Physico-chemical parameters of mixed saliva and their correction in patients in the post-covid period

In patients in the post-COVID period, there is a decrease in the functional activity of the salivary glands. In general, in patients who underwent COVID-19, basal secretion was reduced by 19.51% (P <= 0,05);secretion stimulated by chewing - by 31.67% (P <= 0.01) and secretion stimulated by acid - by 29.60% (P <= 0.01). In this study, the physicochemical parameters of mixed saliva and the effectiveness of their complex therapy in patients in the post-COVID period were evaluated. In patients who have undergone COVID-19, a decrease in the rate of salivation, an increase in rheological properties (surface tension and viscosity), and a decrease in the buffering capacity of saliva are recorded. The established pathological changes in the composition and properties of the oral fluid are the cause of the deterioration of the dental status in this group of patients. It has been proven that the use of vitamin C and zinc in the form of zinc gluconate increases the rate of salivation, normalizes the rheological properties and buffering capacity of saliva.

Long-Term Post-COVID-19 Associated Oral Inflammatory Sequelae.

The oral cavity remains an underappreciated site for SARS-CoV-2 infection despite the myriad oral conditions observed in COVID-19 patients. Recently, replicating SARS-CoV-2 was found inside salivary epithelial cells resulting in inflammation and atrophy of salivary glands. Saliva possesses healing properties crucial for maintaining the health of the oral mucosa. Specifically, salivary antimicrobial peptides, most notable, histatin-5 exclusively produced in salivary glands, plays a vital role in innate immunity against colonizing microbial species. The demonstration of SARS-CoV-2 destruction of gland tissue where histatin-5 is produced strongly indicate that histatin-5 production is compromised due to COVID-19. Here we present a case of a patient presenting with unexplained chronic oral dysesthesia and dysgeusia post-recovery from COVID-19. To explore potential physiological mechanisms behind the symptoms, we comparatively analyzed saliva samples from the patient and matched healthy subject for histatin-5 and key cytokines. Findings demonstrated significantly reduced histatin-5 levels in patient's saliva and activation of the Th17 inflammatory pathway. As histatin-5 exhibits potent activity against the opportunistic oral pathogen Candida albicans, we evaluated saliva potency against C. albicans ex vivo. Compared to control, patient saliva exhibited significantly reduced anti-candidal efficacy. Although speculative, based on history and salivary analysis we hypothesize that salivary histatin-5 production may be compromised due to SARS-CoV-2 mediated salivary gland destruction. With the current lack of emphasis on implications of COVID-19 on oral health, this report may provide lacking mechanistic insights that may lead to reassessment of risks for oral opportunistic infections and mucosal inflammatory processes in acutely-ill and recovered COVID-19 patients.

Proteomic Profiling of Saliva and Tears in Radiated Head and Neck Cancer Patients as Compared to Primary Sjögren's Syndrome Patients.

Patients with head and neck cancer (HNC) and patients with primary Sjögren's syndrome (pSS) may exhibit similar symptoms of dry mouth and dry eyes, as a result of radiotherapy (RT) or a consequence of disease progression. To identify the proteins that may serve as promising disease biomarkers, we analysed saliva and tears from 29 radiated HNC patients and 21 healthy controls, and saliva from 14 pSS patients by mass spectrometry-based proteomics. The study revealed several upregulated, and in some instances overlapping, proteins in the two patient groups. Histone H1.4 and neutrophil collagenase were upregulated in whole saliva of both patient groups, while caspase-14, histone H4, and protein S100-A9 were upregulated in HNC saliva only. In HCN tear fluid, the most highly upregulated protein was mucin-like protein 1. These overexpressed proteins in saliva and tears play central roles in inflammation, host cell injury, activation of reactive oxygen species, and tissue repair. In conclusion, the similarities and differences in overexpressed proteins detected in saliva from HNC and pSS patients may contribute to the overall understanding of the different pathophysiological mechanisms inducing dry mouth. Thus, the recurring proteins identified could possibly serve as future promising biomarkers.

Special Issue: New coronavirus (2019-nCoV or SARS-CoV-2) and the outbreak of the respiratory illness (COVID-19): Part-XI. (Special Issue: New coronavirus (2019-nCoV or SARS-CoV-2) and the outbreak of the respiratory illness (COVID-19): Part-XI.)

This special issue includes 109 articles focusing on COVID-19 and influenza H1N1;coinfections with SARS-CoV-2 and other respiratory viruses in Southeastern France;recurrent COVID-19 pneumonia in the course of chemotherapy;significance of IgA antibody testing for early detection of SARS-CoV-2;immunohistochemical expression of angiotensin-converting enzyme 2 in minor salivary glands during SARS-CoV-2 infection;the safety of remdesivir for COVID-19 patients;SARS-CoV-2 nucleocapsid protein intranasal inoculation induces local and systemic T cell responses in mice;risk factors for prolonged fatigue after recovery from COVID-19;influence of COVID-19 in patients with concurrent tuberculosis coinfections;interpretative immune targets and contemporary position for vaccine development against SARS-CoV-2.

Haemostatic devices in parotid surgery: a systematic review.

OBJECTIVE: The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. METHOD: A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. RESULTS: A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. CONCLUSION: Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

The spectrum of non-characteristic oral manifestations in COVID-19 - a scoping brief commentary.

