Characterization and Pathogenic Speculation of Xerostomia Associated with COVID-19: A Narrative Review
Abstract
:1. Introduction
2. Materials and Methods
3. Results and Discussion
3.1. Xerostomia Characterization
3.1.1. Ethnicity
3.1.2. Age
3.1.3. Gender
3.1.4. Disease Severity
3.1.5. Association with Taste Dysfunction
3.1.6. Comorbidities
3.2. Pathogenic Speculation
3.2.1. Viral Cellular Entry-Relevant Proteins
3.2.2. Renin–Angiotensin System Disturbance
3.2.3. Salivary Gland Inflammation
3.2.4. Zinc Deficiency
3.2.5. Cranial Neuropathy
3.2.6. Intercurrent Taste Dysfunction
3.2.7. Comorbidities and Medications
3.3. Possible Therapy
4. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Johns Hopkins University & Medicine Coronavirus Resource Center Website. Available online: https://coronavirus.jhu.edu/map.html (accessed on 11 October 2021).
- Wang, D.; Hu, B.; Hu, C.; Zhu, F.; Liu, X.; Zhang, J.; Wang, B.; Xiang, H.; Cheng, Z.; Xiong, Y.; et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020, 323, 1061–1069. [Google Scholar] [CrossRef] [PubMed]
- Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; Fan, G.; Xu, J.; Gu, X.; et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020, 395, 497–506. [Google Scholar] [CrossRef] [Green Version]
- Tsuchiya, H. Oral symptoms associated with COVID-19 and their pathogenic mechanisms: A literature review. Dent. J. 2021, 9, 32. [Google Scholar] [CrossRef] [PubMed]
- Etemad-Moghadam, S.; Alaeddini, M. Is SARS-CoV-2 an etiologic agent or predisposing factor for oral lesions in COVID-19 patients? A concise review of reported cases in the literature. Int. J. Dent. 2021, 2021, 6648082. [Google Scholar] [CrossRef]
- Freni, F.; Meduri, A.; Gazia, F.; Nicastro, V.; Galletti, C.; Aragona, P.; Galletti, C.; Galletti, B.; Galletti, F. Symptomatology in head and neck district in coronavirus disease (COVID-19): A possible neuroinvasive action of SARS-CoV-2. Am. J. Otolaryngol. 2020, 41, 102612. [Google Scholar] [CrossRef] [PubMed]
- Biadsee, A.; Biadsee, A.; Kassem, F.; Dagan, O.; Masarwa, S.; Ormianer, Z. Olfactory and oral manifestations of COVID-19: Sex-related symptoms—a potential pathway to early diagnosis. Otolaryngol. Head Neck Surg. 2020, 163, 722–728. [Google Scholar] [CrossRef] [PubMed]
- Chen, L.; Zhao, J.; Peng, J.; Li, X.; Deng, X.; Geng, Z.; Shen, Z.; Guo, F.; Zhang, Q.; Jin, Y.; et al. Detection of 2019-nCoV in saliva and characterization of oral symptoms in COVID-19 patients. Cell Prolif. 2020, 53, e12923. [Google Scholar] [CrossRef]
- Katz, J. Prevalence of dry mouth in COVID-19 patients with and without Sicca syndrome in a large hospital center. Ir. J. Med. Sci. 2021, 190, 1639–1641. [Google Scholar] [CrossRef]
- Niklander, S.; Veas, L.; Barrera, C.; Fuentes, F.; Chiappini, G.; Marshall, M. Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz. Oral Res. 2017, 31, e14. [Google Scholar] [CrossRef] [Green Version]
- Farshidfar, N.; Hamedani, S. Hyposalivation as a potential risk for SARS-CoV-2 infection: Inhibitory role of saliva. Oral Dis. 2021, 27 (Suppl. S3), 750–751. [Google Scholar] [CrossRef]
- Aragoneses, J.; Suárez, A.; Algar, J.; Rodríguez, C.; López-Valverde, N.; Aragoneses, J.M. Oral manifestations of COVID-19: Updated systematic review with meta-analysis. Front. Med. 2021, 8, 726753. [Google Scholar] [CrossRef] [PubMed]
