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Schaefer J, Khanna D. Nutritional and Wellness Strategies for Neurological and Psychiatric Recovery From Post-COVID Syndrome and Post-acute Sequelae of COVID-19. Cureus 2023; 15:e51076. [PMID: 38269219 PMCID: PMC10806386 DOI: 10.7759/cureus.51076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/24/2023] [Indexed: 01/26/2024] Open
Abstract
The post-COVID syndrome was officially recognized as a disability under the Americans with Disabilities Act, indicating that this syndrome has made a significant impact on our populace. Also, post-acute sequelae of COVID-19 (PASC) is a term that describes the long-term health problems that some people experience after being infected with the virus that causes COVID-19. These problems can last for weeks, months, or even years, and can affect various parts of the body, such as the heart, lungs, brain, and blood vessels. This narrative review paper utilized the PubMed database to explore the pathophysiology of post-COVID syndrome's neurological and psychiatric symptoms and PASC and make therapeutic connections to the known mechanisms of various nutritional, supplemental, and wellness approaches. Searches were queried on the PubMed database between March 29 and April 16, 2022, using the phrases "long-covid," "post-COVID syndrome," "Vitamin D covid," "vitamin C covid," "omega-3 covid," "kynurenine covid," "whole-body hyperthermia," "mushrooms immunity," "n-acetyl cysteine covid," "mushrooms cognition," "sugar consumption inflammation," and "covid microbiome." Articles were screened for their relevance to the discussion of post-COVID syndrome's neurological and psychiatric pathophysiology at the discretion of the principal researcher. There were no limitations regarding publication years, but articles from 2005 to April 2022 were cited. Micro-ischemic disease, neuropathy, autoimmune processes, mast-cell activation, and impaired blood-brain barriers have all been implicated in the pathological processes of this syndrome with varying degrees of supportive evidence. The common denominators, however, are inflammation and oxidative stress. Therefore, a beneficial approach to dealing with the complications of post-COVID syndrome would be to reduce the exacerbations of these common denominators with lifestyle and nutritional changes. Replenishing nutritional deficiencies, supplementing with N-acetylcysteine, decreasing consumption of refined sugars, preventing dysbiosis of the microbiome, performing exercises, increasing dietary intake of mushrooms, utilizing beneficial herbs such as rosemary, and increasing the core body temperature through whole-body hyperthermia seem to show potential for efficacy in this pursuit. Considering the safety and evidence-based connections of the therapies explored for dealing with the post-Covid syndrome, it could be of great benefit and of little harm to our patients to include these considerations in formulating post-Covid treatment plans.
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Affiliation(s)
- Jeffrey Schaefer
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Deepesh Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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2
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MOHAMMED FARAZ, FAIROZEKHAN ARISHIYATHAPASUM, MOHAMED SHAMAZ, ALMOUMEN SAUDABDULLAH, BUGSHAN AMRS, ALMOMEN ZAINABI, ALMOMEN AMINAHMOHAMMAD, M SHASHIKIRAN, ALMULHIM KHALIDS. Oral manifestations associated with Novel Coronavirus Disease - 2019 (COVID-19): A questionnaire based hypothetical study. F1000Res 2023; 11:1443. [PMID: 37360936 PMCID: PMC10285348 DOI: 10.12688/f1000research.128125.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
Background: Since the Coronavirus disease 2019 (COVID-19) outbreak in 2019, the virus has evolved drastically, presenting with sets of mutations that influence its properties, including transmissibility and antigenicity. The oral mucosa is postulated as probable portal entry and several oral manifestations have been identified, which places dental professionals in a position to recognize probable COVID-19 patients depending on oral signs and symptoms in the initial phases of the disease itself. As co-existing with COVID-19 seems to be a new reality, greater understanding is required regarding early oral signs and symptoms which can be predictors for timely intervention and prevention of complications in COVID-19 patients. The objective of the study is to identify the distinguishing oral signs and symptoms among COVID-19 patients and to establish possible correlation between severity of COVID-19 infection and oral symptoms. Methods: This study recruited 179 ambulatory, non-hospitalized COVID-19 patients from the Kingdom of Saudi Arabia's Eastern Province's designated hotels for COVID-19 and home isolated patients from the same region using a convenience sample method. Data was collected by qualified and experienced investigators, including two physicians and three dentists, using a validated comprehensive questionnaire through telephonic interviews with the participants. The X 2 was used to assess the categorical variables, and odd's ratio was calculated to determine the strength of the association between general symptoms and oral manifestations. Results: Oral and nasopharyngeal lesions or conditions like loss of smell and taste, xerostomia, sore throat, and burning sensation were predictors of COVID-19-related systemic symptoms such as cough, fatigue, fever, and nasal congestion were identified to be statistically significant (p<0.05). Conclusions: The study reveals the occurrence of olfactory or taste dysfunction, dry mouth, sore throat, and burning sensation along with COVID-19 generic symptoms, should be considered as suggestive yet not conclusive indicators of COVID-19.
