R.M.R.)
| | - Marco Felipe Salas Orozco
- Especialidad en Ortodoncia, Facultad de Estomatología, Univesidad Autónoma de San Luis Potosí, San Luis Potosí, S.L.P. 78290, Mexico; (A.M.Z.); (N.V.Z.A.); (R.M.R.)
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31
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Current status and future of delivery systems for prevention and treatment of infections in the oral cavity. Drug Deliv Transl Res 2021; 11:1703-1734. [PMID: 33770415 PMCID: PMC7995675 DOI: 10.1007/s13346-021-00961-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 12/23/2022]
Abstract
Oral health reflects the general health, and it is fundamental to well-being and quality of life. An infection in the oral cavity can be associated with serious complications in human health. Local therapy of these infections offers many advantages over systemic drug administration, targeting directly to the diseased area while minimizing systemic side effects. Specialized drug delivery systems into the oral cavity have to be designed in such a fashion that they resist to the aqueous environment that is constantly bathed in saliva and subject to mechanical forces. Additionally, a prolonged release of drug should also be provided, which would enhance the efficacy and also decrease the repeated dosing. This review is aimed to summarize the current most relevant findings related to local drug delivery of various drug groups for prevention and treatment of infections (viral, bacterial, fungal) and infection-related manifestations in the oral cavity. Current therapeutic challenges in regard to effective local drug delivery systems will be discussed, and the recent approaches to overcome these obstacles will be reviewed. Finally, future prospects will be overviewed to promote novel strategies that can be implemented in clinical management for prevention and treatment of oral infections.
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Tsuchiya H. Oral Symptoms Associated with COVID-19 and Their Pathogenic Mechanisms: A Literature Review. Dent J (Basel) 2021; 9:32. [PMID: 33799583 PMCID: PMC7999671 DOI: 10.3390/dj9030032] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/03/2021] [Accepted: 03/07/2021] [Indexed: 12/15/2022] Open
Abstract
Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, management of coronavirus disease 2019 (COVID-19) has been challenging for healthcare providers. The oral cavity is referred to as a target of SARS-CoV-2. The aim of this study was to review oral symptoms specific to COVID-19 patients from the point of view of symptom prevalence and pathogenesis and to speculate the pathogenic mechanisms underlying them. Scientific articles were retrieved by searching PubMed/MEDLINE, Google Scholar, medRxiv, and bioRxiv from 3 February 2020 to 31 December 2020, and they were reviewed by title, abstract, and text for relevance. The literature search indicated that COVID-19 patients frequently present with gustatory dysfunction, xerostomia, and oral mucosal lesions, while their prevalence is likely to vary by country, age, gender, and disease severity. Gustatory dysfunction and xerostomia appear at an early stage of SARS-CoV-2 infection and last relatively long. One of possible pathogenic mechanisms of both symptoms is attributed to the expression of viral cellular entry-relevant receptors in taste cells and salivary glands. Dental professionals who can first become aware of oral symptoms associated with COVID-19 will play a more active role in and make a greater contribution to diagnosis and prevention of COVID-19.
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Derruau S, Bouchet J, Nassif A, Baudet A, Yasukawa K, Lorimier S, Prêcheur I, Bloch-Zupan A, Pellat B, Chardin H, Jung S. COVID-19 and Dentistry in 72 Questions: An Overview of the Literature. J Clin Med 2021; 10:779. [PMID: 33669185 PMCID: PMC7919689 DOI: 10.3390/jcm10040779] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has significantly affected the dental care sector. Dental professionals are at high risk of being infected, and therefore transmitting SARS-CoV-2, due to the nature of their profession, with close proximity to the patient's oropharyngeal and nasal regions and the use of aerosol-generating procedures. The aim of this article is to provide an update on different issues regarding SARS-CoV-2 and COVID-19 that may be relevant for dentists. Members of the French National College of Oral Biology Lecturers ("Collège National des EnseignantS en Biologie Orale"; CNESBO-COVID19 Task Force) answered seventy-two questions related to various topics, including epidemiology, virology, immunology, diagnosis and testing, SARS-CoV-2 transmission and oral cavity, COVID-19 clinical presentation, current treatment options, vaccine strategies, as well as infection prevention and control in dental practice. The questions were selected based on their relevance for dental practitioners. Authors independently extracted and gathered scientific data related to COVID-19, SARS-CoV-2 and the specific topics using scientific databases. With this review, the dental practitioners will have a general overview of the COVID-19 pandemic and its impact on their practice.