- Amorim dos Santos, J.; Normando, A.G.C.; Carvalho da Silva, R.L.; Acevedo, A.C.; De Luca Canto, G.; Sugaya, N.; Santos-Silva, A.R.; Guerra, E.N.S. Oral manifestations in patients with COVID-19: A 6-month update. J. Dent. Res. 2021, 100, 1321–1329. [Google Scholar] [CrossRef] [PubMed]
- Fantozzi, P.J.; Pampena, E.; Di Vanna, D.; Pellegrino, E.; Corbi, D.; Mammucari, S.; Alessi, F.; Pampena, R.; Bertazzoni, G.; Minisola, S.; et al. Xerostomia, gustatory and olfactory dysfunctions in patients with COVID-19. Am. J. Otolaryngol. 2020, 41, 102721. [Google Scholar] [CrossRef] [PubMed]
- Sinjari, B.; D’Ardes, D.; Santilli, M.; Rexhepi, I.; D’Addazio, G.; Di Carlo, P.; Chiacchiaretta, P.; Caputi, S.; Cipollone, F. SARS-CoV-2 and oral manifestation: An observational, human study. J. Clin. Med. 2020, 9, 3218. [Google Scholar] [CrossRef] [PubMed]
- Gherlone, E.F.; Polizzi, E.; Tetè, G.; De Lorenzo, R.; Magnaghi, C.; Rovere Querini, P.; Ciceri, F. Frequent and persistent salivary gland ectasia and oral disease after COVID-19. J. Dent. Res. 2021, 100, 464–471. [Google Scholar] [CrossRef]
- AbuBakr, N.; Salem, Z.A.; Kamel, A.H.M. Oral manifestations in mild-to-moderate cases of COVID-19 viral infection in the adult population. Dent. Med. Probl. 2021, 58, 7–15. [Google Scholar] [CrossRef]
- Omezli, M.M.; Torul, D.E. Evaluation of the xerostomia, taste and smell impairments after COVID-19. Med. Oral Patol. Oral Cir. Bucal. 2021, 26, e568–e575. [Google Scholar] [CrossRef]
- Fathi, Y.; Ghasemzadeh Hoseini, E.; Atoof, F.; Mottaghi, R. Xerostomia (dry mouth) in patients with COVID-19: A case series. Future Virol. 2021, 16, 315–319. [Google Scholar] [CrossRef]
- Biadsee, A.; Dagan, O.; Ormianer, Z.; Kassem, F.; Masarwa, S.; Biadsee, A. Eight-month follow-up of olfactory and gustatory dysfunctions in recovered COVID-19 patients. Am. J. Otolaryngol. 2021, 42, 103065. [Google Scholar] [CrossRef]
- El Kady, D.M.; Gomaa, E.A.; Abdella, W.S.; Ashraf Hussien, R.; Abd ElAziz, R.H.; Khater, A.G.A. Oral manifestations of COVID-19 patients: An online survey of the Egyptian population. Clin. Exp. Dent. Res. 2021, 7, 851–860. [Google Scholar] [CrossRef]
- Anaya, J.M.; Rojas, M.; Salinas, M.L.; Rodríguez, Y.; Roa, G.; Lozano, M.; Rodríguez-Jiménez, M.; Montoya, N.; Zapata, E.; Post-COVID Study Group; et al. Post-COVID syndrome. A case series and comprehensive review. Autoimmun. Rev. 2021, 20, 102947. [Google Scholar] [CrossRef] [PubMed]
- Tomo, S.; Miyahara, G.I.; Simonato, L.E. Oral mucositis in a SARS-CoV-2-infected patient: Secondary or truly associated condition? Oral Dis. 2021, in press. [Google Scholar] [CrossRef] [PubMed]
- Eghbali Zarch, R.; Hosseinzadeh, P. COVID-19 from the perspective of dentists: A case report and brief review of more than 170 cases. Dermatol. Ther. 2021, 34, e14717. [Google Scholar] [CrossRef] [PubMed]
- Díaz Rodríguez, M.; Jimenez Romera, A.; Villarroel, M. Oral manifestations associated with COVID-19. Oral Dis. 2021, in press. [Google Scholar] [CrossRef]
- da Mota Santana, L.A.; Sousa-E-Silva, N.; Gonçalo, R.; de Oliveira, E.M.; de Oliveira Corrêa, R.; Moreno, A.; de Souza, L.N. Persistent hyposalivation in patients after COVID-19 infection: Temporary or lasting alteration? Oral Surg. 2021, in press. [Google Scholar] [CrossRef]
- Martelli Júnior, H.; Gueiros, L.A.; de Lucena, E.G.; Coletta, R.D. Increase in the number of Sjögren’s syndrome cases in Brazil in the COVID-19 Era. Oral Dis. 2021, in press. [Google Scholar] [CrossRef]
