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Current Oral Health Reports

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Open Access 21-02-2024 | SARS-CoV-2

The Mouth as a Site of SARS-CoV-2 Infection

Authors: N Atyeo, P Perez, B Matuck, KM Byrd, BM Warner

Published in: Current Oral Health Reports | Issue 2/2024

Abstract

Purpose of Review

During the height of the coronavirus pandemic, the oral cavity was recognized as a critically important site for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The purpose of this review is to analyze the literature surrounding SARS-CoV-2 entry, replication, and transmission and the resulting impact on host tissues in the oral cavity.

Recent Findings

The detection of viral genetic material in saliva allows for widespread surveillance testing and emphasizes the importance of viral transmission through shed in saliva. As the cohort of patients who have recovered from acute SARS-CoV-2 infection grows, several questions remain about the long-term impacts of viral infection on the oral tissues, including whether the oral cavity may serve as a persistent viral reservoir. Therefore, a thorough understanding of the viral life cycle in the diverse tissues of the oral cavity is warranted. We conclude with a broad outlook on the long-term effects of SARS-CoV-2 infection in the oral cavity and how these effects may relate to the post-acute coronavirus syndrome sequelae experienced by recovered patients.

Summary

SARS-CoV-2 can enter and replicate in the oral cavity and be spread between individuals via shed in saliva. Several acute oral manifestations of infection have been reported, and the lingering effects of infection on oral tissues are an area of ongoing investigation.

Gutierrez-Camacho JR, Avila-Carrasco L, Martinez-Vazquez MC, Garza-Veloz I, Zorrilla-Alfaro SM, Gutierrez-Camacho V, et al. Oral lesions associated with COVID-19 and the participation of the buccal cavity as a key player for establishment of immunity against SARS-CoV-2. Int J Environ Res Public Health. 2022;19(18). https://doi.org/10.3390/ijerph191811383.

Bemquerer LM, de Arruda JAA, Soares MPD, Mesquita RA, Silva TA. The oral cavity cannot be forgotten in the COVID-19 era: is there a connection between dermatologic and oral manifestations? J Am Acad Dermatol. 2021;84(3):e143–5. https://doi.org/10.1016/j.jaad.2020.11.034.CrossRefPubMed

Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca Canto G, Sugaya N, et al. Oral manifestations in patients with COVID-19: a living systematic review. J Dent Res. 2021;100(2):141–54. https://doi.org/10.1177/0022034520957289.CrossRefPubMed

• Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca Canto G, Sugaya N, et al. Oral manifestations in patients with COVID-19: a 6-month update. J Dent Res. 2021;100(12):1321–9. https://doi.org/10.1177/00220345211029637. A comprehensive systemic review covering 183 studies and over 60,000 patients that outlines the prevalence of oral signs and symptoms in SARS-CoV-2 infection.CrossRefPubMed

Lin W, Gao F, Wang X, Qin N, Chen X, Tam KY, et al. The oral manifestations and related mechanisms of COVID-19 caused by SARS-CoV-2 infection. Front Cell Neurosci. 2022;16:1006977. https://doi.org/10.3389/fncel.2022.1006977.CrossRefPubMed

Faruque MRJ, Bikker FJ, Laine ML. Comparing SARS-CoV-2 viral load in human saliva to oropharyngeal swabs, nasopharyngeal swabs, and sputum: a systematic review and meta-analysis. Can J Infect Dis Med Microbiol. 2023;2023:5807370. https://doi.org/10.1155/2023/5807370.CrossRefPubMedPubMedCentral

Caixeta DC, Paranhos LR, Blumenberg C, Garcia-Júnior MA, Guevara-Vega M, Taveira EB, et al. Salivary SARS-CoV-2 RNA for diagnosis of COVID-19 patients: a systematic revisew and meta-analysis of diagnostic accuracy. Jpn Dent Sci Rev. 2023;59:219–38. https://doi.org/10.1016/j.jdsr.2023.06.004.CrossRefPubMedPubMedCentral

• Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-80.e8. https://doi.org/10.1016/j.cell.2020.02.052. This was a hallmark study that was the first to show that SARS-CoV-2 uses a similar mechanism for cellular entry as SARS-CoV, with the spike protein primed by TMPRSS2 and then binding to the ACE2 receptor.CrossRefPubMedPubMedCentral

V’Kovski P, Kratzel A, Steiner S, Stalder H, Thiel V. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol. 2021;19(3):155–70. https://doi.org/10.1038/s41579-020-00468-6.CrossRefPubMed

10.

