ABSTRACT
The coronavirus disease 2019 (Covid-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that clinically affects multiple organs of the human body. Cells in the oral cavity express viral entry receptor angiotensin-converting enzyme 2 that allows viral replication and may cause tissue inflammation and destruction. Recent studies have reported that Covid-19 patients present oral manifestations with multiple clinical aspects. In this review, we aim to summarise main signs and symptoms of Covid-19 in the oral cavity, its possible association with oral diseases, and the plausible underlying mechanisms of hyperinflammation reflecting crosstalk between Covid-19 and oral diseases. Ulcers, blisters, necrotising gingivitis, opportunistic coinfections, salivary gland alterations, white and erythematous plaques and gustatory dysfunction were the most reported clinical oral manifestations in patients with Covid-19. In general, the lesions appear concomitant with the loss of smell and taste. Multiple reports show evidences of necrotic/ulcerative gingiva, oral blisters and hypergrowth of opportunistic oral pathogens. SARS-CoV-2 exhibits tropism for endothelial cells and Covid-19-mediated endotheliitis can not only promote inflammation in oral tissues but can also facilitate virus spread. In addition, elevated levels of proinflammatory mediators in patients with Covid-19 and oral infectious disease can impair tissue homeostasis and cause delayed disease resolution. This suggests potential crosstalk of immune-mediated pathways underlying pathogenesis. Interestingly, few reports suggest recurrent herpetic lesions and higher bacterial growth in Covid-19 subjects, indicating SARS-CoV-2 and oral virus/bacteria interaction. Larger cohort studies comparing SARS-CoV-2 negative and positive subjects will reveal oral manifestation of the virus on oral health and its role in exacerbating oral infection.
Subject(s)
COVID-19/complications , Gingivitis, Necrotizing Ulcerative/complications , Herpesviridae Infections/complications , Oral Ulcer/complications , Periodontal Diseases/complications , Sialadenitis/complications , Stomatitis, Aphthous/complications , Xerostomia/complications , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/immunology , Anosmia/complications , Anosmia/immunology , Anosmia/pathology , Anosmia/virology , COVID-19/immunology , COVID-19/pathology , COVID-19/virology , Dysgeusia/complications , Dysgeusia/immunology , Dysgeusia/pathology , Dysgeusia/virology , Gene Expression , Gingivitis, Necrotizing Ulcerative/immunology , Gingivitis, Necrotizing Ulcerative/pathology , Gingivitis, Necrotizing Ulcerative/virology , Herpesviridae Infections/immunology , Herpesviridae Infections/pathology , Herpesviridae Infections/virology , Humans , Mouth/immunology , Mouth/pathology , Mouth/virology , Oral Ulcer/immunology , Oral Ulcer/pathology , Oral Ulcer/virology , Periodontal Diseases/immunology , Periodontal Diseases/pathology , Periodontal Diseases/virology , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Serine Endopeptidases/genetics , Serine Endopeptidases/immunology , Sialadenitis/immunology , Sialadenitis/pathology , Sialadenitis/virology , Stomatitis, Aphthous/immunology , Stomatitis, Aphthous/pathology , Stomatitis, Aphthous/virology , Xerostomia/immunology , Xerostomia/pathology , Xerostomia/virologyABSTRACT
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.
Subject(s)
Betacoronavirus/metabolism , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Saliva/immunology , Saliva/virology , Sialadenitis/diagnosis , Aged , Angiotensin-Converting Enzyme 2 , Betacoronavirus/genetics , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Dental Care , Dentists/psychology , Diagnostic Tests, Routine/methods , Female , Humans , Immunity, Innate , Infection Control/methods , Male , Middle Aged , Pandemics , Patient Safety , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Practice Patterns, Dentists' , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Salivary Gland Neoplasms/diagnosis , Salivary Glands/metabolism , Salivary Glands/virology , Salivary Proteins and Peptides/immunology , Sialadenitis/virology , Telemedicine/methods , XerostomiaABSTRACT
Acute sialadenitis may be caused by viruses, including coronaviruses. Although there are anecdotal reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) salivary gland infections, there have been no well-documented cases of sialadenitis in patients with COVID-19 described in the literature. We report a case of parotitis and submandibular gland sialadenitis, as well as an isolated case of parotitis, in two patients with concurrent SARS-CoV-2 infections. Computed tomography imaging demonstrated parotid and submandibular gland enlargement with heterogenous enhancement and attenuation, consistent with sialadenitis. Medical management was sufficient for successful resolution of the acute sialadenitis. Laryngoscope, 130:2595-2597, 2020.