ABSTRACT
COVID-19, a recently emerged disease caused by SARS-CoV-2 infection, can present with different degrees of severity and a large variety of signs and symptoms. The oral manifestations of COVID-19 often involve the tongue, with loss of taste being one of the most common symptoms of the disease. This study aimed to detect SARS-CoV-2 RNA and assess possible morphological and immunopathological alterations in the lingual tissue of patients who died with a history of SARS-CoV-2 infection. Sixteen cadavers from 8 SARS-CoV-2 positive (COVID-19+) and 8 negative (COVID-19-) subjects provided 16 tongues, that were biopsied. Samples underwent molecular analysis through Real-Time RT-PCR for the detection of SARS-CoV-2 RNA. Lingual papillae were harvested and processed for histological analysis and for immunohistochemical evaluation for ACE2, IFN-γ and factor VIII. Real-Time RT-PCR revealed the presence of SARS-CoV-2 RNA in filiform, foliate, and circumvallate papillae in 6 out of 8 COVID-19+ subjects while all COVID-19- samples resulted negative. Histology showed a severe inflammation of COVID-19+ papillae with destruction of the taste buds. ACE2 and IFN-γ resulted downregulated in COVID-19+ and no differences were evidenced for factor VIII between the two groups. The virus was detectable in most COVID-19+ tongues. An inflammatory damage to the lingual papillae, putatively mediated by ACE2 and IFN-γ in tongues from COVID-19+ cadavers, was observed. Further investigations are needed to confirm these findings and deepen the association between taste disorders and inflammation in SARS-CoV-2 infection.
Subject(s)
COVID-19 , Tongue , Angiotensin-Converting Enzyme 2 , COVID-19/immunology , COVID-19/pathology , Cadaver , Factor VIII , Humans , Inflammation , RNA, Viral , SARS-CoV-2 , Tongue/pathology , Tongue/virologyABSTRACT
It has been reported that ACE2 is the main host cell receptor of 2019-nCoV and plays a crucial role in the entry of virus into the cell to cause the final infection. To investigate the potential route of 2019-nCov infection on the mucosa of oral cavity, bulk RNA-seq profiles from two public databases including The Cancer Genome Atlas (TCGA) and Functional Annotation of The Mammalian Genome Cap Analysis of Gene Expression (FANTOM5 CAGE) dataset were collected. RNA-seq profiling data of 13 organ types with para-carcinoma normal tissues from TCGA and 14 organ types with normal tissues from FANTOM5 CAGE were analyzed in order to explore and validate the expression of ACE2 on the mucosa of oral cavity. Further, single-cell transcriptomes from an independent data generated in-house were used to identify and confirm the ACE2-expressing cell composition and proportion in oral cavity. The results demonstrated that the ACE2 expressed on the mucosa of oral cavity. Interestingly, this receptor was highly enriched in epithelial cells of tongue. Preliminarily, those findings have explained the basic mechanism that the oral cavity is a potentially high risk for 2019-nCoV infectious susceptibility and provided a piece of evidence for the future prevention strategy in dental clinical practice as well as daily life.
Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Mouth Mucosa , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/transmission , Tongue , Angiotensin-Converting Enzyme 2 , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/genetics , Databases, Genetic , Epithelial Cells/metabolism , Epithelial Cells/virology , Gene Expression Profiling , Humans , Mouth Mucosa/enzymology , Mouth Mucosa/virology , Pneumonia, Viral/genetics , SARS-CoV-2 , Tongue/metabolism , Tongue/virologySubject(s)
COVID-19/complications , Mouth/pathology , Mouth/virology , Adult , Aged , Female , Gingiva/pathology , Gingiva/virology , Humans , Lip/pathology , Lip/virology , Male , Middle Aged , Mouth/cytology , Palate/pathology , Palate/virology , Tongue/pathology , Tongue/virologySubject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Hydroxychloroquine/therapeutic use , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Specimen Handling/methods , COVID-19 , Chemoprevention , Clinical Studies as Topic , Coronavirus Infections/drug therapy , Health Services Accessibility , Humans , Nasopharynx/virology , Nose/virology , Pneumonia, Viral/drug therapy , Randomized Controlled Trials as Topic , SARS-CoV-2 , Self Care , Sensitivity and Specificity , Tongue/virologySubject(s)
Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Specimen Handling/methods , Betacoronavirus , COVID-19 , COVID-19 Testing , Health Personnel , Humans , Nasopharynx/virology , Nose/virology , Pandemics , Patients , SARS-CoV-2 , Sensitivity and Specificity , Tongue/virology , Turbinates/virologyABSTRACT
The novel coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a pandemic in March 2020. A plethora of respiratory sampling methods for SARS-CoV-2 viral detection has been used and in the current evolving situation, there is no international consensus on the recommended method of respiratory sampling for diagnosis. Otolaryngologists deal intimately with the upper respiratory tract and a clear understanding of the respiratory sampling methods is of paramount importance. This article aims to provide an overview of the various methods and their evidence till date.