Zhang Q, Xiang R, Huo S, Zhou Y, Jiang S, Wang Q, et al. Molecular mechanism of interaction between SARS-CoV-2 and host cells and interventional therapy. Signal Transduct Target Ther. 2021;6(1):233. https://doi.org/10.1038/s41392-021-00653-w.CrossRefPubMedPubMedCentral

11.

Xu J, Li Y, Gan F, Du Y, Yao Y. Salivary glands: potential reservoirs for COVID-19 asymptomatic infection. J Dent Res. 2020;99(8):989. https://doi.org/10.1177/0022034520918518.CrossRefPubMed

12.

Zhong M, Lin B, Pathak JL, Gao H, Young AJ, Wang X, et al. ACE2 and furin expressions in oral epithelial cells possibly facilitate COVID-19 infection via respiratory and fecal-oral routes. Front Med (Lausanne). 2020;7:580796. https://doi.org/10.3389/fmed.2020.580796.CrossRefPubMed

13.

• Sakaguchi W, Kubota N, Shimizu T, Saruta J, Fuchida S, Kawata A, et al. Existence of SARS-CoV-2 Entry Molecules in the Oral Cavity. Int J Mol Sci. 2020;21(17). https://doi.org/10.3390/ijms21176000. This study used patient tissues from various sites in the oral cavity to demonstrate the expression of SARS-CoV-2 entry receptor and protease ACE2 and TMPRSS, respectively.

14.

Sawa Y, Ibaragi S, Okui T, Yamashita J, Ikebe T, Harada H. Expression of SARS-CoV-2 entry factors in human oral tissue. J Anat. 2021;238(6):1341–54. https://doi.org/10.1111/joa.13391.CrossRefPubMedPubMedCentral

15.

•• Huang N, Pérez P, Kato T, Mikami Y, Okuda K, Gilmore RC, et al. SARS-CoV-2 infection of the oral cavity and saliva. Nat Med. 2021;27(5):892–903. https://doi.org/10.1038/s41591-021-01296-8. This paper provided single-cell atlases of both the salivary glands and gingival epithelium to demonstrate the specific cell types in which ACE2 was expressed, demonstrated SARS-CoV-2 replication in the tissues of the oral cavity, and was the first to demonstrate that saliva from infected individuals contains infectious virus.CrossRefPubMedPubMedCentral

16.

Pascolo L, Zupin L, Melato M, Tricarico PM, Crovella S. TMPRSS2 and ACE2 coexpression in SARS-CoV-2 salivary glands infection. J Dent Res. 2020;99(10):1120–1. https://doi.org/10.1177/0022034520933589.CrossRefPubMed

17.

Song J, Li Y, Huang X, Chen Z, Li Y, Liu C, et al. Systematic analysis of ACE2 and TMPRSS2 expression in salivary glands reveals underlying transmission mechanism caused by SARS-CoV-2. J Med Virol. 2020;92(11):2556–66. https://doi.org/10.1002/jmv.26045.CrossRefPubMedPubMedCentral

18.

•• Matuck BF, Dolhnikoff M, Duarte-Neto AN, Maia G, Gomes SC, Sendyk DI, et al. Salivary glands are a target for SARS-CoV-2: a source for saliva contamination. J Pathol. 2021;254(3):239–43. https://doi.org/10.1002/path.5679. A study in post-mortem biopsies that showed SARS-CoV-2 infection of the minor and major salivary glands by immunohistochemistry and also showed particles consistent in size and shape with Coronaviridae in the salivary glands by electron microscopy.CrossRefPubMedPubMedCentral

19.

Zhu F, Zhong Y, Ji H, Ge R, Guo L, Song H, et al. ACE2 and TMPRSS2 in human saliva can adsorb to the oral mucosal epithelium. J Anat. 2022;240(2):398–409. https://doi.org/10.1111/joa.13560.CrossRefPubMed

20.