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Affiliation(s)
- Stéphane Derruau
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (S.D.); (S.L.)
- Pôle de Médecine Bucco-dentaire, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
- BioSpecT EA-7506, UFR de Pharmacie, Université de Reims Champagne-Ardenne, 51096 Reims, France
| | - Jérôme Bouchet
- UFR Odontologie-Montrouge, Université de Paris, 92120 Montrouge, France; (J.B.); (B.P.); (H.C.)
- Laboratory “Orofacial Pathologies, Imaging and Biotherapies” URP 2496, University of Paris, 92120 Montrouge, France
| | - Ali Nassif
- UFR Odontologie-Garancière, Université de Paris, 75006 Paris, France;
- AP-HP, Sites hospitaliers Pitié Salpêtrière et Rothschild, Service d’Orthopédie Dento-Faciale, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), 75013-75019 Paris, France
- INSERM, UMR_S 1138, Laboratoire de Physiopathologie Orale et Moléculaire, Centre de Recherche des Cordeliers, 75006 Paris, France
| | - Alexandre Baudet
- Faculté de Chirurgie Dentaire, Université de Lorraine, 54505 Vandœuvre-lès-Nancy, France; (A.B.); (K.Y.)
- Centre Hospitalier Régional Universitaire de Nancy, 54000 Nancy, France
| | - Kazutoyo Yasukawa
- Faculté de Chirurgie Dentaire, Université de Lorraine, 54505 Vandœuvre-lès-Nancy, France; (A.B.); (K.Y.)
- Centre Hospitalier Régional Universitaire de Nancy, 54000 Nancy, France
| | - Sandrine Lorimier
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (S.D.); (S.L.)
- Pôle de Médecine Bucco-dentaire, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
- Université de Reims Champagne-Ardenne, MATIM EA, UFR Sciences, 51687 Reims, France
| | - Isabelle Prêcheur
- Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06000 Nice, France;
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
- Laboratoire Microbiologie Orale, Immunothérapie et Santé (MICORALIS EA 7354), Faculté de Chirurgie Dentaire, 06300 Nice, France
| | - Agnès Bloch-Zupan
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 67000 Strasbourg, France;
- Pôle de Médecine et de Chirurgie Bucco-Dentaires, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, Université de Strasbourg, 67400 Illkirch-Graffenstaden, France
| | - Bernard Pellat
- UFR Odontologie-Montrouge, Université de Paris, 92120 Montrouge, France; (J.B.); (B.P.); (H.C.)
- Laboratory “Orofacial Pathologies, Imaging and Biotherapies” URP 2496, University of Paris, 92120 Montrouge, France
| | - Hélène Chardin
- UFR Odontologie-Montrouge, Université de Paris, 92120 Montrouge, France; (J.B.); (B.P.); (H.C.)
- AP-HP, Hôpital Henri Mondor, 94010 Créteil, France
- ESPCI, UMR CBI 8231, 75005 Paris, France
| | - Sophie Jung
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 67000 Strasbourg, France;
- Pôle de Médecine et de Chirurgie Bucco-Dentaires, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
- INSERM UMR_S 1109 «Molecular Immuno-Rheumatology», Institut Thématique Interdisciplinaire de Médecine de Précision de Strasbourg, Transplantex NG, Fédération hospitalo-universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France
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Yang CW, Shi ZL. Uncovering potential host proteins and pathways that may interact with eukaryotic short linear motifs in viral proteins of MERS, SARS and SARS2 coronaviruses that infect humans. PLoS One 2021; 16:e0246150. [PMID: 33534852 PMCID: PMC7857568 DOI: 10.1371/journal.pone.0246150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 01/14/2021] [Indexed: 12/30/2022] Open
Abstract
A coronavirus pandemic caused by a novel coronavirus (SARS-CoV-2) has spread rapidly worldwide since December 2019. Improved understanding and new strategies to cope with novel coronaviruses are urgently needed. Viruses (especially RNA viruses) encode a limited number and size (length of polypeptide chain) of viral proteins and must interact with the host cell components to control (hijack) the host cell machinery. To achieve this goal, the extensive mimicry of SLiMs in host proteins provides an effective strategy. However, little is known regarding SLiMs in coronavirus proteins and their potential targets in host cells. The objective of this study is to uncover SLiMs in coronavirus proteins that are present within host cells. These SLiMs have a high possibility of interacting with host intracellular proteins and hijacking the host cell machinery for virus replication and dissemination. In total, 1,479 SLiM hits were identified in the 16 proteins of 590 coronaviruses infecting humans. Overall, 106 host proteins were identified that may interact with SLiMs in 16 coronavirus proteins. These SLiM-interacting proteins are composed of many intracellular key regulators, such as receptors, transcription factors and kinases, and may have important contributions to virus replication, immune evasion and viral pathogenesis. A total of 209 pathways containing proteins that may interact with SLiMs in coronavirus proteins were identified. This study uncovers potential mechanisms by which coronaviruses hijack the host cell machinery. These results provide potential therapeutic targets for viral infections.
