COVID-19 and oral cancer: Critical viewpoint.

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has marked the beginning of a new pandemic named coronavirus disease 2019 (COVID-19). The World Health Organization has announced it as a health emergency that is of international concern. The disease has been reported to cause respiratory illness, pneumonia and even hinder the immunity of an individual. Individuals with disturbed immune responses have been found to be quite susceptible to this viral infection. Oral cancer patients are also at high risk in this pandemic situation and might encounter severe detrimental outcomes. Angiotensin receptors, documented in studies as the path of entry of this virus, are highly expressed in the epithelial cells of oral mucosa, making the group of individuals with oral cancers even more vulnerable. Extracellular matrix metalloproteinase inducer is another potential target for SARS-CoV-2. An exhaustion of angiotensin converting enzyme 2 cell receptors leads to protumoral effects, whereas a downregulation of extracellular matrix metalloproteinase inducer leads to antitumoral effects. Thus, it causes a variation of the biological behavior of the tumor. This article focusses on the molecular mechanisms, effects and patho-physiology of COVID-19 in oral squamous cell carcinoma patients. The different molecular changes in oral squamous cell carcinoma in the background of COVID-19 will modify various environmental factors for this pathology and have an effect on the carcinogenesis process. Understanding the behavior of the tumor will help plan advanced treatment strategies for oral squamous cell carcinoma patients in the background of COVID-19.

Dental caries in children and COVID-19 - An interleukin association: A review of a novel concept

COVID-19 is a pandemic throughout the world, leading to the hunger of knowledge as well as evidences regarding the corona virus which causes this disease. Interleukins are the chemokines which belong to the family of cytokines which are chemotactic in nature and cause the recruitment of cells of inflammation. In the recent COVID 19 pandemic the adverse outcomes in children, though reported less, has been related to the establishment of a cytokine storm, the components of which are common with the cytokine expression profile of Dental caries and early childhood caries in children. IL-6 levels are raised in the serum of the patients infected with COVID-19. Dental caries in children has been attributed to having its pathophysiology related in a cytokine response. Salivary IL-6 levels have been found to be elevated in children with multiple carious lesions. Hypotheses The present letter aims to propose that the multiple carious lesions can be a biomarker for the patients affected with COVID 19 due to raised IL-6 levels. Evaluation of hypotheses: The authors screened the data on COVID 19 and its association with dental caries in children. This paper is an hypotheses to highlight the importance of raised levels of IL-6 as a biomarker in the saliva of children with carious lesions and those affected with COVID-19. This communication proposes the connection between COVID-19 and dental caries through their cytokine connection to form a translational basis for recommending maintenance of oral hygiene in the COVID era. Thus every dentist must suspect every patient affected with multiple carious lesions to be a carrier of COVID-19.

Viral cytopathic effect in maxillary sinus epithelium and SARS-CoV-2: Pitfalls in diagnostic characterization.

Viral cytopathic effects (VCE) are a well-known phenomenon associated with SARS-CoV-2 infection, especially in the cells associated with the lungs. Because maxillary sinus epithelium expresses angiotensin-converting enzyme 2, cells associated with it are more likely to become infected with SARS-CoV-2 and develop VCE. If VCE is seen in with background of a confirmatory COVID-19 diagnosis, then connecting both become quite convincing. However, the diagnostic problem is expected when a similar VCE is seen without any confirmatory diagnosis of CODIV-19. We reported a biopsy sample of maxillary sinusitis in a COVID-19 negative patient. Histopathological examination revealed a pathognomonic VCE in the localized proliferating pseudostratified ciliated epithelium. The only confirmatory aspect linking this VCE with the SARS-CoV-2 was the detection of virus particles at the tissue level. In the present paper, pitfalls and recommendations for future research on this topic are discussed.

Natural vaccines accumulated in face masks during COVID-19: Underappreciated role of facial masking.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a causal agent behind coronavirus disease 2019 (COVID-19). Despite promising developments in therapeutic and preventive avenues, the importance of facial masking is a key factor for the protective measures among exposed human populations. Preclinical and clinical data on the importance of facial masking concerning asymptomatic over symptomatic COVID-19 cases is limited. The recent introduction of the concept of SARS-CoV-2 associated molecular particle patterns (SAMPPs) as a natural vaccine has opened new avenues for the comprehensive development of immunity. To take this further, the scope of natural vaccines accumulated in facemasks during facial masking needs to be highlighted that may directly or indirectly contribute to building adaptive immunity among human populations. This paper attempts to discuss the underappreciated contributions of facial masking in the management of COVID-19 at the global level.