Fernandes Matuck B, Dolhnikoff M, Maia GVA, Isaac Sendyk D, Zarpellon A, Costa Gomes S, et al. Periodontal tissues are targets for Sars-Cov-2: a post-mortem study. J Oral Microbiol. 2020;13(1):1848135. https://doi.org/10.1080/20002297.2020.1848135.CrossRefPubMedPubMedCentral

21.

Nakayama T, Lee IT, Jiang S, Matter MS, Yan CH, Overdevest JB, et al. Determinants of SARS-CoV-2 entry and replication in airway mucosal tissue and susceptibility in smokers. Cell Rep Med. 2021;2(10):100421. https://doi.org/10.1016/j.xcrm.2021.100421.CrossRefPubMedPubMedCentral

22.

Marques BBF, Guimarães TC, Fischer RG, Tinoco JMM, Pires FR, Lima Junior JDC, et al. Morphological alterations in tongue epithelial cells infected by SARS-CoV-2: a case-control study. Oral Dis. 2022;28(Suppl 2):2417–22. https://doi.org/10.1111/odi.13988.CrossRefPubMed

23.

Fernández-Rojas MA, Ávila G, Romero-Valdovinos M, Plett-Torres T, Salazar AM, Sordo M, et al. Elevated levels of cytotoxicity, cytokines, and anti-SARS-CoV-2 antibodies in mild cases of COVID-19. Viral Immunol. 2023. https://doi.org/10.1089/vim.2023.0012.CrossRefPubMed

24.

Pinto TG, Alpire MES, Ribeiro DA. Cytogenetic biomonitoring in buccal mucosa cells of COVID-19 patients: preliminary findings. In Vivo. 2021;35(6):3495–9. https://doi.org/10.21873/invivo.12651.CrossRefPubMedPubMedCentral

25.

•• To KK, Tsang OT, Yip CC, Chan KH, Wu TC, Chan JM, et al. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis. 2020;71(15):841–3. https://doi.org/10.1093/cid/ciaa149. One of the first papers published during the pandemic that demonstrated the presence of SARS-CoV-2 genetic material in 91.7% of specimens from self-collected saliva samples from SARS-CoV-2 positive patients.CrossRefPubMed

26.

•• Stein SR, Ramelli SC, Grazioli A, Chung JY, Singh M, Yinda CK, et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature. 2022;612(7941):758–63. https://doi.org/10.1038/s41586-022-05542-y. This study conducted autopsies in 44 patients who passed following SARS-CoV-2 infection and demonstrated the persistent presence of SARS-CoV-2 genetic material weeks to months following infection, including in salivary gland tissues, revealing potential reservoirs of the virus.CrossRefPubMedPubMedCentral

27.

Jimenez-Cauhe J, Ortega-Quijano D, de Perosanz-Lobo D, Burgos-Blasco P, Vañó-Galván S, Fernandez-Guarino M, et al. Enanthem in Patients With COVID-19 and Skin Rash. JAMA Dermatol. 2020;156(10):1134–6. https://doi.org/10.1001/jamadermatol.2020.2550.CrossRefPubMedPubMedCentral

28.

Menni C, Valdes AM, Freidin MB, Ganesh S, Moustafa JSE-S, Visconti A, et al. Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection. medRxiv. 2020:2020.04.05.20048421. https://doi.org/10.1101/2020.04.05.20048421.

29.

Weir EM, Exten C, Gerkin RC, Munger SD, Hayes JE. Transient loss and recovery of oral chemesthesis, taste and smell with COVID-19: a small case-control series. Physiol Behav. 2023;271:114331. https://doi.org/10.1016/j.physbeh.2023.114331.CrossRefPubMed

30.

Fathi Y, Hoseini EG, Atoof F, Mottaghi R. Xerostomia (dry mouth) in patients with COVID-19: a case series. Future Virol. 2021. https://doi.org/10.2217/fvl-2020-0334.CrossRefPubMedCentral

31.

Gebretsadik HG. An update on oral clinical courses among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a clinical follow-up (a prospective prevalent cohort) study. PLoS ONE. 2022;17(10):e0275817. https://doi.org/10.1371/journal.pone.0275817.CrossRefPubMedPubMedCentral

32.