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Affiliation(s)
- Chu-Wen Yang
- Department of Microbiology, Center for Applied Artificial Intelligence Research, Soochow University, Taipei, Taiwan
- * E-mail:
| | - Zhi-Ling Shi
- Ocean School of Fuzhou University, Fuzhou University, Fuzhou, China
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Capocasale G, Nocini R, Faccioni P, Donadello D, Bertossi D, Albanese M, Zotti F. How to deal with coronavirus disease 2019: A comprehensive narrative review about oral involvement of the disease. Clin Exp Dent Res 2021; 7:101-108. [PMID: 33021087 PMCID: PMC7675550 DOI: 10.1002/cre2.332] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this narrative review was to collect all findings from literature about oral signs and symptoms of COVID-19, in order to draw a picture of oral involvement of this challenging viral infection, to help oral professionals in a better triage and early diagnosis. MATERIAL AND METHODS The search for international literature was made including articles written in English and reporting about oral manifestations in patients with a diagnosis of COVID-19. The publication time was limited to 2019 and 2020, up to May 20, 2020. A narrative review was performed. RESULTS Twenty-three articles were included in this review. Three different oral manifestations were found: taste alteration, oral blister and ulcers, and oral lesions associated with Kawasaki-like diseases (erythema, bleeding of lips, "strawberry tongue"). The higher expression of Angiotensin-converting enzyme 2 in the oral cavity and in endothelial cells might be responsible for oral manifestation and the major report of signs and symptoms in the occidental countries. CONCLUSIONS Detecting oral signs and symptoms of COVID-19 could be useful to perform a better preliminary triage in dental setting, and in recognizing possible early manifestations of the disease. However, considering the outbreak of COVID-19 and the consequent difficulty of undergoing oral examinations, the oral manifestations might be misdiagnosed; then, we would encourage oral professionals to perform other studies about this topic.
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Affiliation(s)
- Giorgia Capocasale
- Section of Dentistry and Maxillofacial Surgery, Department of Surgical Sciences, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
| | - Riccardo Nocini
- Section of Ears, Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and PediatricsUniversity of VeronaVeronaItaly
| | - Paolo Faccioni
- Section of Dentistry and Maxillofacial Surgery, Department of Surgical Sciences, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
| | - Dario Donadello
- Section of Dentistry and Maxillofacial Surgery, Department of Surgical Sciences, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
| | - Dario Bertossi
- Section of Dentistry and Maxillofacial Surgery, Department of Surgical Sciences, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
| | - Massimo Albanese
- Section of Dentistry and Maxillofacial Surgery, Department of Surgical Sciences, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
| | - Francesca Zotti
- Section of Dentistry and Maxillofacial Surgery, Department of Surgical Sciences, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
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Katz J. Prevalence of dry mouth in COVID-19 patients with and without Sicca syndrome in a large hospital center. Ir J Med Sci 2021; 190:1639-1641. [PMID: 33433842 PMCID: PMC7801862 DOI: 10.1007/s11845-020-02480-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/14/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Joseph Katz
- Department of Oral & Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
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Živković-Marinkov E, Milisavljević D, Stanković M, Filipović G, Bojanović M, Nikolić N, Babac S. Oral manifestations in patients infected with COVID-19. ACTA STOMATOLOGICA NAISSI 2021. [DOI: 10.5937/asn2184334z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction:In addition to the characteristic clinical picture of respiratory infection, patients with COVID-19 can also be diagnosed with oral manifestations. Aim: The aim of this study was to review current literature for the prevalence of changes in the oral cavity i.e., the presence of oral symptoms in patients with COVID-19, in order to indicate that oral manifestations may occur due to viral infection with SARS-CoV-2. Methods: Important information relevant to the study was obtained by searching the available electronic PubMed and Google Scholar database. Results: Oral lesions were found in different locations in patients with COVID-19: tongue mucosa (dorsum and lateral sides of the tongue), buccal mucosa, hard and soft palate, inner lip and gingiva. The most common were ulcerations in different parts of the oral cavity. It is still unclear whether oral lesions in SARS-CoV-2 virus infection were a consequence of the primary effect of the virus itself or a secondary manifestation of the infection. The high presence of angiotensin-converting enzyme 2 in oral epithelial cells of the tongue and salivary glands indicates that the oral cavity may be particularly susceptible to SARS-CoV-2 infection. Taste disorder is the most common oral symptom in patients with COVID-19. Conclusion: Oral lesions, xerostomia, taste disorders can occur in patients diagnosed with COVID-19. Therefore, a comprehensive intraoral examination is necessary in order to determine changes in the oral cavity and apply proper treatment.