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Affiliation(s)
- FARAZ MOHAMMED
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, P.O. Box 1982, Saudi Arabia
| | - ARISHIYA THAPASUM FAIROZEKHAN
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, P.O. Box 1982, Saudi Arabia
| | - SHAMAZ MOHAMED
- Senior Manager, BioQuest Solutions Pvt Ltd, Bangalore, Karnataka, India
| | - SAUD ABDULLAH ALMOUMEN
- Oral & Maxillofacial Surgery - Dental Division, Ministry of Health, Dammam, Eastern Province, Saudi Arabia
- Postgraduate Scholar, Oral & Maxillofacial Surgery, Riyadh Elm University, Riyadh, Saudi Arabia
| | - AMR S. BUGSHAN
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, P.O. Box 1982, Saudi Arabia
| | - ZAINAB I. ALMOMEN
- Medical Intern, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, P.O. Box 1982, Saudi Arabia
| | | | - SHASHI KIRAN M
- Manager, BioQuest Solutions Pvt Ltd, Bangalore, Karnataka, India
| | - KHALID S. ALMULHIM
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia
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3
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Lin W, Gao F, Wang X, Qin N, Chen X, Tam KY, Zhang C, Zhang M, Sha O. The oral manifestations and related mechanisms of COVID-19 caused by SARS-CoV-2 infection. Front Cell Neurosci 2023; 16:1006977. [PMID: 36687524 PMCID: PMC9846147 DOI: 10.3389/fncel.2022.1006977] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) was reported to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and patients present mostly with respiratory symptoms. There have been an increasing number of reports on oral manifestations, and some of these signs are informative in terms of identifying SARS-CoV-2 infection. The goal of present study was to review and synthesize the clinical characteristics and underlying mechanisms of COVID-19 oral manifestations, as well as to evaluate the factors influencing SARS-CoV-2 infectivity, in order to conduct further in-depth investigations and help clinicians diagnose COVID-19 patients exhibiting oral symptoms.
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Affiliation(s)
- Weiming Lin
- Shenzhen University Medical School, Shenzhen, China
| | - Feng Gao
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China
| | - Xia Wang
- Shenzhen University Medical School, Shenzhen, China
| | - Nianhong Qin
- Shenzhen University Medical School, Shenzhen, China
| | - Xianxiong Chen
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China
| | - Kin Yip Tam
- Faculty of Health Sciences, University of Macau, Macau, Macau SAR, China
| | - Chengfei Zhang
- Shenzhen University Medical School, Shenzhen, China,School of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mingxia Zhang
- The Third People’s Hospital of Shenzhen, Shenzhen, China,Mingxia Zhang,
| | - Ou Sha
- School of Dentistry, Shenzhen University Medical School, Shenzhen, China,*Correspondence: Ou Sha,
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4
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Fetyukov AV, Pshennikov DS, Zaitseva SE. [Olfactory, gustatory and auditory disorders associated with COVID-19. A systematic review of their distribution and pathogenesis]. Vestn Otorinolaringol 2023; 88:61-66. [PMID: 38153895 DOI: 10.17116/otorino20238806161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
The presented systematic review contains basic information about the frequency, characteristic features of the course and pathogenesis of olfactory, gustatory and auditory disorders that occur with COVID-19, with which an otorhinolaryngologist meets in his practice. These disorders are often the first, and sometimes the only, manifestations of the underlying disease, which determines their role in early diagnosis and timely detection of the underlying disease. The article includes original articles, clinical case reports and literary reviews.
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Affiliation(s)
| | - D S Pshennikov
- Ryazan State Medical University, Ryazan, Russia
- Semashko Ryazan Regional Clinical Hospital, Ryazan, Russia
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Lin TY, Shen PC, Lee SA, Yeh SM, Chang KV, Wang TG. Case report: Dysphagia after COVID-19 infection in a stroke patient-Is neurostimulation a potential management? Front Neurol 2023; 14:1126390. [PMID: 36949856 PMCID: PMC10025385 DOI: 10.3389/fneur.2023.1126390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
A 90-year-old man with stroke was weaned from tube feeding 4 months after stroke onset. However, he had a coronavirus disease 2019 (COVID-19) infection after 2 months and suffered from drastically worsened oropharyngeal dysphagia that required a reinsertion of the nasogastric tube. A videofluoroscopic swallowing study revealed poor bolus oral transit, significantly delayed swallowing reflex, reduced pharyngeal movements, and insufficient cough response. Repetitive transcranial magnetic stimulation and neuromuscular electrical stimulation were applied, in addition to conventional swallowing training. The feeding tube was removed after 20 treatment sessions. Clinicians should be aware of the risk of dysphagia after COVID-19 infection in patients with underlying neurological diseases. The management of post-COVID-19 dysphagia has not yet been fully established. Repetitive transcranial electrical stimulation combined with neuromuscular electrical stimulation may be used as an auxiliary intervention in specific cases.
