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Coronavirus disease, since its first case reported in China in 2019, has increased at an exponential rate globally, still growing strong and challenging the Healthcare System Globally. It primarily causes Pneumonia by infiltrating the respiratory tract. However, recent studies detecting SARS-COV RNA in saliva; and affinity of the virus to ACE2 receptors which are abundantly found in epithelial lining of oral mucosa suggest that the oral cavity might probably be the first contact area for the Coronavirus. The aim of this review is to compile and present evidence-based overview of oral manifestations of COVID-19, with a view to presenting a means of early disease detection. The literature shows that the most frequently affected sites in the oral cavity are tongue, lips and palate with varied manifestations like nonspecific oral Ulcerations/blisters, Dysgeusia, Xerostomia due to reduced salivary flow, oral candidiasis and Gingivitis. The occurrence of oral lesions in COVID patients could be multifactorial; due to direct or indirect action of SARS-COV2 on oral mucosa, secondary to the therapeutic drugs used in COVID-19 treatment; lowered general health status following prolonged hospitalisation and co-infections. COVID-19 associated oral manifestations may be underreported due to lack of knowledge among Physicians and Dentists. They should be sensitized to perform a thorough oral examination in COVID affected patients to provide an early diagnosis of the disease and take up measures to limit the progression and spread of disease
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As of August 16,2021,there have been 207,173,086 confirmed cases and 4,361,996 deaths due to the coronavirus disease(COVID-19),and the pandemic remains a global challenge.To date,no effective and approved drugs are available for the treatment of COVID-19.Angiotensin-converting enzyme 2(ACE2)plays a crucial role in the invasion into host cells by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the etiological agent of COVID-19.Notably,ACE2 density is influenced by medical con-ditions,such as hypertension,or by drugs,including angiotensin-converting enzyme inhibitors(ACEIs)and angiotensin receptor blockers(ARBs),which can change the fate of SARS-CoV-2 infectivity.ACE2 is a target for these drugs and can be manipulated to limit the viral entry and replication within the cells.Different strategies aimed at blocking ACE2 with small molecules,peptides,and antibodies,or by neutralizing the virus through its competitive binding with human recombinant soluble ACE2(hrsACE2)are currently under investigation.In this article,we review the current state of knowledge that em-phasizes the need to find effective therapeutic agents against COVID-19 by exploiting ACE2 as a potential target.The increased soluble ACE2 levels and the application of hrsACE2 in patients with COVID-19 can be implemented to control the disease.It has not yet been established whether hypertension and other comorbidities,independent of age,have a direct role in COVID-19.Therefore,the use of renin-angiotensin system inhibitors,ACEls and ARBs,should not be discontinued during COVID-19 treatment.
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Introducción: La COVID-19 es un importante problema de salud definido como pandemia. Estudios en felinos y murinos describieron cuadros de conjuntivitis, uveítis anterior, retinitis y neuritis óptica. En humanos lo más frecuente es la conjuntivitis viral aguda, sin embargo, su estudio continúa en evolución. Se investiga la infección por coronavirus adquirida mediante la transmisión ocular, pero su mecanismo no se ha esclarecido totalmente. Objetivos: Describir las principales manifestaciones oftalmológicas, así como el papel del dinamismo de la superficie ocular y la presencia de receptores moleculares en la transmisión del SARS-CoV-2 por esta vía. Métodos: Se realizó una revisión de la literatura en idioma español e inglés, en los repositorios PubMed, Ebsco, Scielo y Google Académico desde el 1ro de enero hasta el 31 de julio de 2020. Además, se consultaron sitios web de organismos y asociaciones oftalmológicas. Conclusiones: La conjuntivitis viral es la principal presentación oftalmológica del coronavirus 2019. Aunque existe un bajo riesgo de infestación a través de lágrimas, su mecanismo de transmisión por esta vía se ha descrito. Incluso en ausencia de conjuntivitis, el SARS-CoV-2 puede existir o replicarse en la conjuntiva, por tanto, la protección ocular es aconsejable(AU)
Introduction: COVID-19 is an important global health problem which has been declared pandemic by the World Health Organization. Studies on felines and murines have described cases of conjunctivitis, anterior uveitis, retinitis and optic neuritis. The most common condition in humans is acute viral conjunctivitis; however, its study is still in progress. Research is conducted about coronavirus infection acquired by ocular transmission, the mechanism of which has not been totally clarified. Objectives: Describe the main ophthalmic manifestations, as well as the role played by ocular surface dynamics and the presence of molecular receptors in SARS-CoV-2 transmission by this route. Methods: A literature review was conducted of papers published in Spanish or English in the repositories PubMed, Ebsco, Scielo and Google Scholar from 1 January to 31 July 2020. Websites of ophthalmological agencies and associations were also consulted. Conclusions: Viral conjunctivitis is the main ophthalmic presentation of coronavirus 2019. Although the risk of contagion through tears is low, the transmission mechanism by this route has not been described. Even in the absence of conjunctivitis, SARS-CoV-2 may exist or replicate in the conjunctiva. Ocular protection is therefore advisable(AU)
Assuntos
Humanos , Uveíte Anterior , Conjuntivite Viral , Infecções por Coronavirus , COVID-19/complicaçõesRESUMO
The recent outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has been brought to global attention in the search of knowledge about the virus and its pathogenesis. The immune response is essential to control and eliminate the infection, however, maladjusted immune responses may result in severe disease fisiopathology. Gaining a deeper understanding of the interaction between SARS-CoV-2 and the immune systems of the hosts may help us anticipate the development of persistent pulmonary inflammation and, why not, be the first step to therapeutic success and trying to save more lives. In this review, we provide an update on CoV virology and our vision of pathogenesis understanding it from the stages of infection, without forgetting the cytokine storm resulting from the interaction of the virus with ACE2 receptors widely distributed in the body.
La reciente emergencia de síndrome de distrés respiratorio agudo producido por coronavirus 2 (SARS-CoV-2), enfermedad denominada COVID-19 ha traído la atención mundial a la búsqueda de conocimiento sobre este virus y su patogenia. La respuesta inmune es esencial para controlar y erradicar la infección, sin embargo, las respuestas inmunes descontroladas pueden resultar en la fisiopatología de la enfermedad grave. Lograr una comprensión más profunda de la interacción entre SARS-COV-2 y el sistema inmune de los huéspedes podría ayudar a anticiparnos al desarrollo de una inflamación pulmonar persistente causada por el SARS-CoV-2, y por qué no, ser la puerta de entrada al éxito terapéutico e intentar salvar mayor número de vidas. En esta revisión, proporcionamos una actualización sobre la virología y nuestra visión de la patogenia, entendiéndola desde las fases o etapas de la infección, sin olvidar el estallido de citoquinas resultantes de la interacción del virus con los receptores ACE2 ampliamente distribuidos en el organismo.