- Carubbi, F.; Alunno, A.; Ferri, C.; Gerli, R.; Bartoloni, E. The impact of SARS-CoV-2 outbreak on primary Sjögren’s syndrome: An Italian experience. Front. Med. 2020, 7, 608728. [Google Scholar] [CrossRef]
- Cirillo, N.; Bizzoca, M.E.; Lo Muzio, E.; Cazzolla, A.P.; Lo Muzio, L. Gustatory dysfunction in COVID-19 patients: A rapid systematic review on 27,687 cases. Acta Odontol. Scand. 2021, 79, 418–425. [Google Scholar] [CrossRef]
- Field, E.A.; Fear, S.; Higham, S.M.; Ireland, R.S.; Rostron, J.; Willetts, R.M.; Longman, L.P. Age and medication are significant risk factors for xerostomia in an English population, attending general dental practice. Gerodontology 2001, 18, 21–24. [Google Scholar] [CrossRef]
- Han, P.; Lakshminarayanan, P.; Jiang, W.; Shpitser, I.; Hui, X.; Lee, S.H.; Cheng, Z.; Guo, Y.; Taylor, R.H.; Siddiqui, S.A.; et al. Dose/volume histogram patterns in salivary gland subvolumes influence xerostomia injury and recovery. Sci. Rep. 2019, 9, 3616. [Google Scholar] [CrossRef]
- Billings, M.; Dye, B.A.; Iafolla, T.; Baer, A.N.; Grisius, M.; Alevizos, I. Significance and implications of patient-reported xerostomia in Sjögren’s syndrome: Findings from the National Institutes of Health cohort. EBioMedicine 2016, 12, 270–279. [Google Scholar] [CrossRef] [Green Version]
- Hopcraft, M.S.; Tan, C. Xerostomia: An update for clinicians. Aust. Dent. J. 2010, 55, 238–244. [Google Scholar] [CrossRef]
- Peghin, M.; Palese, A.; Venturini, M.; De Martino, M.; Gerussi, V.; Graziano, E.; Bontempo, G.; Marrella, F.; Tommasini, A.; Fabris, M.; et al. Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients. Clin. Microbiol. Infect. 2021, 27, 1507–1513. [Google Scholar] [CrossRef]
- Okada, Y.; Yoshimura, K.; Toya, S.; Tsuchimochi, M. Pathogenesis of taste impairment and salivary dysfunction in COVID-19 patients. Jpn. Dent. Sci. Rev. 2021, 57, 111–122. [Google Scholar] [CrossRef] [PubMed]
- Hoffmann, M.; Kleine-Weber, H.; Schroeder, S.; Krüger, N.; Herrler, T.; Erichsen, S.; Schiergens, T.S.; Herrler, G.; Wu, N.H.; Nitsche, A.; et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020, 181, 271–280. [Google Scholar] [CrossRef]
- Bestle, D.; Heindl, M.R.; Limburg, H.; Van Lam van, T.; Pilgram, O.; Moulton, H.; Stein, D.A.; Hardes, K.; Eickmann, M.; Dolnik, O.; et al. TMPRSS2 and furin are both essential for proteolytic activation of SARS-CoV-2 in human airway cells. Life Sci. Alliance 2020, 3, e202000786. [Google Scholar] [CrossRef]
- Song, J.; Li, Y.; Huang, X.; Chen, Z.; Li, Y.; Liu, C.; Chen, Z.; Duan, X. Systematic analysis of ACE2 and TMPRSS2 expression in salivary glands reveals underlying transmission mechanism caused by SARS-CoV-2. J. Med. Virol. 2020, 92, 2556–2566. [Google Scholar] [CrossRef]
- Sakaguchi, W.; Kubota, N.; Shimizu, T.; Saruta, J.; Fuchida, S.; Kawata, A.; Yamamoto, Y.; Sugimoto, M.; Yakeishi, M.; Tsukinoki, K. Existence of SARS-CoV-2 entry molecules in the oral cavity. Int. J. Mol. Sci. 2020, 21, 6000. [Google Scholar] [CrossRef]
- Yoshimura, K.; Toya, S.; Okada, Y. Morphological analysis of angiotensin-converting enzyme 2 expression in the salivary glands and associated tissues. J. Hard Tissue Biol. 2021, 30, 265–272. [Google Scholar] [CrossRef]
- Matuck, B.F.; Dolhnikoff, M.; Duarte-Neto, A.N.; Maia, G.; Gomes, S.C.; Sendyk, D.I.; Zarpellon, A.; de Andrade, N.P.; Monteiro, R.A.; Pinho, J.R.R.; et al. Salivary glands are a target for SARS-CoV-2: A source for saliva contamination. J. Pathol. 2021, 254, 239–243. [Google Scholar] [CrossRef]