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Affiliation(s)
- Ting-Yu Lin
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
| | - Peng-Chieh Shen
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
| | - Shao-An Lee
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
| | - Shu-Ming Yeh
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
- *Correspondence: Shu-Ming Yeh
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan
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Pathogenesis and progression of anosmia and dysgeusia during the COVID-19 pandemic. Eur Arch Otorhinolaryngol 2023; 280:505-509. [PMID: 36209486 PMCID: PMC9548302 DOI: 10.1007/s00405-022-07689-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/04/2022] [Indexed: 01/21/2023]
Abstract
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is the causative agent of COVID-19 which was detected in late 2019 in Wuhan, China. As of September 2022, there have been over 612 million confirmed cases of COVID-19 with over 6.5 million associated deaths. In many cases, anosmia and dysgeusia have been identified as primary symptoms of COVID-19 infection in patients. While the loss of smell (anosmia) and loss of taste (dysgeusia) due to COVID-19 infection is transient in most patients, many report that these symptoms persist following recovery. Understanding the pathogenesis of these symptoms is paramount to early treatment of the infection. We conducted a literature review of Google Scholar and PubMed to find and analyze studies discussing anosmia and dysgeusia in the context of COVID-19 to understand the progression and management of these symptoms. The mechanism for dysgeusia is largely unknown; however, pathogenesis of anosmia includes inflammation and cytokine release resulting from the infection that alters neuronal signaling, thus inducing the loss of smell that patients experience. Anosmia may be managed and potentially resolved sooner with a combination therapy of olfactory training and budesonide irrigation of the nasal cavity. It is important to note that the variants of SARS-CoV-2 are genetically distinguished from the original virion due to a mutation in their spike proteins, giving them a different symptom profile regarding anosmia and dysgeusia. This variability in symptomatology is an area of study that needs to be further explored.
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Ferrulli A, Senesi P, Terruzzi I, Luzi L. Eating Habits and Body Weight Changes Induced by Variation in Smell and Taste in Patients with Previous SARS-CoV-2 Infection. Nutrients 2022; 14:nu14235068. [PMID: 36501098 PMCID: PMC9738767 DOI: 10.3390/nu14235068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022] Open
Abstract
Olfactory and gustatory dysfunction are recognized as common symptoms in patients with COVID-19, with a prevalence ranging, respectively, between 41-61% and 38.2-49%. This review focused on relating the variations in dietary habits with the reduction/loss of smell and/or taste in patients who contracted the COVID-19 infection. Primarily, we reviewed the main pathological mechanisms involved in COVID 19-induced anosmia/dysosmia and ageusia/dysgeusia. Then, we explored and summarized the behavioural changes in food intake and body weight during the COVID-19 pandemic in relation to sensory impairment and the underlying mechanisms. Most studies on this topic argue that the altered chemosensory perception (taste and smell) mainly induces reduced appetite, leading to a faster fullness sensation during the consumption of a meal and, therefore, to a decrease in body weight. On the other hand, a reduced perception of the food's sensory properties may trigger compensatory responses that lead some individuals to increase food intake with a different effect on body weight. Regarding body weight, most studies evaluated malnutrition in patients hospitalized for COVID-19; more studies are warranted to investigate nutritional status specifically in non-hospitalized patients with olfactory and gustatory dysfunctions caused by COVID-19 infection.
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Affiliation(s)
- Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- Correspondence: or ; Tel.: +39-02-8599-4572
| | - Pamela Senesi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
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8
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El Tantawi M, Sabbagh HJ, Alkhateeb NA, Quritum M, Abourdan J, Qureshi N, Qureshi S, Hamoud A, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Gomaa N, Al_Nahdi R, Mahmoud N, El Wazziki H, Alnaas M, Samodien B, Mahmoud R, Abu Assab N, Saad S, Al-Hachim S, Alshaikh A, Abdelaziz W. Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study. PeerJ 2022; 10:e13555. [PMID: 35860046 PMCID: PMC9291069 DOI: 10.7717/peerj.13555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/17/2022] [Indexed: 01/17/2023] Open
Abstract
Background Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered. Objectives The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers. Methods This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations. Results Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19- infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86). Conclusion Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.