Virus-induced oral abnormalities, occurring especially in severe COVID-19 cases of hospitalized patients, have various characteristics and clinical features being, either directly or indirectly, related to SARS-CoV-2 infection. Deregulation of the immune system as a result of SARS-CoV-2 infection may lead to the impairment of the normal defense pathway in the SARS-CoV-2 positive patients. This scoping mini-review is aimed to critically appraise the existing evidence concerning the potential link between COVID-19 condition and abnormal manifestations within oral cavity, affecting oral mucosa, salivary glands and sensory elements. COVID-induced oral mucosa manifestations, with various clinical aspects, are likely to occur as coinfections and secondary symptoms, as immune system imbalance is per se a causative factor of secondary manifestations. Oral mucosal lesions related to SARS-CoV-2 infection do not seem to demonstrate gender predilection, with the average reported age around 50 years of age. They include mainly white and erythematous plaques, ulcers, blisters, petechiae. The affected intraoral areas were mainly: tongue, palate, lips, gingiva, and buccal mucosa. The "aggressive" therapies utilized to treat COVID-19, including drug interactions may aggravate or initiate OMLs pathologies. Neglected oral hygiene or partial or complete abandonment of oral hygiene during intensive hospitalization constitutes an independent factor promoting a wide range of oral pathologies. In addition, stress factor indirectly impairs functioning of the immune system. Oral mucosa lesions occurring in COVID-19 cases present with a wide variation of non-characteristic features. These intraoral, soft tissues abnormalities seem to be reversible and transient. A potential impact of severe oral pathologies to systemic health resulting from SARS-CoV-2 infection, along with associated poor oral hygiene should not be ignored, predominantly in seriously ill patients hospitalized in intensive care units. Med Pr. 2021;72(6):685-92.

Discovery of new salivary gland - A substantial histological analysis.

Regardless of the COVID-19 pandemic in 2020, discovering a new salivary gland turned into all the rage among the medical fraternity. The significance of the disclosure has been correlated with its clinical relevance in radiotherapy of oropharyngeal carcinoma. However, there are views against this new revelation, owing to the lack of substantial evidence. We have endeavoured to illuminate Tubarial glands with potential shreds of evidence.

Xerostomia and Taste Alterations in COVID-19.

A recent letter published in the Ear, Nose & Throat Journal called attention to the hypothesis that the xerostomia reported in patients with the Coronavirus Disease 2019 (COVID-19) occurs due to the neuroinvasive and neurotropism potential of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In fact, angiotensin-converting enzyme 2 (ACE-2), the main site of entry of SARS-CoV-2 into the cell, was found to be present in the ductal elements of salivary gland and several other tissues. However, some points are worth to be addressed.

Periodontal pocket and COVID-19: Could there be a possible link?

COVID-19 is the emerging health emergency ruining the well being of individuals and devastating the global economies. Sustained research focusing on the virus has been on throughout the world. However, no definitive remedies have yet been derived in the containment of the virus. Steady knowledge on the pathogenesis of the virus has revealed certain consistent features specific to the disease which includes massive destruction of the lung due to the presence of excessive angiotensin-converting enzyme receptors (ACE2) which are essential for the viral entry inside the host. Once, access is gained multiplication occurs resulting in suppressing the immune response of the body against the virus. Henceforth, the equilibrium of the host is disrupted leading to manifestation of the disease. The Periodontal pocket also presents with pathology very much similar to COVID-19 and a possibility of dual role can be thought of pertaining to aspects of Periodontal Medicine.

Oral saliva and COVID-19.

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.

COVID-19 salivary signature: diagnostic and research opportunities.

The COVID-19 (caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) epidemic started in Wuhan (Hubei Province, China) in mid-December 2019 and quickly spread across the world as a pandemic. As a key to tracing the disease and to implement strategies aimed at breaking the chain of disease transmission, extensive testing for SARS-CoV-2 was suggested. Although nasopharyngeal/oropharyngeal swabs are the most commonly used biological samples for SARS-CoV-2 diagnosis, they have a number of limitations related to sample collection and healthcare personnel safety. In this context, saliva is emerging as a promising alternative to nasopharyngeal/oropharyngeal swabs for COVID-19 diagnosis and monitoring. Saliva collection, being a non-invasive approach with possibility for self-collection, circumvents to a great extent the limitations associated with the use of nasopharyngeal/oropharyngeal swabs. In addition, various salivary biomarkers including the salivary metabolomics offer a high promise to be useful for better understanding of COVID-19 and possibly in the identification of patients with various degrees of severity, including asymptomatic carriers. This review summarises the clinical and scientific basis for the potential use of saliva for COVID-19 diagnosis and disease monitoring. Additionally, we discuss saliva-based biomarkers and their potential clinical and research applications related to COVID-19.

Salivary Glands, Saliva and Oral Findings in COVID-19 Infection

Abstract The world is under the threat of the novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite several efforts to contain the disease spread, it still constitutes a public health emergency of international concern. Several published reports in the scientific literature called attention of the oral cavity as the potential route of infection, the implications for dental practice and the use of saliva in the diagnose of the COVID-19. The aim of this article is to provide an overview of the literature on the salivary glands and saliva in the context of SARS-CoV-2 infection. A brief discussion of taste disturbances and oral findings in COVID-19 patients is also presented. The literature shows that SARS-CoV-2 could infect the salivary glands. It is not possible, however, to make speculations regarding them as reservoirs for the SARS-CoV-2. In addition, patients with COVID-19 presented several oral repercussions, including hyposalivation and taste disturbances. A few reports showed oral ulcers and blisters associated with SARS-CoV-2 infection. However, it remains not fully understood and might lead to erroneous assumptions. Overall, further studies are necessary to understand the real role of salivary glands and saliva in the context of SARS-CoV-2 infection.