The "oral" history of COVID-19: Primary infection, salivary transmission, and post-acute implications.
The "oral" history of COVID-19: Primary infection, salivary transmission, and post-acute implications.
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DOI：
10.1002/jper.21-0277
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发表时间：
2021-10
影响因子：
4.3
通讯作者：
中科院分区：
文献类型：
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作者：
截至2021年5月，COVID-19的病原体严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）已导致全球超过325万人死亡。已知COVID-19在临床上具有异质性，并且所报告的COVID-19的口腔体征和症状是否与口腔组织的直接感染有关仍然未知。在这里，我们回顾并总结了SARS-CoV-2对腺体、口腔粘膜和唾液的原发性感染的证据。不仅在所有口腔组织中发现了SARS-CoV-2的进入因素，而且这些组织也是SARS-CoV-2感染和复制的部位。此外，来自无症状个体的唾液含有游离病毒和SARS-CoV-2感染的口腔上皮细胞，两者都被发现传播病毒。总的来说，这些研究支持口腔在SARS-CoV-2感染的传播和传播中的积极作用。除了保持适当使用个人防护设备和方案以限制通过气溶胶或液滴产生的微生物传播外，牙科社区还将参与共同管理COVID-19“长途运输者”-现在称为急性COVID-19综合征。因此，我们建议，随着SARS-CoV-2的继续传播以及与COVID-19相关的新临床挑战的记录，口腔症状应纳入诊断和预后分类以及多学科护理计划。
Severe acute respiratorysyndrome coronavirus 2 (SARS‐CoV‐2), the causative agent of COVID‐19, has led to more than 3.25 million recorded deaths worldwide as of May 2021. COVID‐19 is known to be clinically heterogeneous, and whether the reported oral signs and symptoms in COVID‐19 are related to the direct infection of oral tissues has remained unknown. Here, we review and summarize the evidence for the primary infection of the glands, oral mucosae, and saliva by SARS‐CoV‐2. Not only were the entry factors for SARS‐CoV‐2 found in all oral tissues, but these were also sites of SARS‐CoV‐2 infection and replication. Furthermore, saliva from asymptomatic individuals contained free virus and SARS‐CoV‐2‐infected oral epithelial cells, both of which were found to transmit the virus. Collectively, these studies support an active role of the oral cavity in the spread and transmission of SARS‐CoV‐2 infection. In addition to maintaining the appropriate use of personal protective equipment and regimens to limit microbial spread via aerosol or droplet generation, the dental community will also be involved in co‐managing COVID‐19 “long haulers”—now termed Post‐Acute COVID‐19 Syndrome. Consequently, we propose that, as SARS‐CoV‐2 continues to spread and as new clinical challenges related to COVID‐19 are documented, oral symptoms should be included in diagnostic and prognostic classifications as well as plans for multidisciplinary care.