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Affiliation(s)
- Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Joud Abourdan
- Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, Scotland, United Kingdom
| | - Shabnum Qureshi
- Department of Education, University of Kashmir, Srinagar, Kashmir, India
| | - Ahmed Hamoud
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Nada Mahmoud
- Faculty of Dentistry, National Ribat University, Khartoum, Sudan
| | - Ruba Odeh
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery/Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Rawiah Jaber
- General Courses, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mohammed Shabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Noha Gomaa
- Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
| | - Raqiya Al_Nahdi
- Department of Dental Surgery, Oman Dental College, Muscat, Oman
| | | | - Hanane El Wazziki
- Department of Cereal Plant Pathology, National Institute of Aricultural Research, Settat, Morocco
| | - Manal Alnaas
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Bahia Samodien
- Western Cape Education Department, Western Cape, South Africa
| | - Rawa Mahmoud
- International Medical Center, Jeddah, Saudi Arabia
| | - Nour Abu Assab
- Schools of Awqaf, Directorate of Education, Jerusalem, Palestine
| | | | - Sondos Al-Hachim
- Health Education Services, Ingham County, Lansing, Michigan, United States of America
| | - Ali Alshaikh
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wafaa Abdelaziz
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Lyras EM, Zimmermann K, Wagner LK, Dörr D, Klose CSN, Fischer C, Jung S, Yona S, Hovav AH, Stenzel W, Dommerich S, Conrad T, Leutz A, Mildner A. Tongue immune compartment analysis reveals spatial macrophage heterogeneity. eLife 2022; 11:77490. [PMID: 35749158 PMCID: PMC9232218 DOI: 10.7554/elife.77490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/29/2022] [Indexed: 12/29/2022] Open
Abstract
The tongue is a unique muscular organ situated in the oral cavity where it is involved in taste sensation, mastication, and articulation. As a barrier organ, which is constantly exposed to environmental pathogens, the tongue is expected to host an immune cell network ensuring local immune defence. However, the composition and the transcriptional landscape of the tongue immune system are currently not completely defined. Here, we characterised the tissue-resident immune compartment of the murine tongue during development, health and disease, combining single-cell RNA-sequencing with in situ immunophenotyping. We identified distinct local immune cell populations and described two specific subsets of tongue-resident macrophages occupying discrete anatomical niches. Cx3cr1+ macrophages were located specifically in the highly innervated lamina propria beneath the tongue epidermis and at times in close proximity to fungiform papillae. Folr2+ macrophages were detected in deeper muscular tissue. In silico analysis indicated that the two macrophage subsets originate from a common proliferative precursor during early postnatal development and responded differently to systemic LPS in vivo. Our description of the under-investigated tongue immune system sets a starting point to facilitate research on tongue immune-physiology and pathology including cancer and taste disorders.
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Affiliation(s)
| | - Karin Zimmermann
- Max-Delbrück-Center for Molecular Medicine Berlin, Berlin, Germany
| | | | - Dorothea Dörr
- Max-Delbrück-Center for Molecular Medicine Berlin, Berlin, Germany.,Institute of Biology, Humboldt University of Berlin, Berlin, Germany
| | - Christoph S N Klose
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Microbiology, Infectious Diseases and Immunology, Charité Berlin, Berlin, Germany
| | | | | | - Simon Yona
- Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Avi-Hai Hovav
- Institute of Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Werner Stenzel
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Charité Berlin, Berlin, Germany
| | - Steffen Dommerich
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Otorhinolaryngology, Charité Berlin, Berlin, Germany
| | - Thomas Conrad
- Max-Delbrück-Center for Molecular Medicine Berlin, Berlin, Germany
| | - Achim Leutz
- Max-Delbrück-Center for Molecular Medicine Berlin, Berlin, Germany.,Institute of Biology, Humboldt University of Berlin, Berlin, Germany
| | - Alexander Mildner
- Max-Delbrück-Center for Molecular Medicine Berlin, Berlin, Germany.,InFLAMES Research Flagship Center, University of Turku, Turku, Finland.,Institute of Biomedicine, Medicity, University of Turku, Turku, Finland
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10
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Hafez W, Abdelshakor M, Gador M, Abdelli I, Ahmed S. The Prevalence and Implications of Olfactory/Gustatory Dysfunctions among Adult COVID-19 Patients: A Retrospective Cohort Multiethnic Populations Study. Trop Med Infect Dis 2022; 7:tropicalmed7070115. [PMID: 35878127 PMCID: PMC9320986 DOI: 10.3390/tropicalmed7070115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Olfactory and gustatory dysfunctions (OGDs) was found in COVID-19 patients. Only a few studies looked into the prevalence of OGDs in the United Arab Emirates (UAE). The purpose of this study was to estimate the prevalence OGDs among multiethnic COVID-19 patients in the UAE, and its association to patients’ characteristics and disease outcomes; (2) Methods: There were 1785 COVID-19 patients included in our cohort; (3) Results: Males made up most of the study participants (86.3%). A total of 11.7% of the participants reported OGDs. Female gender and ethnicity had significantly higher symptom prevalence (p < 0.001). COVID-19 severity had a strong inverse association with OGDs (p = 0.007). Other illness outcomes, such as ICU admission, pneumonia development, and mortality, showed no correlation. Males, Asians, and patients with comorbidities all had statistically significantly lower prevalence odds. On the other hand, Emirati, Arab, and Iranian patients had a higher prevalence. COVID-19 patients with OGDs had a considerably shorter time until viral clearance than those without the symptom; (4) Conclusions: in nonsevere COVID-19, olfactory/gustatory dysfunction is common. As a result, it could be applied as a predictive sign for early disease diagnosis and prognosis.