Chern A, Famuyide AO, Moonis G, Lalwani AK. Sialadenitis: a possible early manifestation of COVID-19. Laryngoscope. 2020;130(11):2595–7. https://doi.org/10.1002/lary.29083.CrossRefPubMedPubMedCentral

33.

Friedrich RE, Droste TL, Angerer F, Popa B, Koehnke R, Gosau M, et al. COVID-19-associated parotid gland abscess. In Vivo. 2022;36(3):1349–53. https://doi.org/10.21873/invivo.12837.CrossRefPubMedPubMedCentral

34.

To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20(5):565–74. https://doi.org/10.1016/s1473-3099(20)30196-1.CrossRefPubMedPubMedCentral

35.

Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(7809):465–9. https://doi.org/10.1038/s41586-020-2196-x.CrossRefPubMed

36.

Wyllie AL, Fournier J, Casanovas-Massana A, Campbell M, Tokuyama M, Vijayakumar P, et al. Saliva or nasopharyngeal swab specimens for detection of SARS-CoV-2. N Engl J Med. 2020;383(13):1283–6. https://doi.org/10.1056/NEJMc2016359.CrossRefPubMed

37.

Jacob AA, C CC, Mohan G, Mathew R, Matteethra GC, M A, et al. Evaluation of the efficacy of tongue swab and saliva as samples for testing COVID-19 infection in symptomatic cases in comparison with nasopharyngeal swab. J Med Microbiol. 2023;72(8). https://doi.org/10.1099/jmm.0.001743.

38.

Azzi L, Carcano G, Gianfagna F, Grossi P, Gasperina DD, Genoni A, et al. Saliva is a reliable tool to detect SARS-CoV-2. J Infect. 2020;81(1):e45–50. https://doi.org/10.1016/j.jinf.2020.04.005.CrossRefPubMedPubMedCentral

39.

Bordi L, Sberna G, Lalle E, Fabeni L, Mazzotta V, Lanini S, et al. Comparison of SARS-CoV-2 detection in nasopharyngeal swab and saliva samples from patients infected with Omicron variant. Int J Mol Sci. 2023;24(5). https://doi.org/10.3390/ijms24054847

40.

Xu Q, Milanez-Almeida P, Martins AJ, Radtke AJ, Hoehn KB, Oguz C, et al. Adaptive immune responses to SARS-CoV-2 persist in the pharyngeal lymphoid tissue of children. Nat Immunol. 2023;24(1):186–99. https://doi.org/10.1038/s41590-022-01367-z.CrossRefPubMed

41.

• Lima TM, Martins RB, Miura CS, Souza MVO, Cassiano MHA, Rodrigues TS, et al. Tonsils are major sites of persistence of SARS-CoV-2 in children. Microbiol Spectr. 2023:e0134723. https://doi.org/10.1128/spectrum.01347-23. This recent study analyzed tonsillar tissue samples from 48 patients aged 3 to 11 years old and found that 27% of samples were positive for SARS-CoV-2, some even months after the child had been exposed to the virus, indicating a persistent infection in this tissue type.

42.

Silva J, Lucas C, Sundaram M, Israelow B, Wong P, Klein J, et al. Saliva viral load is a dynamic unifying correlate of COVID-19 severity and mortality. medRxiv. 2021. https://doi.org/10.1101/2021.01.04.21249236.

43.

Bansal M, Khatri M, Taneja V. Potential role of periodontal infection in respiratory diseases - a review. J Med Life. 2013;6(3):244–8.PubMedPubMedCentral

44.

Gupta S, Mohindra R, Chauhan PK, Singla V, Goyal K, Sahni V, et al. SARS-CoV-2 detection in gingival crevicular fluid. J Dent Res. 2021;100(2):187–93. https://doi.org/10.1177/0022034520970536.CrossRefPubMed

45.

Bumm CV, Folwaczny M. Infective endocarditis and oral health-a narrative review. Cardiovasc Diagn Ther. 2021;11(6):1403–15. https://doi.org/10.21037/cdt-20-908.CrossRefPubMedPubMedCentral

46.