Perspective on Forensic Odontology and COVID-19.

Novel coronavirus infection (COVID-19) is the most deadly pandemic disease of the century and is now known for its high infectivity, morbidity, and mortality. It is conceivable to expect the ramifications of this pandemic in the form of depression and frustration. An increase in crime rate and violence is expected in the near future. Forensic experts along with forensic odontologists will be receiving many cases shortly and they should be ready to face the challenges. In the present paper, a critical perspective is presented on COVID-19 and its socioeconomic impact. Recommendations are provided for effectively carrying out the investigative procedures related to forensic odontology. Clinical relevance: Novel coronavirus infection (COVID-19) is the most deadly pandemic disease of the century and is now known for its high infectivity, morbidity, and mortality. Hence, it is recommended to treat every forensic sample as potential COVID-19 infected. In this regard, the present paper gives some important recommendations for handling the samples that are related to forensic odontology. These will prevent the infection spread in the forensic experts, which are considered as the backbone of this critical COVID-19 situation. Keywords: Coronavirus, COVID-19, Forensic medicine, Forensic odontology.

Novel Viewpoints on Tobacco Smoking and COVID-19.

We read with great interest an article by Karanasos et al. titled "Impact of smoking status on disease severity and mortality of hospitalized patients with COVID-19 infection: a systematic review and meta-analysis".1 It is inferred that there is an adverse impact of smoking on disease severity and mortality of hospitalized COVID-19 patients, which is more pronounced in younger patients without diabetes. Literature is flooded with papers on possible interaction and outcome of COVID-19 association with smoking. However, there are still conflicting views on the effect of smoking in patient outcomes. These conclusions are data-driven and lack valid pathogenetic background for interpretation.

Is a COVID-19 vaccine developed by nature already at work?

The COVID-19 positive cases are increasing at an alarming rate across the world. On the contrary, the morbidity and mortality are showing decreasing trend as time progresses. The most intriguing part is the rise in asymptomatic Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) positive cases in the population, which made us speculate some kind of gradual development of immunity in the population. To date, no attention has been given to the accumulation of killed/inactivated/degenerated SARS-CoV-2 associated molecular particle patterns (SAMPPs). In this paper, we introduced the concept of SAMMPs and its existence on inanimate objects is quite conceivable due to the size of SARS-CoV-2 and exuberant shedding of the virus in respiratory secretions. SAMPPs can come into the contact with mucosal surfaces and thereof associated antigen-presenting dendritic cells. Thus, we hypothesized the existence of SAMPPs mediated the development of immunity against SARS-CoV-2 infection, which has caused an increase in the incidence rate of asymptomatic cases and a decrease in mortality rate. To understand the existence of SAMPPs associated natural immunity against SARS-CoV-2, future population based serological testing are recommended to investigate serum antibody levels against various molecular particles associated with SAMPPs.

EMMPRIN/BASIGIN as a biological modulator of oral cancer and COVID-19 interaction: Novel propositions.

Extracellular matrix metalloproteinase inducer (EMMPRIN), which is also called BASIGIN/CD147, is a cell surface glycoprotein that belongs to the immunoglobulin superfamily and plays a significant role in intercellular recognition in immunology, cellular differentiation and development. Apart from ACE-2, recently EMMPRIN, has been regarded as a target for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attachment and entry into the host cell. Since one of the routes of entry for the virus is the oral cavity, it becomes imperative to percept oral comorbidities such oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs) in terms of EMMPRIN as a target for SARS-CoV-2. In the present paper, it is proposed that OSCC, by the virtue of upregulation of EMMPRIN expression, increases the susceptibility to coronavirus disease (COVID-19). In turn, COVID-19 in OSCC patients causes exhaustion of EMMPRIN receptor due to binding with 'S' receptor leading to a downregulation of related carcinogenesis events. We proposed that in the ACE-2 depleted situation in OSCC, EMMPRIN receptor might get high jacked by the COVID-19 virus for the entry into the host cells. Apart from the anti-monoclonal antibody, it is recommended to explore the use of grape seed and skin containing mouthwash as an adjunct, which could also have anti EMMPRIN effects in patients with OSCC and OPMDs.