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Affiliation(s)
- Wael Hafez
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
- The Medical Research Division, Department of Internal Medicine, The National Research Center, El Buhouth Street, Ad Doqi, Cairo 12622, Egypt
- Correspondence:
| | - Mahmoud Abdelshakor
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
| | - Muneir Gador
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
| | - Ikram Abdelli
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
| | - Shougyat Ahmed
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
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11
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Becker J, Papagianni A, Herrmann E, Nöller F, Sommer C, Rittner HL. Transient hypoalgesia after COVID-19 infection. Pain Rep 2022; 7:e990. [PMID: 35295965 PMCID: PMC8920299 DOI: 10.1097/pr9.0000000000000990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/14/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. In-depth phenotype analysis of a patient after COVID-19 disease in spring 2020 with long-lasting dysgeusia and transient hypoalgesia as supported by clinical examination, reduced axon flare reaction and loss of intraepidermal fibers. Introduction: Loss of smell or taste are often-cited complications during COVID-19 disease, but there is no clear evidence for affection of the peripheral nervous system. Methods: Here, we report a 48-year-old man presenting with persistent dysgeusia and hypoalgesia of the lower legs, hands, and cheeks after COVID-19 infection in Spring 2020. Results: Upon clinical examination 7 months after the infection, the patient could not feel pain after pinprick stimuli. Quantitative sensory testing revealed increased thermal detection thresholds at the face but no changes at the foot. Electrical C-fiber stimulation elicited lower pain ratings at the distal leg compared with the proximal leg, but overall higher pain ratings than in healthy control subjects. The axon flare reaction in response to histamine and acetylcholine was almost absent with no pain sensation. Skin punch biopsy revealed a reduced intraepidermal nerve fiber density at the lower leg, and transient receptor potential vanilloid 1 and calcitonin gene-related peptide immunoreactivity were similar to a healthy control. Symptoms and positive tests improved 5 months later. Conclusion: In summary, we describe a case of hypoalgesia after COVID-19 disease. Studies investigating long-COVID syndrome should test not only for painful neuropathic symptoms but also for hypoalgesia, especially in patients with prolonged dysgeusia.
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Affiliation(s)
| | | | | | - Frank Nöller
- Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Claudia Sommer
- Neurology, University Hospital of Würzburg, Würzburg, Germany
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12
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Ghods K, Alaee A. Olfactory and Taste Disorders in Patients Suffering from Covid-19, a Review of Literature. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:1-6. [PMID: 35291682 PMCID: PMC8918638 DOI: 10.30476/dentjods.2021.87800.1284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/22/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023]
Abstract
Corona virus epidemic has caused a widespread disaster around the world. In studies, there are pieces of evidence of olfactory and taste dysfunction in patients with Covid-19. These symptoms occur independently or can be associated with other symptoms such as dry cough. The mechanism of the above-mentioned disorders and their clinical features in patients are not yet known. The rate of incidence of olfactory dysfunction in patients has been varied from 29.64% to 75.23% and the rate of incidence of taste dysfunction among the people can be different from 20.46% to 68.95%. Therefore, clinicians including ENT specialists and dentists should pay attention to the symptoms of anosmia and ageusia in these patients to prevent delayed diagnosis and inappropriate treatments. In this review article, data have been collected by searching the available articles in the domestic and foreign journals using databases such as PubMed, PubMed Central, Medline, EBSCO, Google Scholar, and Embase with key words of Anosmia, Ageusia, Dysgeusia, Covid-19, and Coronavirus from 2019 to 2020. Among the relevant references, 38 authoritative articles were chosen. The data showed that it seems olfactory and taste function disorders are the obvious symptoms of Covid-19, which can occur independently or with other symptoms, but the pathogenesis is not well specified yet. Therefore, further studies are required to achieve a reliable result in this area.
