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Oral Pathology in COVID-19 and SARS-CoV-2 Infection-Molecular Aspects

Agnieszka Drozdzik1, Marek Drozdzik2

  • 1Department of Integrated Dentistry, Pomeranian Medical University in Szczecin, Powstancow Wlkp 72, 70-111 Szczecin, Poland.

International Journal of Molecular Sciences
|February 15, 2022
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects the oral cavity via ACE2 and TMPRSS2. Saliva transmits the virus, highlighting the need for local treatments to curb COVID-19 spread.

Area of Science:

  • Oral Medicine
  • Virology
  • Infectious Diseases

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission primarily occurs through respiratory droplets and aerosols originating from the oral cavity.
  • Oral tissues, including mucosa and salivary glands, express key SARS-CoV-2 entry factors like angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2).
  • Viral replication within oral cells can lead to localized and systemic infection, manifesting as distinct clinical signs and symptoms.

Purpose of the Study:

  • To review and evaluate existing evidence on the molecular mechanisms of SARS-CoV-2 infection within the oral cavity.
  • To explore the role of saliva and oral structures in SARS-CoV-2 transmission.
  • To identify factors influencing oral SARS-CoV-2 infection and potential local therapeutic interventions.

Main Methods:

  • A systematic literature review was conducted using PubMed and Scopus databases.
  • Keywords included SARS-CoV-2, COVID-19, oral virus infection, saliva, ACE2, TMPRSS2, and topical treatments.
  • Sixty-three articles published up to December 28, 2021, were included after data extraction and quality assessment by two reviewers.

Main Results:

  • The oral cavity's epithelial cells and salivary glands express SARS-CoV-2 entry receptors (ACE2) and proteases (TMPRSS2), facilitating viral infection.
  • Saliva, in both cellular and acellular components, harbors SARS-CoV-2, significantly contributing to disease transmission.
  • Cellular damage from viral replication correlates with oral clinical manifestations of COVID-19.

Conclusions:

  • The oral cavity is a critical site for SARS-CoV-2 infection and a significant source of viral transmission.
  • Understanding the molecular processes involved is essential for developing targeted interventions.
  • Local pharmacotherapeutic strategies hold promise for limiting SARS-CoV-2 entry and spread within the oral environment.
Keywords:
COVID-19SARS-CoV-2oral cavity

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