Lloyd-Jones G, Molayem S, Pontes CC, Chapple I. The COVID-19 pathway: a proposed oral-vascular-pulmonary route of SARS-CoV-2 infection and the importance of oral healthcare measures. J Oral Med Dent Res. 2021;2:1–25. https://doi.org/10.52793/JOMDR.2020.2(1)-13.CrossRef

47.

Marouf N, Cai W, Said KN, Daas H, Diab H, Chinta VR, et al. Association between periodontitis and severity of COVID-19 infection: a case-control study. J Clin Periodontol. 2021;48(4):483–91. https://doi.org/10.1111/jcpe.13435.CrossRefPubMedPubMedCentral

48.

Gupta S, Mohindra R, Singla M, Khera S, Sahni V, Kanta P, et al. The clinical association between periodontitis and COVID-19. Clin Oral Investig. 2022;26(2):1361–74. https://doi.org/10.1007/s00784-021-04111-3.CrossRefPubMed

49.

Isho B, Abe KT, Zuo M, Jamal AJ, Rathod B, Wang JH, et al. Persistence of serum and saliva antibody responses to SARS-CoV-2 spike antigens in COVID-19 patients. Sci Immunol. 2020;5(52). https://doi.org/10.1126/sciimmunol.abe5511

50.

Seaman WT, Keener O, Mei W, Mollan KR, Jones CD, Pettifor A, et al. Oral SARS-CoV-2 host responses predict the early COVID-19 disease course. Res Sq. 2023. https://doi.org/10.21203/rs.3.rs-3154698/v1. PubMed PMID: 37645853; PubMed Central PMCID: PMCPMC10462189 manufacturer of the N-antigen and anti-SARS-CoV-2 Spike RBD protein IgG/IgM LFA cartridges used in this study. No other authors declare any conflicts of interest.

51.

Chellamuthu P, Angel AN, MacMullan MA, Denny N, Mades A, Santacruz M, et al. SARS-CoV-2 specific IgG antibodies persist over a 12-month period in oral mucosal fluid collected from previously infected individuals. Front Immunol. 2021;12:777858. https://doi.org/10.3389/fimmu.2021.777858.CrossRefPubMedPubMedCentral

52.

Vilela ACS, Costa CA, Oliveira SA, Souza M, Fiaccadori FS, Leles CR, et al. Validity and reliability of immunochromatographic IgM/IgG rapid tests for COVID-19 salivary diagnosis. Oral Dis. 2022;28(Suppl 2):2465–73. https://doi.org/10.1111/odi.14059.CrossRefPubMed

53.

Wadhwa S, Yoon AJ, Kister K, Bolin I, Chintalapudi N, Besmer A, et al. Detection of SARS-CoV-2 IgG antibodies and inflammatory cytokines in saliva-a pilot study. J Oral Biol Craniofac Res. 2023;13(2):267–71. https://doi.org/10.1016/j.jobcr.2023.02.008.CrossRefPubMedPubMedCentral

54.

Faustini SE, Cook A, Hill H, Al-Taei S, Heaney J, Efstathiou E, et al. Saliva antiviral antibody levels are detectable but correlate poorly with serum antibody levels following SARS-CoV-2 infection and/or vaccination. J Infect. 2023;87(4):328–35. https://doi.org/10.1016/j.jinf.2023.07.018.CrossRefPubMed

55.

Jang H, Choudhury S, Yu Y, Sievers BL, Gelbart T, Singh H, et al. Persistent immune and clotting dysfunction detected in saliva and blood plasma after COVID-19. Heliyon. 2023;9(7):e17958. https://doi.org/10.1016/j.heliyon.2023.e17958.CrossRefPubMedPubMedCentral

56.

Saulle I, Garziano M, Cappelletti G, Limanaqi F, Strizzi S, Vanetti C, et al. Salivary miRNA profiles in COVID-19 patients with different disease severities. Int J Mol Sci. 2023;24(13). https://doi.org/10.3390/ijms241310992

57.

Alqedari H, Altabtbaei K, Espinoza JL, Bin-Hasan S, Alghounaim M, Alawady A, et al. Host-microbiome associations in saliva predict COVID-19 severity. bioRxiv. 2023. https://doi.org/10.1101/2023.05.02.539155

58.