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Affiliation(s)
- Kimia Ghods
- Student of Dentistry, Membership of Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arezoo Alaee
- Dept. of Oral Medicine, Membership of Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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13
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Tsuchiya H. Gustatory and Saliva Secretory Dysfunctions in COVID-19 Patients with Zinc Deficiency. Life (Basel) 2022; 12:life12030353. [PMID: 35330104 PMCID: PMC8950751 DOI: 10.3390/life12030353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/22/2022] Open
Abstract
Given the ever-progressing studies on coronavirus disease 2019 (COVID-19), it is critical to update our knowledge about COVID-19 symptomatology and pathophysiology. In the present narrative review, oral symptoms were overviewed using the latest data and their pathogenesis was hypothetically speculated. PubMed, LitCovid, ProQuest, and Google Scholar were searched for relevant studies from 1 April 2021 with a cutoff date of 31 January 2022. The literature search indicated that gustatory dysfunction and saliva secretory dysfunction are prevalent in COVID-19 patients and both dysfunctions persist after recovery from the disease, suggesting the pathogenic mechanism common to these cooccurring symptoms. COVID-19 patients are characterized by hypozincemia, in which zinc is possibly redistributed from blood to the liver at the expense of zinc in other tissues. If COVID-19 induces intracellular zinc deficiency, the activity of zinc-metalloenzyme carbonic anhydrase localized in taste buds and salivary glands may be influenced to adversely affect gustatory and saliva secretory functions. Zinc-binding metallothioneins and zinc transporters, which cooperatively control cellular zinc homeostasis, are expressed in oral tissues participating in taste and saliva secretion. Their expression dysregulation associated with COVID-19-induced zinc deficiency may have some effect on oral functions. Zinc supplementation is expected to improve oral symptoms in COVID-19 patients.
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14
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Catamo E, Robino A, Tinti D, Dovc K, Franceschi R, Giangreco M, Gasparini P, Barbi E, Cauvin V, Rabbone I, Battelino T, Tornese G. Altered Taste Function in Young Individuals With Type 1 Diabetes. Front Nutr 2022; 8:797920. [PMID: 35096943 PMCID: PMC8790289 DOI: 10.3389/fnut.2021.797920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/08/2021] [Indexed: 01/08/2023] Open
Abstract
Past studies on altered taste function in individuals with type 1 diabetes have yielded inconsistent results. We therefore evaluated taste recognition and possible association with personal and diseases characteristics in young individuals with type 1 diabetes and healthy controls. Taste recognition and intensity for 6-n-propylthiouracil (PROP), quinine, citric acid, sucrose, and sodium chloride were assessed using a filter paper method in 276 participants with type 1 diabetes and 147 healthy controls. Personal and clinical data were recorded for all participants during a baseline visit. Regression analysis was adjusted for sex, age, and standardized BMI. Overall, 47% of participants with type 1 diabetes vs. 63.5% of healthy controls recognized all tastes (p = 0.006). Moreover, a lower capacity for recognizing the bitter taste of PROP and the sour taste of citric acid was found in participants with type 1 diabetes compared to healthy controls (p = 0.014 and p = 0.003, respectively). While no significant effect of glycemic control on taste recognition was found, an association with lower age at onset emerged. Our findings suggest an impaired taste perception in individuals with type 1 diabetes, possibly linked to age at onset.