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Halsey R, Priftakis D, Mackenzie S, Wan S, Davis LM, Lilburn D, Thornton A, Papathanasiou N, Gnanasegaran G, Bomanji J. COVID-19 in the act: incidental 18F-FDG PET/CT findings in asymptomatic patients and those with symptoms not primarily correlated with COVID-19 during the United Kingdom coronavirus lockdown. Eur J Nucl Med Mol Imaging 2021; 48:269-281. [PMID: 32761260 PMCID: PMC7406218 DOI: 10.1007/s00259-020-04972-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/23/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE The emergence of the novel SARS-CoV-2 pathogen and lethal COVID-19 disease pandemic poses major diagnostic challenges. The study aims to describe the spectrum and prevalence of thoracic and extrathoracic incidental findings in patients who have undergone 18F-FDG PET/CT during the first 3 weeks of the COVID-19 UK lockdown. METHODS This is a single-centre retrospective controlled observational study. 18F-FDG PET/CT scans (n = 160) acquired from 23/3/2020 to 9/4/2020 were retrospectively reviewed for incidental findings in the lungs and extrapulmonary sites (heart, nasal sinuses, parotid and salivary glands, colon, large vessels, renal cortex, brain, spleen and testes). A date-matched control group (n = 205) of patients from 2019 was used for comparison. RESULTS The total prevalence of suspicious findings was 26/160 (16.25%). Fifteen patients presented with incidental findings in the lungs, while eleven patients had only non-pulmonary incidental findings. There was a significant increase in the appearance of incidental 18F-FDG PET/CT findings during the 2nd week (OR = 3.8) and 3rd week (OR = 7.6) in relation to the 1st week. There was a significant increase in the average maximum standardised uptake values (SUVmax) in the parotid/salivary glands of patients scanned during week 2 in relation to week 1 (p = 0.036). There was no significant difference in the prevalence of incidental findings compared to the control group, but the number of pulmonary vs. extrathoracic findings was different between the two populations. CONCLUSION The study provides a novel base of evidence to identify asymptomatic patients and those without symptoms strongly associated with COVID-19 with incidental 18F-FDG PET/CT findings suspicious of SARS-CoV-2 infection during the initial stages of the pandemic.
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Affiliation(s)
- Richard Halsey
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Dimitrios Priftakis
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Strachan Mackenzie
- Department Haematology, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Simon Wan
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Laura M. Davis
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - David Lilburn
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Andrew Thornton
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Nikolaos Papathanasiou
- Nuclear Medicine and PET/CT Department, University Hospital of Patras, Rio, 265 04 Patras, Greece
| | - Gopinath Gnanasegaran
- Department of Nuclear Medicine, Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG UK
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
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Karthika P, Rathy R, Jayanthi P, Harish R, Ameena M, Krishnasree R. Oral Manifestations of COVID-19 Patients: A Systematic Review. JOURNAL OF OROFACIAL SCIENCES 2021. [DOI: 10.4103/jofs.jofs_91_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Eghbali Zarch R, Hosseinzadeh P. COVID-19 from the perspective of dentists: A case report and brief review of more than 170 cases. Dermatol Ther 2021; 34:e14717. [PMID: 33368888 PMCID: PMC7883121 DOI: 10.1111/dth.14717] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022]
Abstract
A novel coronavirus which has appeared from China, has been circulating hastily around the world. We summarized the publications including oral manifestation of coronavirus disease 2019 (COVID-19) cases based on PubMed and Google Scholar data bases, and also present a case that highlights oral lesions 2 days prior to the first COVID-19 general symptoms. Two authors independently reviewed the papers, 17 studies of more than 170 confirmed cases between ages of 9 and 90 were included. The most common oral manifestation was dry mouth followed by dysgeusia and pseudomembranous fungal structure. Change in tongue sensation and ulceration, muscle pain during mastication, swelling in oral cavity, and herpetic lesions were other common symptoms. Associated symptoms, latency time, treatment, and prognosis have also been meticulously reviewed. We hope that careful clinical intraoral examination on all COVID-19 positive patients and equally on any patients who need dental care will pave the way for further studies.
