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新型冠状病毒感染患者的口腔病变:口腔是否可能成为靶器官?

Oral lesions in patients with SARS-CoV-2 infection: could the oral cavity be a target organ?

机构信息

Oral Medicine Department, Hospital Sírio-Libanês, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), São Paulo, Brazil.

Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Brazil.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Feb;131(2):e45-e51. doi: 10.1016/j.oooo.2020.07.014. Epub 2020 Aug 18.


DOI:10.1016/j.oooo.2020.07.014
PMID:32888876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7434495/
Abstract

Several viruses transmitted through saliva, such as herpes simplex virus, cytomegalovirus, and Zika virus, are capable of infecting and replicating in the oral mucosa, leading to painful oral ulcers. Few studies have described the oral manifestations of coronavirus disease 2019 (COVID-19). There is growing evidence that angiotensin-converting enzyme 2 (ACE2), the main host cell receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly expressed on the epithelial cells of the tongue and of the salivary glands, which may explain the development of dysgeusia in patients with COVID-19. Hence, it is important to understand if SARS-CoV-2 can infect and replicate in oral keratinocytes and fibroblasts, causing oral ulcerations and superficial necrosis. Here, we report a series of 8 cases of COVID-19 infection, with oral necrotic ulcers and aphthous-like ulcerations which developed early in the course of disease after the development of dysgeusia and affected the tongue, lips, palate, and oropharynx. A short review of the literature regarding the important role of ACE2 in SARS-CoV-2 cellular entry is also provided, bringing new insights into oral keratinocytes and minor salivary glands as potential targets.

摘要

几种通过唾液传播的病毒,如单纯疱疹病毒、巨细胞病毒和寨卡病毒,能够感染和复制口腔黏膜,导致疼痛的口腔溃疡。很少有研究描述了 2019 年冠状病毒病(COVID-19)的口腔表现。越来越多的证据表明,血管紧张素转换酶 2(ACE2)是严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的主要宿主细胞受体,在舌和唾液腺的上皮细胞中高度表达,这可能解释了 COVID-19 患者味觉障碍的发展。因此,了解 SARS-CoV-2 是否能够感染和复制口腔角质形成细胞和成纤维细胞,导致口腔溃疡和表面坏死非常重要。在这里,我们报告了一系列 8 例 COVID-19 感染病例,这些患者在味觉障碍发生后不久,在疾病早期就出现了口腔坏死性溃疡和口疮样溃疡,累及舌、唇、腭和口咽。还对 ACE2 在 SARS-CoV-2 细胞进入中的重要作用进行了文献综述,为口腔角质形成细胞和小唾液腺作为潜在靶点提供了新的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/451936a9ad9f/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/d85589229039/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/43cf65050cc1/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/4c3481d7ddf6/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/1c6a923f73af/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/451936a9ad9f/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/d85589229039/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/43cf65050cc1/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/4c3481d7ddf6/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/1c6a923f73af/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46e3/7434495/451936a9ad9f/gr5_lrg.jpg

相似文献

[1]
Oral lesions in patients with SARS-CoV-2 infection: could the oral cavity be a target organ?

Oral Surg Oral Med Oral Pathol Oral Radiol. 2021-2

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Oral Manifestations, Dental Interventions, and Clinical Outcomes in Hospitalized COVID-19 Patients: A Two-Year Cohort Study in São Paulo, Brazil.

Dent J (Basel). 2025-8-11

[2]
Oral manifestations of COVID-19 vaccinated individuals, post-infection, and different variants: a Brazilian population study.

Braz Oral Res. 2025-8-4

[3]
Obliteration of oral and maxillofacial region by SARS-CoV-2 infection.

GMS Hyg Infect Control. 2025-6-16

[4]
Angiotensin‑converting enzyme 2 expression in human tumors: Implications for prognosis and therapy (Review).

Oncol Rep. 2025-9

[5]
Oral hygiene influence on the incidence and severity of oral manifestations in Coronavirus Disease 2019.

BMC Oral Health. 2025-5-21

[6]
Unveiling the Oral Lesions, Dysgeusia and Osteonecrosis Related to COVID-19: A Comprehensive Systematic Review.

J Clin Med. 2025-2-14

[7]
Viral infection and antiviral immunity in the oral cavity.

Nat Rev Immunol. 2025-4

[8]
Exploring the relationship between cycle threshold values and oral manifestations in COVID-19: a comprehensive overview.

Acta Odontol Scand. 2024-9-23

[9]
The Effect of COVID-19 Infection on Orofacial Pain: A Cross-sectional Study.

Int Dent J. 2025-4

[10]
Pathological changes in oral epithelium and the expression of SARS-CoV-2 entry receptors, ACE2 and furin.

PLoS One. 2024

本文引用的文献

[1]
New Insights for the Pathogenesis of COVID-19-Related Dysgeusia.

J Dent Res. 2020-9

[2]
Virtual assistance in oral medicine for prioritizing oral cancer diagnosis during the COVID-19 pandemic.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2020-7

[3]
The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis.

Otolaryngol Head Neck Surg. 2020-5-5

[4]
The probability of detection of SARS-CoV-2 in saliva.

Stat Methods Med Res. 2020-4

[5]
SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes.

Nat Med. 2020-5

[6]
Anosmia, hyposmia, and dysgeusia as indicators for positive SARS-CoV-2 infection.

World J Otorhinolaryngol Head Neck Surg. 2020-11

[7]
Features of anosmia in COVID-19.

Med Mal Infect. 2020-4-17

[8]
Saliva: potential diagnostic value and transmission of 2019-nCoV.

Int J Oral Sci. 2020-4-17

[9]
Salivary Glands: Potential Reservoirs for COVID-19 Asymptomatic Infection.

J Dent Res. 2020-7

[10]
Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection.

Front Med. 2020-3-12

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