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Published in: Current Oral Health Reports 2/2024

26-03-2024 | SARS-CoV-2

The Mouth as a Reservoir of SARS-CoV-2

Authors: Sabrina Carvalho Gomes, Luisa Martins Miller, Luana Xavier, Fernando Valentim Bitencourt

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

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Abstract

Purpose of Review

This systematic review addresses the question: Is the oral cavity a reservoir of SARS-CoV-2 in participants who tested positive for viral RNA in nasopharyngeal and oropharyngeal samples? Four databases and a complementary search on the reference list of included studies were consulted. Paired reviewers independently searched the literature, extracted data, and evaluated the risk of bias (Joanna Briggs Institute).

Recent Findings

A total of 3173 references were identified, and after a 2-phase selection, 24 studies were included. In total, 10 diagnostic test accuracy and 14 cross-sectional studies determined the presence of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR) incorporating experimental and control samples. It was shown that saliva, gingival crevicular fluid, dental plaque, and gingival tissue harbored viral RNA. A high level of heterogenicity between studies was observed. The risk of bias analysis raised major concerns regarding the lack of clear criteria for inclusion, with most studies being of moderate to low quality. SARS-CoV-2 RNA is present in oral cavity samples, reinforcing the contribution of the oral cavity as a potential route of entry for infection and may offer a practical and affordable point-of-care platform for COVID-19 diagnosis. Furthermore, comprehending the oral cavity as a reservoir of SARS-CoV-2 may provide insight into its persistence and transmissibility.