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Affiliation(s)
| | - Pegah Hosseinzadeh
- Faculty of Dentistry, Postgraduate resident of OrthodonticsGuilan University of Medical SciencesRashtIran
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Halboub E, Al-Maweri SA, Alanazi RH, Qaid NM, Abdulrab S. Orofacial manifestations of COVID-19: a brief review of the published literature. Braz Oral Res 2020; 34:e124. [PMID: 33146320 DOI: 10.1590/1807-3107bor-2020.vol34.0124] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has spread exponentially across the world. The typical manifestations of COVID-19 include fever, dry cough, headache and fatigue. However, atypical presentations of COVID-19 are being increasingly reported. Recently, a number of studies have recognized various mucocutaneous manifestations associated with COVID-19. This study sought to summarize the available literature and provide an overview of the potential orofacial manifestations of COVID-19. An online literature search in the PubMed and Scopus databases was conducted to retrieve the relevant studies published up to July 2020. Original studies published in English that reported orofacial manifestations in patients with laboratory-confirmed COVID-19 were included; this yielded 16 articles involving 25 COVID-19-positive patients. The results showed a marked heterogeneity in COVID-19-associated orofacial manifestations. The most common orofacial manifestations were ulcerative lesions, vesiculobullous/macular lesions, and acute sialadentitis of the parotid gland (parotitis). In four cases, oral manifestations were the first signs of COVID-19. In summary, COVID-19 may cause orofacial manifestations that might be the initial features in several cases. However, the occurrence of orofacial manifestations in COVID-19 seems to be underreported, mainly due to the lack of oral examination of patients with suspected and/or confirmed COVID-19. Oral examination of all suspected and confirmed COVID-19 cases is crucial for better understanding and documenting COVID-19-associated orofacial manifestations.
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Affiliation(s)
- Esam Halboub
- Jazan University, College of Dentistry, Department of Maxillofacial Surgery and Diagnostic Sciences, Jazan, Saudi Arabia
| | - Sadeq Ali Al-Maweri
- AlFarabi College of Dentistry and Nursing, Department of Oral Medicine and Diagnostic Sciences, Riyadh, Saudi Arabia
| | - Rawan Hejji Alanazi
- AlFarabi College of Dentistry and Nursing, Department of Oral Medicine and Diagnostic Sciences, Riyadh, Saudi Arabia
| | - Nashwan Mohammed Qaid
- AlFarabi College of Dentistry and Nursing, Department of Restorative Dental Sciences, Riyadh, Saudi Arabia
| | - Saleem Abdulrab
- Primary Health Care Corporation, Madinat Khalifa Health Center, Doha, Qatar
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Juhász MF, Ocskay K, Kiss S, Hegyi P, Párniczky A. Insufficient etiological workup of COVID-19-associated acute pancreatitis: A systematic review. World J Gastroenterol 2020; 26:6270-6278. [PMID: 33177799 PMCID: PMC7596641 DOI: 10.3748/wjg.v26.i40.6270] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/11/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, mostly causing respiratory symptoms, is also known to affect the gastrointestinal tract. Several case reports hypothesize that SARS-CoV-2 could be an etiological factor in acute pancreatitis (AP).
AIM To assess all the available evidence in the literature relating to coronavirus disease 2019 (COVID-19) and AP.
METHODS We performed a systematic review of the available literature on the topic. The systematic search was conducted on 15 May 2020 on MEDLINE, EMBASE, CENTRAL, Web of Science and Scopus with a search key using the terms “amylase,” “lipase,” “pancr*,” “COVID-19” and synonyms. Due to the low quality and poor comparability of the studies, a meta-analysis was not performed.