- Soares, C.D.; Mosqueda-Taylor, A.; Hernandez-Guerrero, J.C.; de Carvalho, M.G.F.; de Almeida, O.P. Immunohistochemical expression of angiotensin-converting enzyme 2 in minor salivary glands during SARS-CoV-2 infection. J. Med. Virol. 2021, 93, 1905–1906. [Google Scholar] [CrossRef] [PubMed]
- Huang, N.; Pérez, P.; Kato, T.; Mikami, Y.; Okuda, K.; Gilmore, R.C.; Conde, C.D.; Gasmi, B.; Stein, S.; Beach, M.; et al. SARS-CoV-2 infection of the oral cavity and saliva. Nat. Med. 2021, 27, 892–903. [Google Scholar] [CrossRef] [PubMed]
- Zupin, L.; Pascolo, L.; Crovella, S. Is FURIN gene expression in salivary glands related to SARS-CoV-2 infectivity through saliva? J. Clin. Pathol. 2021, 74, 209–211. [Google Scholar] [CrossRef] [PubMed]
- Zhu, F.; Zhong, Y.; Ji, H.; Ge, R.; Guo, L.; Song, H.; Wu, H.; Jiao, P.; Li, S.; Wang, C.; et al. ACE2 and TMPRSS2 in human saliva can adsorb to the oral mucosal epithelium. J. Anat. 2021, in press. [Google Scholar] [CrossRef] [PubMed]
- Proctor, G.B.; Carpenter, G.H. Salivary secretion: Mechanism and neural regulation. Monogr. Oral Sci. 2014, 24, 14–29. [Google Scholar] [CrossRef] [PubMed]
- Aure, M.H.; Konieczny, S.F.; Ovitt, C.E. Salivary gland homeostasis is maintained through acinar cell self-duplication. Dev. Cell 2015, 33, 231–237. [Google Scholar] [CrossRef] [Green Version]
- Desimmie, B.A.; Raru, Y.Y.; Awadh, H.M.; He, P.; Teka, S.; Willenburg, K.S. Insights into SARS-CoV-2 persistence and its relevance. Viruses 2021, 13, 1025. [Google Scholar] [CrossRef]
- Li, N.; Wang, X.; Lv, T. Prolonged SARS-CoV-2 RNA shedding: Not a rare phenomenon. J. Med. Virol. 2020, 92, 2286–2287. [Google Scholar] [CrossRef]
- Salmon-Ceron, D.; Slama, D.; de Broucker, T.; Karmochkine, M.; Pavie, J.; Sorbets, E.; Etienne, N.; Batisse, D.; Spiridon, G.; Baut, V.L.; et al. Clinical, virological and imaging profile in patients with prolonged forms of COVID-19: A cross-sectional study. J. Infect. 2021, 82, e1–e4. [Google Scholar] [CrossRef]
- Beyerstedt, S.; Casaro, E.B.; Rangel, É.B. COVID-19: Angiotensin-converting enzyme 2 (ACE2) expression and tissue susceptibility to SARS-CoV-2 infection. Eur. J. Clin. Microbiol. Infect. Dis. 2021, 40, 905–919. [Google Scholar] [CrossRef]
- Cano, I.P.; Dionisio, T.J.; Cestari, T.M.; Calvo, A.M.; Colombini-Ishikiriama, B.L.; Faria, F.; Siqueira, W.L.; Santos, C.F. Losartan and isoproterenol promote alterations in the local renin-angiotensin system of rat salivary glands. PLoS ONE 2019, 14, e0217030. [Google Scholar] [CrossRef]
- Miesbach, W. Pathological role of angiotensin II in subsequently severe COVID-19. TH Open 2020, 4, e138–e144. [Google Scholar] [CrossRef]
- McKinley, M.J.; Denton, D.A.; Hatzikostas, S.; Weisinger, R.S. Effect of angiotensin II on parotid saliva secretion in conscious sheep. Am. J. Physiol. 1979, 237, E56–E60. [Google Scholar] [CrossRef] [PubMed]
- Fazekas, A.; Olgart, L.; Gazelius, B.; Kerezoudis, N.; Edwall, L. Effects of angiotensin II on blood flow in rat submandibular gland. Acta Physiol. Scand. 1991, 142, 503–507. [Google Scholar] [CrossRef]
- Hanna, S.J.; Brelen, M.E.; Edwards, A.V. Effects of reducing submandibular blood flow on secretory responses to parasympathetic stimulation in anaesthetized cats. Exp. Physiol. 1999, 84, 677–687. [Google Scholar] [CrossRef] [PubMed]