Summary

The oral cavity can serve as a reservoir of SARS-CoV-2. Awareness of the significance of the oral cavity as a SARS-CoV-2 viral reservoir may help to shape COVID-19 containment measures and further potential therapeutic initiatives.
Appendix
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Literature
14.
go back to reference Abasiyanik MF, Flood B, Lin J, Ozcan S, Rouhani SJ, Pyzer A, Trujillo J, Zhen C, Wu P, Jumic S, Wang A, Gajewski TF, Wang P, Hartley M, Ameti B, Niemiec R, Fernando M, Aydogan B, Bethel C, Matushek S, Izumchenko E Sensitive detection and quantification of SARS-CoV-2 in saliva. medRxiv. 2020; https://doi.org/10.1101/2020.12.04.20241059 Abasiyanik MF, Flood B, Lin J, Ozcan S, Rouhani SJ, Pyzer A, Trujillo J, Zhen C, Wu P, Jumic S, Wang A, Gajewski TF, Wang P, Hartley M, Ameti B, Niemiec R, Fernando M, Aydogan B, Bethel C, Matushek S, Izumchenko E Sensitive detection and quantification of SARS-CoV-2 in saliva. medRxiv. 2020; https://​doi.​org/​10.​1101/​2020.​12.​04.​20241059
16.
go back to reference Andrade LM, Lau-Junior W, Oliveira RAM, Rodrigues ES, Santos EV, Borges JS, Evaristo M, Marques AA, Baccarin AD, Milhomens J, Garibaldi PMM, Ferreira NN, Moraes GR, Macedo LD, Calado RT, Borges M, Sabbaga MCE, Vessoni SCS, Covas DT, Kashima S. Uso da saliva como amostra biológica no diagnóstico da COVID-19 por RT-PCR. Hematol Transfus Cell Ther. 2022;44:S681-2. https://doi.org/10.1016/j.htct.2022.09.1171.CrossRef Andrade LM, Lau-Junior W, Oliveira RAM, Rodrigues ES, Santos EV, Borges JS, Evaristo M, Marques AA, Baccarin AD, Milhomens J, Garibaldi PMM, Ferreira NN, Moraes GR, Macedo LD, Calado RT, Borges M, Sabbaga MCE, Vessoni SCS, Covas DT, Kashima S. Uso da saliva como amostra biológica no diagnóstico da COVID-19 por RT-PCR. Hematol Transfus Cell Ther. 2022;44:S681-2. https://​doi.​org/​10.​1016/​j.​htct.​2022.​09.​1171.CrossRef
33.
go back to reference •• Gomes SC, Fachin S, da Fonseca JG, Angst PDM, Lamers ML, da Silva ISB, & Nunes LN Dental biofilm of symptomatic COVID-19 patients harbours SARS-CoV-2. J Clin Periodontol. 2021; https://doi.org/10.1111/jcpe.13471. This evidence is crucial because it supports the hypothesis that the oral cavity can serve as a source of viral infection. By addressing the oral route of transmission, public health initiatives can more comprehensively tackle the multifaceted nature of SARS‐CoV‐2 transmission. •• Gomes SC, Fachin S, da Fonseca JG, Angst PDM, Lamers ML, da Silva ISB, & Nunes LN Dental biofilm of symptomatic COVID-19 patients harbours SARS-CoV-2. J Clin Periodontol. 2021; https://​doi.​org/​10.​1111/​jcpe.​13471. This evidence is crucial because it supports the hypothesis that the oral cavity can serve as a source of viral infection. By addressing the oral route of transmission, public health initiatives can more comprehensively tackle the multifaceted nature of SARS‐CoV‐2 transmission.
35.
go back to reference Matuck BF, Dolhnikoff M, Duarte-Neto AN, Maia G, Gomes SC, Sendyk DI, Zarpellon A, de Andrade NP, Monteiro RA, Pinho JRR, Gomes-Gouvêa MS, Souza SC, Kanamura C, Mauad T, Saldiva PHN, Braz-Silva PH, Caldini EG, da Silva LFF. Salivary glands are a target for SARS-CoV-2: a source for saliva contamination. J Pathol. 2021. https://doi.org/10.1002/path.5679.CrossRefPubMedPubMedCentral Matuck BF, Dolhnikoff M, Duarte-Neto AN, Maia G, Gomes SC, Sendyk DI, Zarpellon A, de Andrade NP, Monteiro RA, Pinho JRR, Gomes-Gouvêa MS, Souza SC, Kanamura C, Mauad T, Saldiva PHN, Braz-Silva PH, Caldini EG, da Silva LFF. Salivary glands are a target for SARS-CoV-2: a source for saliva contamination. J Pathol. 2021. https://​doi.​org/​10.​1002/​path.​5679.CrossRefPubMedPubMedCentral
36.
go back to reference Miyake S, Ashikari K, Kato S, Takatsu T, Kuwashima H, Kaneko H, Nagai K, Watari I, Sato T, Yamaoka Y, Yamamoto T. Severe acute respiratory syndrome coronavirus 2 prevalence in saliva and gastric and intestinal fluid in patients undergoing gastrointestinal endoscopy in coronavirus disease 2019 endemic areas: prospective cross-sectional study in Japan. Dig Endosc. 2022; https://doi.org/10.1111/den.13945 Miyake S, Ashikari K, Kato S, Takatsu T, Kuwashima H, Kaneko H, Nagai K, Watari I, Sato T, Yamaoka Y, Yamamoto T. Severe acute respiratory syndrome coronavirus 2 prevalence in saliva and gastric and intestinal fluid in patients undergoing gastrointestinal endoscopy in coronavirus disease 2019 endemic areas: prospective cross-sectional study in Japan. Dig Endosc. 2022; https://​doi.​org/​10.​1111/​den.​13945
37.
go back to reference Perret P, Cecilia Abarca, Katia Solari, Sandra Aguilera, Pablo García-Huidobro, Diego Olivares, Felipe Palma, Carlos Contreras, María Ana, Martínez-Valdebenito Constanza, Ferrés Marcela. Detección del SARS-CoV-2 mediante RT-qPCR utilizando saliva en pacientes ambulatorios con estudio de COVID-19. Rev Chil Infect. 2022;39(4):372–81. https://doi.org/10.4067/s0716-10182022000400372.CrossRef Perret P, Cecilia Abarca, Katia Solari, Sandra Aguilera, Pablo García-Huidobro, Diego Olivares, Felipe Palma, Carlos Contreras, María Ana, Martínez-Valdebenito Constanza, Ferrés Marcela. Detección del SARS-CoV-2 mediante RT-qPCR utilizando saliva en pacientes ambulatorios con estudio de COVID-19. Rev Chil Infect. 2022;39(4):372–81. https://​doi.​org/​10.​4067/​s0716-1018202200040037​2.CrossRef
42.
go back to reference Nagura-Ikeda M, Imai K, Tabata S, Miyoshi K, Murahara N, Mizuno T, Horiuchi M, Kato K, Imoto Y, Iwata M, Mimura S, Ito T, Tamura K, Kato Y. Clinical evaluation of self-collected saliva by quantitative reverse transcription-PCR (RT-qPCR), direct RT-qPCR, reverse transcription-loop-mediated isothermal amplification, and a rapid antigen test to diagnose COVID-19. J Clin Microbiol. 2020. https://doi.org/10.1128/JCM.01438-20.CrossRefPubMedPubMedCentral Nagura-Ikeda M, Imai K, Tabata S, Miyoshi K, Murahara N, Mizuno T, Horiuchi M, Kato K, Imoto Y, Iwata M, Mimura S, Ito T, Tamura K, Kato Y. Clinical evaluation of self-collected saliva by quantitative reverse transcription-PCR (RT-qPCR), direct RT-qPCR, reverse transcription-loop-mediated isothermal amplification, and a rapid antigen test to diagnose COVID-19. J Clin Microbiol. 2020. https://​doi.​org/​10.​1128/​JCM.​01438-20.CrossRefPubMedPubMedCentral
46.
Metadata
Title
The Mouth as a Reservoir of SARS-CoV-2
Authors
Sabrina Carvalho Gomes
Luisa Martins Miller
Luana Xavier
Fernando Valentim Bitencourt
Publication date
26-03-2024
Publisher
Springer International Publishing
Published in
Current Oral Health Reports / Issue 2/2024
Electronic ISSN: 2196-3002
DOI
https://doi.org/10.1007/s40496-024-00369-0

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