Alfaifi A, Sultan AS, Montelongo-Jauregui D, Meiller TF, Jabra-Rizk MA. Long-term post-COVID-19 associated oral inflammatory sequelae. Front Cell Infect Microbiol. 2022;12:831744. https://doi.org/10.3389/fcimb.2022.831744.CrossRefPubMedPubMedCentral

59.

Armstrong AJS, Horton DB, Andrews T, Greenberg P, Roy J, Gennaro ML, et al. Saliva microbiome in relation to SARS-CoV-2 infection in a prospective cohort of healthy US adults. EBioMedicine. 2023;94:104731. https://doi.org/10.1016/j.ebiom.2023.104731.CrossRefPubMedPubMedCentral

60.

Sekaran K, Varghese RP, Doss CG, Alsamman AM, Zayed H, El Allali A. Airway and Oral microbiome profiling of SARS-CoV-2 infected asthma and non-asthma cases revealing alterations-a pulmonary microbial investigation. PLoS One. 2023;18(8):e0289891. https://doi.org/10.1371/journal.pone.0289891.CrossRefPubMedPubMedCentral

61.

Miller EH, Annavajhala MK, Chong AM, Park H, Nobel YR, Soroush A, et al. Oral microbiome alterations and SARS-CoV-2 saliva viral load in patients with COVID-19. Microbiol Spectr. 2021;9(2):e0005521. https://doi.org/10.1128/Spectrum.00055-21.CrossRefPubMed

62.

Apostolou E, Rizwan M, Moustardas P, Sjögren P, Bertilson BC, Bragée B, et al. Saliva antibody-fingerprint of reactivated latent viruses after mild/asymptomatic COVID-19 is unique in patients with myalgic-encephalomyelitis/chronic fatigue syndrome. Front Immunol. 2022;13:949787. https://doi.org/10.3389/fimmu.2022.949787.CrossRefPubMedPubMedCentral

63.

Hannestad U, Apostolou E, Sjögren P, Bragée B, Polo O, Bertilson BC, et al. Post-COVID sequelae effect in chronic fatigue syndrome: SARS-CoV-2 triggers latent adenovirus in the oral mucosa. Front Med (Lausanne). 2023;10:1208181. https://doi.org/10.3389/fmed.2023.1208181.CrossRefPubMedPubMedCentral

64.

Bowe B, Xie Y, Al-Aly Z. Postacute sequelae of COVID-19 at 2 years. Nat Med. 2023;29(9):2347–57. https://doi.org/10.1038/s41591-023-02521-2.CrossRefPubMedPubMedCentral

65.

Gherlone EF, Polizzi E, Tetè G, De Lorenzo R, Magnaghi C, Rovere Querini P, et al. Frequent and persistent salivary gland ectasia and oral disease after COVID-19. J Dent Res. 2021;100(5):464–71. https://doi.org/10.1177/0022034521997112.CrossRefPubMed

66.

• Shen Y, Voigt A, Goranova L, Abed MA, Kleiner DE, Maldonado JO, et al. Evidence of a Sjögren’s disease-like phenotype following COVID-19 in mice and human. JCI Insight. 2023. https://doi.org/10.1172/jci.insight.166540. This recent paper used a mouse model to demonstrate a decrease in salivary flow, increase in production of auto-antibodies, and increase in inflammation in the salivary glands following infections with SARS-CoV-2, while in convalescent patients, there was a slight increase in serum auto-antibodies as well as histological signs of salivary gland pathology.

Title: The Mouth as a Site of SARS-CoV-2 Infection
Authors: N Atyeo
P Perez
B Matuck
KM Byrd
BM Warner
Publication date: 21-02-2024
Publisher: Springer International Publishing
Keywords: SARS-CoV-2
COVID-19
Published in: Current Oral Health Reports / Issue 2/2024
Electronic ISSN: 2196-3002
DOI: https://doi.org/10.1007/s40496-024-00367-2

At a glance: The STEP trials

Springer Medicine

The Mouth as a Site of SARS-CoV-2 Infection

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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