Viral enanthema in oral mucosa: A possible diagnostic challenge in the COVID‐19 pandemic

Rocha, Breno Amaral; Souto, Giovanna Ribeiro; Grossmann, Soraya de Mattos Camargo; Aguiar, Maria Cássia Ferreira de; Andrade, Bruno Augusto Benevenuto de; Romañach, Mário José; Horta, Martinho Campolina Rebello

doi:10.1111/odi.13473

Cited by 23 publications

(29 citation statements)

References 10 publications

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“…Initially, COVID-19-related olfactory and gustatory dysfunction was described as a possible surrogate marker of SARS-CoV-2 infection, sometimes presented as a single symptom of the disease [ 8 ]. Then, a few isolated cases or short series of oral manifestations of COVID-19 such as oral ulcers, petechiae, and reddish spots, mostly on the palate, in addition to desquamative gingivitis and blisters on the lower lip and cheek mucosa were reported[ 9 , 10 , 11 , 12 , 13 , 14 ]. The authors point out that, such oral lesions have a special character in the early diagnosis and management of the disease [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Complications of COVID-19 in the maxillo-facial region: Clinical case and review of the literature

Boymuradov

Rustamova

Bobamuratova

et al. 2021

Advances in Oral and Maxillofacial Surgery

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COVID-19 is currently causing a pandemic around the world. With the increase in the number of patients, there was a slight increase in the incidence of various complications. In particular, infectious and inflammatory diseases of the face and jaw are observed in patients with COVID-19 in the early infectious stages of the disease, as well as in the late stages. In the previous literature, as a sign or complication of COVID-19 were mentioned cases of changes in the oral cavity - ulcers, rashes, and inflammation of salivary glands. The conditions presented in this article are a serious complication of COVID-19, radically different from the usual course of osteomyelitis, in which the patient has a course with a predominance of long-term, chronic-progressive, atrophic processes. Treatment was somewhat ineffective due to local chronic inflammation (pansinusitis), metabolic, microcirculatory, immune, and coagulation disorders in patients.

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Section: Discussionmentioning

confidence: 99%

Complications of COVID-19 in the maxillo-facial region: Clinical case and review of the literature

Boymuradov

Rustamova

Bobamuratova

et al. 2021

Advances in Oral and Maxillofacial Surgery

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“…Dry mouth and amblygeustia are experienced by a relatively high proportion of COVID-19 patients ( 12 ). Also, viral enanthema in the oral mucosa is considered as a possible diagnostic challenge in the COVID-19 pandemic ( 13 ). As the oropharyngeal cavity is a route of COVID-19 transmission, it might have adverse impacts on patients' oral health.…”

Section: Introductionmentioning

confidence: 99%

ACE2 and Furin Expressions in Oral Epithelial Cells Possibly Facilitate COVID-19 Infection via Respiratory and Fecal–Oral Routes

et al. 2020

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Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that mainly transfers from human to human via respiratory and gastrointestinal routes. The S-glycoprotein in the virus is the key factor for the entry of SARS-CoV-2 into the cell, which contains two functional domains: S1 is an angiotensin-converting enzyme 2 (ACE2) receptor binding domain, and S2 is necessary for fusion of the coronavirus and cell membranes. Moreover, it has been reported that ACE2 is likely to be the receptor for SARS-CoV-2. In addition, mRNA level expression of Furin enzyme and ACE2 receptor had been reported in airway epithelia, cardiac tissue, and enteric canals. However, the expression patterns of ACE2 and Furin in different cell types of oral tissues are still unclear.Methods: In order to investigate the potential infective channel of the new coronavirus via the oropharyngeal cavity, we analyze the expression of ACE2 and Furin in human oral mucosa using the public single-cell sequence datasets. Furthermore, immunohistochemistry was performed in mucosal tissue from different oral anatomical sites to confirm the expression of ACE2 and Furin at the protein level.Results: The bioinformatics results indicated the differential expression of ACE2 and Furin on epithelial cells from different oral anatomical sites. Immunohistochemistry results revealed that both the ACE2-positive and Furin-positive cells in the target tissues were mainly positioned in the epithelial layers, partly expressed in fibroblasts, further confirming the bioinformatics results.Conclusions: Based on these findings, we speculated that SARS-CoV-2 could invade oral mucosal cells through two possible routes: binding to the ACE2 receptor and fusion with cell membrane activated by Furin protease. Our results indicated that oral mucosa tissues are susceptible to SARS-CoV-2 that could facilitate COVID-19 infection via respiratory and fecal–oral routes.

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“…Similarly, in the case reported by Amorim Dos Santos et al, it was observed as oral changes the presence of persistent white plaque and several ulcers on the dorsum of the tongue resembling the late stage of recurrent herpetic oral lesions. Some authors have discussed the possibility of the relationship between these oral alterations and SARS-CoV-2 infection (Abu-Hammad et al, 2020;Al-Khatib, 2020;Amorim Dos Santos et al;Petrescu et al, 2020;Ponce & Tjioe, 2020;Rocha et al, 2020). Abu-Hammad et al emphasize the possibility of these oral changes being associated with other infections of viral or fungal etiology.…”

Section: Discussionmentioning

confidence: 99%

Oral Alterations in a COVID-19 Patient: Case Report and Update of Main Findings

Gomes

Ferreira

Silva

et al. 2021

Int. J. Odontostomat.

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was characterized as a pandemic due to the worldwide dissemination and the severity with which the disease attacks the human organism. Some oral lesions have been observed in COVID-19 patients. However, there is still no concrete evidence of the real influence of SARS-CoV-2 on the human body, especially in the oral region. In this context, the present report discusses a case of a COVID-19 patient with oral alterations. The male patient presented ulcerative lesions of painful symptomatology and petechiae in the oral mucosa. This study also performed a literature review of the main oral alterations reported in the literature. Although more studies with a larger number of cases should be performed, the present clinical case may have manifested signs of this pathology in the oral cavity since the epithelial cells of the oral mucosa have ACE2 receptors.

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Viral enanthema in oral mucosa: A possible diagnostic challenge in the COVID‐19 pandemic

Cited by 23 publications

References 10 publications

Complications of COVID-19 in the maxillo-facial region: Clinical case and review of the literature

Complications of COVID-19 in the maxillo-facial region: Clinical case and review of the literature

ACE2 and Furin Expressions in Oral Epithelial Cells Possibly Facilitate COVID-19 Infection via Respiratory and Fecal–Oral Routes

Oral Alterations in a COVID-19 Patient: Case Report and Update of Main Findings

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