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Affiliation(s)
- Eulalia Catamo
- Institute for Maternal and Child Health, Scientific Institute for Research, Hospitalization and Healthcare Burlo Garofolo (IRCCS), Trieste, Italy
| | - Antonietta Robino
- Institute for Maternal and Child Health, Scientific Institute for Research, Hospitalization and Healthcare Burlo Garofolo (IRCCS), Trieste, Italy
| | - Davide Tinti
- Center for Pediatric Diabetology, A.O.U. Città della Salute e della Scienza, Torino, Italy
| | - Klemen Dovc
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Endocrinology, Diabetes and Metabolism, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Manuela Giangreco
- Institute for Maternal and Child Health, Scientific Institute for Research, Hospitalization and Healthcare Burlo Garofolo (IRCCS), Trieste, Italy
| | - Paolo Gasparini
- Institute for Maternal and Child Health, Scientific Institute for Research, Hospitalization and Healthcare Burlo Garofolo (IRCCS), Trieste, Italy.,Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health, Scientific Institute for Research, Hospitalization and Healthcare Burlo Garofolo (IRCCS), Trieste, Italy.,Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Vittoria Cauvin
- Division of Pediatrics, S. Chiara General Hospital, Trento, Italy
| | - Ivana Rabbone
- Center for Pediatric Diabetology, A.O.U. Città della Salute e della Scienza, Torino, Italy.,Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Tadej Battelino
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Endocrinology, Diabetes and Metabolism, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gianluca Tornese
- Institute for Maternal and Child Health, Scientific Institute for Research, Hospitalization and Healthcare Burlo Garofolo (IRCCS), Trieste, Italy
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Olfactory Dysfunction in COVID-19 Patients Who Do Not Report Olfactory Symptoms: A Pilot Study with Some Suggestions for Dentists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031036. [PMID: 35162061 PMCID: PMC8834295 DOI: 10.3390/ijerph19031036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Smell and taste dysfunction are frequently reported by SARS-CoV-2 positive patients. The degree of olfactory and gustatory dysfunction varies from a very mild reduction to their complete loss. Several studies have been performed to determine their prevalence in COVID-19 patients, mostly using subjective measurement methods. The literature lacks long-term studies regarding duration and recovery. METHODS We assessed olfactory performance, using the Sniffin' Sticks olfactory test, in a group of patients who had not reported olfactory dysfunction, around 131 days after their COVID-19 diagnosis. RESULTS 11 out of 20 subjects showed no olfactory reduction (65%), while 9 subjects showed reduced TDI score (45%). A total of 13 subjects (65%) scored above the cutoff point for Threshold, 16 subjects (80%) scored above the cutoff point for discrimination and 13 subjects (65%) scored above the cutoff point for identification. CONCLUSION Objective measurement methods of olfactory performance show a higher prevalence of olfactory reduction compared to patients' self-reported questionnaires. Olfactory dysfunction can last even months after its onset and because of its high prevalence, it could be a screening symptom for suspect COVID-19 cases.
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Cuevas-Gonzalez MV, Espinosa-Cristóbal LF, Donohue-Cornejo A, Tovar-Carrillo KL, Saucedo-Acuña RA, García-Calderón AG, Guzmán-Gastelum DA, Cuevas-Gonzalez JC. COVID-19 and its manifestations in the oral cavity: A systematic review. Medicine (Baltimore) 2021; 100:e28327. [PMID: 34941133 PMCID: PMC8701462 DOI: 10.1097/md.0000000000028327] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND SARS-CoV-2 is the virus responsible for coronavirus disease-19 (COVID-19) disease, which has been shown to trigger multiple affectations. One of the first tissue areas to come into contact with the virus is the oral cavity, which develops various alterations. Hence, the objective of this systematic review was to identify the main signs and symptoms of this disease in the oral cavity, and the following research question was established: What are the main oral signs and symptoms in COVID-19-positive persons? METHODS The electronic databases of PUBMED, SCOPUS, and SCIENCE DIRECT were analyzed, the keywords "ORAL DISEASES," "ORAL MANIFESTACTIONS," and "COVID-19" were used taking into account the following inclusion criteria: studies whose main objective was oral manifestations secondary to the confirmation of COVID-19, plus clinical cases, case series, and retrospective or prospective studies. For the assessment of the risk of bias the JBI Critical Appraisal Checklist for Case Series tool was used. RESULTS A total of 18 studies were included, the most common initial signs/symptoms after contagion of SARS-CoV-2 were dysgeusia, dry mouth, and burning mouth, and the main signs/symptoms were the presence of ulcerative lesions, dysgeusia, and Candida albicans infections. CONCLUSIONS It is very important to detect any alteration in the mucosa in patients with COVID-19 and to provide assertive treatment to avoid complications, and try to maintain adequate oral hygiene throughout the course of the disease to avoid the colonization of opportunistic microorganisms and to avoid complications both orally and systemically.