RESULTS Six case reports and two retrospective cohorts were included, containing data on eleven COVID-19 patients with AP. Five patients had AP according to the Atlanta classification. Other publications did not provide sufficient information on the diagnostic criteria. Most cases were considered SARS-CoV-2-induced, while several established etiological factors were not investigated. We were able to identify other possible causes in most of them.
CONCLUSION We strongly highlight the need for adherence to the guidelines during a diagnostic and etiological workup, which could alter therapy.
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Affiliation(s)
- Márk Félix Juhász
- Institute for Translational Medicine, University of Pécs, Medical School, Pécs 7624, Hungary
| | - Klementina Ocskay
- Institute for Translational Medicine, University of Pécs, Medical School, Pécs 7624, Hungary
| | - Szabolcs Kiss
- Doctoral School of Clinical Medicine, University of Szeged, Szeged 6720, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs 7624, Hungary
| | - Andrea Párniczky
- Institute for Translational Medicine, University of Pécs, Medical School, Pécs 7624, Hungary
- Department of Pediatrics, Heim Pál National Institute for Pediatrics, Budapest 1089, Hungary
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Afsal AS, Musthafa N, Fathima MS, Lakshmi GG. Inflammation of papillae of Wharton's duct in COVID-19 patients: A debatable entity. SPECIAL CARE IN DENTISTRY 2020; 41:127-128. [PMID: 33026110 PMCID: PMC7675480 DOI: 10.1111/scd.12526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 12/26/2022]
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Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca Canto G, Sugaya N, Santos-Silva AR, Guerra ENS. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res 2020; 100:141-154. [PMID: 32914677 DOI: 10.1177/0022034520957289] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This living systematic review aims to summarize evidence on the prevalence of oral signs and symptoms in patients with COVID-19. The review was reported per the PRISMA checklist, and the literature search was conducted in 6 databases and in gray literature. Studies published in any language mentioning oral symptoms and signs in patients with COVID-19 were included. The risk of bias was assessed by the Joanna Briggs Institute appraisal tools. The certainty of evidence was evaluated through GRADE assessment. After a 2-step selection, 40 studies were included: 33 cross-sectional and 7 case reports. Overall, 10,228 patients (4,288 males, 5,770 females, and 170 unknown) from 19 countries were assessed. Gustatory impairment was the most common oral manifestation, with a prevalence of 45% (95% CI, 34% to 55%; I2 = 99%). The pooled eligible data for different taste disorders were 38% for dysgeusia and 35% for hypogeusia, while ageusia had a prevalence of 24%. Taste disorders were associated with COVID-19 (odds ratio [OR], 12.68; 95% CI, 6.41 to 25.10; I2 = 63%; P < 0.00001), mild/moderate severity (OR, 2.09; 95% CI, 1.25 to 3.49; I2 = 66%; P = 0.005), and female patients (OR, 1.64; 95% CI, 1.23 to 2.17; I2 = 70%; P = 0.0007). Oral mucosal lesions presented multiple clinical aspects, including white and erythematous plaques, irregular ulcers, small blisters, petechiae, and desquamative gingivitis. Tongue, palate, lips, gingiva, and buccal mucosa were affected. In mild cases, oral mucosal lesions developed before or at the same time as the initial respiratory symptoms; however, in those who required medication and hospitalization, the lesions developed approximately 7 to 24 d after onset symptoms. Therefore, taste disorders may be common symptoms in patients with COVID-19 and should be considered in the scope of the disease's onset and progression. Oral mucosal lesions are more likely to present as coinfections and secondary manifestations with multiple clinical aspects (PROSPERO CRD42020184468).
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Affiliation(s)
- J Amorim Dos Santos
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - A G C Normando
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil.,Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - R L Carvalho da Silva
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - A C Acevedo
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - G De Luca Canto
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - N Sugaya
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - A R Santos-Silva
- Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - E N S Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
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45
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Abstract
The novel coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), first appeared in December 2019, in Wuhan, China and evolved into a pandemic. As Angiotensin-Converting Enzyme 2 (ACE2) is one of the potential target receptors for SARS-CoV-2 in human body, which is expressed in different tissues, multiple organs might become affected. In the initial phase of the current pandemic, a handful of post-mortem case-series revealed COVID-19-related pathological changes in various organs. Although pathological examination is not a feasible method of diagnosis, it can elucidate pathological changes, pathogenesis of the disease, and the cause of death in COVID-19 cases. Herein, we thoroughly reviewed multiple organs including lung, gastrointestinal tract, liver, kidney, skin, heart, blood, spleen, lymph nodes, brain, blood vessels, and placenta in terms of COVID-19-related pathological alterations. Also, these findings were compared with SARS and MERS infection, wherever applicable. We found a diverse range of pathological changes, some of which resemble those found in SARS and MERS.
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46
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Abstract
Outbreak pneumonia announced in Wuhan, China, in December 2019, had its causative factor classified as a new coronavirus (SARS-CoV-2). Since saliva can host several viruses including SARS-CoV-2, the transmission chance of viruses through saliva, particularly those causing respiratory infections, is unavoidable. COVID-19 can be detected through salivary diagnostic testing which has lots of advantages for medical care professionals and patients. It should be noted that not only does saliva offer an ecological niche for the colonization and development of oral microorganisms, but it also prevents the overgrowth of particular pathogens such as viral factors. The aim of this study is to gather all the information about saliva and its association with COVID-19 for the whole health care professionals across the world.
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Affiliation(s)
- Maryam Baghizadeh Fini
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran; Master of Health Promotion, Oklahoma State University, Stillwater, OK, USA.
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47
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Teichert-Filho R, Baldasso CN, Campos MM, Gomes MS. Protective device to reduce aerosol dispersion in dental clinics during the COVID-19 pandemic. Int Endod J 2020; 53:1588-1597. [PMID: 32735690 PMCID: PMC7436703 DOI: 10.1111/iej.13373] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 01/25/2023]
Abstract
AIM To describe the use of a new protective device to reduce aerosol dispersion in dental clinics during the COVID-19 pandemic. METHODOLOGY The device consists of a rigid translucent acrylic structure (methyl polymethacrylate), adjusted to the dental chair, involving the patient's head, neck and chest. There is also a piping system to generate negative pressure, for aspiration and filtering of the air inside the device chamber. The operator works through small holes in the acrylic structure, to reduce contact with the microparticles arising from aerosols during dental procedures. Simulated dental procedures using a fluorescent dye in the water of the dental equipment were carried out, with and without the use of the device. The presence of the dye was analysed at various locations, such as on personal protective equipment (PPE), the dental chair and on the clinic floor. RESULTS In the simulated dental procedure without the device, the dye was obvious on surgical gloves, aprons (waist, chest, legs, fists) and face shields, as well as on the dental chair (backrest, light reflector) and clinic floor. In the simulated dental procedure using the device, the dye was observed only on surgical gloves, apron (fists), inside the pipe system and internal walls of the acrylic chamber. There was a certain limitation of movement and visualization by the dentist whilst using the device. CONCLUSIONS The present device is a low-cost complementary resource for use in conjunction with standard PPE, to reduce the transmission of SARS-CoV-2 in the dental setting. Further clinical trials should be carried out to test the efficacy of this device to reduce aerosol dispersion and the consequent vector of contamination, as well as the ergonomic impacts related to its use.
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Affiliation(s)
- R Teichert-Filho
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Centro Médico-Odontológico da Brigada Militar do Rio Grande do Sul, Porto Alegre, Brazil
| | - C N Baldasso
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - M M Campos
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - M S Gomes
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.,Centro Médico-Odontológico da Brigada Militar do Rio Grande do Sul, Porto Alegre, Brazil
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48
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The practice of oral and maxillofacial radiology during COVID-19 outbreak. Oral Radiol 2020; 36:400-403. [PMID: 32638200 PMCID: PMC7338339 DOI: 10.1007/s11282-020-00465-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 12/21/2022]
Abstract
The current coronavirus disease 2019 (COVID-19) outbreak has brought substantial challenges to the world health system, including the practice of dental and maxillofacial radiology (DMFR). DMFR will carry on an imperative role in healthcare during this crisis. This rapid communication has collected and evaluated all the best current evidence and published guidelines as well as professional recommendations to help maxillofacial radiologists and dental practitioners for safer radiological and imaging examinations on healthy, suspected, or confirmed COVID-19 patients during outbreak. Some strategies have been depicted including procedural indications, infection control, and correct employment of personal protection equipment along with evoking the proper practice environment during and after the COVID-19 outbreak.
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