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Affiliation(s)
| | | | - Alejandro Donohue-Cornejo
- Institute of Biomedical Sciences, Autonomous University of Ciudad Juarez, Juarez City, Chihuahua, Mexico
| | | | - Rosa Alicia Saucedo-Acuña
- Institute of Biomedical Sciences, Autonomous University of Ciudad Juarez, Juarez City, Chihuahua, Mexico
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17
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Thomas DC, Chablani D, Parekh S, Pichammal RC, Shanmugasundaram K, Pitchumani PK. Dysgeusia: A review in the context of COVID-19. J Am Dent Assoc 2021; 153:251-264. [PMID: 34799014 PMCID: PMC8595926 DOI: 10.1016/j.adaj.2021.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/07/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022]
Abstract
Background Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During the COVID-19 pandemic, taste disorders have found their way into the realm of general as well as specialty dentistry, with significance in screening for patients who potentially may have the virus. Types of Studies Reviewed The authors searched electronic databases (PubMed, Embase, Web of Science, Google Scholar) for studies focused on dysgeusia, ageusia, and other taste disorders and their relationship to local and systemic causes. Results The authors found pertinent literature explaining the normal physiology of taste sensation, proposals for suggested new tastes, presence of gustatory receptors in remote tissues of the body, and etiology and pathophysiology of taste disorders, in addition to the valuable knowledge gained about gustatory disorders in the context of COVID-19. Along with olfactory disorders, taste disorders are one of the earliest suggestive symptoms of COVID-19 infection. Conclusions Gustatory disorders are the result of local or systemic etiology or both. Newer taste sensations, such as calcium and fat tastes, have been discovered, as well as taste receptors that are remote from the oropharyngeal area. Literature published during the COVID-19 pandemic to date reinforces the significance of early detection of potential patients with COVID-19 by means of screening for recent-onset taste disorders. Practical Implications Timely screening and identification of potential gustatory disorders are paramount for the dental care practitioner to aid in the early diagnosis of COVID-19 and other serious systemic disorders.
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Wu YH, Wu YC, Lang MJ, Lee YP, Jin YT, Chiang CP. Review of oral ulcerative lesions in COVID-19 patients: A comprehensive study of 51 cases. J Dent Sci 2021; 16:1066-1073. [PMID: 34306539 PMCID: PMC8279930 DOI: 10.1016/j.jds.2021.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Indexed: 01/21/2023] Open
Abstract
Numerous oral manifestations of COVID-19 have been reported in the literatures. Common oral lesions in COVID-19 patients included ulcerations, xerostomia, dysgeusia, gingival inflammation, and erythema. Among them, oral ulceration is the most frequent finding and is present as various but distinct patterns. Thus, we conducted a comprehensive review of 51 COVID-19 patients with oral ulcerative lesions to further analyze the various oral ulcerative lesions in COVID-19 patients. There were a median age of 41.4 years and a slight female predilection in these patients. Most oral lesions manifested as an aphtha-like ulceration but lack of an evidence of recurrent aphthous stomatitis. Some of them were present as herpetiform ulcerations without HSV infection. Widespread ulcerations accompanied with necrosis were observed in the more severe and immunosuppressed older patients. Although some reported patients were asymptomatic, most of them had systemic symptoms concurring or slightly preceding the oral ulcerative lesions and the latency from the onset of systemic symptoms to oral ulcerative lesions were under 10 days, suggesting that oral ulceration was one of the early symptoms of COVID-19. Therefore, the oral ulcerative lesions may be considered as oral markers for early diagnosis of the underlying COVID-19 infection in the asymptomatic patients.
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Affiliation(s)
- Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Ming-Jane Lang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yi-Pang Lee
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
- Corresponding author. Department of Pathology, Taiwan Adventist Hospital, No. 424, Section 2, Bade Road, Taipei 10556, Taiwan.
| | - Chun-Pin Chiang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Corresponding author. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan.
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19
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Farid H, Khan M, Jamal S, Ghafoor R. Oral manifestations of Covid-19-A literature review. Rev Med Virol 2021; 32:e2248. [PMID: 34028129 PMCID: PMC8209937 DOI: 10.1002/rmv.2248] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022]
Abstract
Initially, it was reported that coronavirus 2019 disease (Covid-19) affects respiratory, gastrointestinal and neurological systems, but the oral, olfactory and integumentary systems are also involved. This review discusses various oral manifestations of Covid-19 reported in the literature along with possible underlying mechanisms. The reported manifestations include taste impairment, oral mucosal changes (petechiae, ulcers, plaque-like lesions, reactivation of herpes simplex virus 1(HSV1), geographical tongue and desquamative gingivitis) and dry mouth. The prominent location for mucosal lesions are tongue, palate and labial mucosa. The exact pathogenesis of these oral symptoms is not known. Angiotensin-converting enzyme 2 (ACE2) cell receptors are expressed in abundance on oral mucosa allowing severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) to infect them. Gustatory impairment along with olfactory changes is now listed as a symptom of Covid-19 by the World Health Organization, but further research is needed to confirm a link between reported additional oral symptoms and Covid-19. Dental professionals may encounter individuals with Covid-19 and be called upon to identify various oral manifestations of this disease.
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Affiliation(s)
- Huma Farid
- Margalla Institute of Health Sciences, Rawalpindi, Pakistan
| | - Madiha Khan
- Aga Khan University Hospital, Karachi, Pakistan
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