- Ekholm, M.; Kahan, T.; Jörneskog, G.; Bröijersen, A.; Wallén, N.H. Angiotensin II infusion in man is proinflammatory but has no short-term effects on thrombin generation in vivo. Thromb. Res. 2009, 124, 110–115. [Google Scholar] [CrossRef] [PubMed]
- Krishnamurthy, S.; Vasudeva, S.B.; Vijayasarathy, S. Salivary gland disorders: A comprehensive review. World J. Stomatol. 2015, 4, 56–71. [Google Scholar] [CrossRef]
- Huang, Y.F.; Muo, C.H.; Tsai, C.H.; Liu, S.P.; Chang, C.T. The association with xerostomia from sialadenitis and the jaw osteonecrosis in head and neck cancer population: A nationwide cohort study. Clin. Oral Investig. 2019, 23, 585–593. [Google Scholar] [CrossRef]
- Chern, A.; Famuyide, A.O.; Moonis, G.; Lalwani, A.K. Sialadenitis: A possible early manifestation of COVID-19. Laryngoscope 2020, 130, 2595–2597. [Google Scholar] [CrossRef]
- Lim, Z.Y.; Ang, A.; Cross, G.B. COVID-19 associated parotitis. IDCases 2021, 24, e01122. [Google Scholar] [CrossRef]
- Wang, C.; Wu, H.; Ding, X.; Ji, H.; Jiao, P.; Song, H.; Li, S.; Du, H. Does infection of 2019 novel coronavirus cause acute and/or chronic sialadenitis? Med. Hypotheses 2020, 140, 109789. [Google Scholar] [CrossRef]
- Yıldırım, Y.S.S.; Kaygusuz, I.; Ozercan, I.H.; Cetiner, H.; Sakallioglu, O.; Akyigit, A.; Duzer, S. Histopathological changes in parotid gland following submandibular gland failure: An experimental animal study. Braz. J. Otorhinolaryngol. 2019, 85, 422–426. [Google Scholar] [CrossRef]
- Jothimani, D.; Kailasam, E.; Danielraj, S.; Nallathambi, B.; Ramachandran, H.; Sekar, P.; Manoharan, S.; Ramani, V.; Narasimhan, G.; Kaliamoorthy, I.; et al. COVID-19: Poor outcomes in patients with zinc deficiency. Int. J. Infect. Dis. 2020, 100, 343–349. [Google Scholar] [CrossRef]
- Gonçalves, T.J.M.; Gonçalves, S.E.A.B.; Guarnieri, A.; Risegato, R.C.; Guimarães, M.P.; de Freitas, D.C.; Razuk-Filho, A.; Junior, P.B.B.; Parrillo, E.F. Association between low zinc levels and severity of acute respiratory distress syndrome by new coronavirus SARS-CoV-2. Nutr. Clin. Pract. 2021, 36, 186–191. [Google Scholar] [CrossRef]
- Yasui, Y.; Yasui, H.; Suzuki, K.; Saitou, T.; Yamamoto, Y.; Ishizaka, T.; Nishida, K.; Yoshihara, S.; Gohma, I.; Ogawa, Y. Analysis of the predictive factors for a critical illness of COVID-19 during treatment—relationship between serum zinc level and critical illness of COVID-19. Int. J. Infect. Dis. 2020, 100, 230–236. [Google Scholar] [CrossRef]
- Heller, R.A.; Sun, Q.; Hackler, J.; Seelig, J.; Seibert, L.; Cherkezov, A.; Minich, W.B.; Seemann, P.; Diegmann, J.; Pilz, M.; et al. Prediction of survival odds in COVID-19 by zinc, age and selenoprotein P as composite biomarker. Redox Biol. 2021, 38, 101764. [Google Scholar] [CrossRef]
- Elham, A.S.; Azam, K.; Azam, J.; Mostafa, L.; Nasrin, B.; Marzieh, N. Serum vitamin D, calcium, and zinc levels in patients with COVID-19. Clin. Nutr. ESPEN 2021, 43, 276–282. [Google Scholar] [CrossRef]
- Beigmohammadi, M.T.; Bitarafan, S.; Abdollahi, A.; Amoozadeh, L.; Salahshour, F.; Mahmoodi Ali Abadi, M.; Soltani, D.; Motallebnejad, Z.A. The association between serum levels of micronutrients and the severity of disease in patients with COVID-19. Nutrition 2021, 91–92, 111400. [Google Scholar] [CrossRef]
- Tanaka, M. Secretory function of the salivary gland in patients with taste disorders or xerostomia: Correlation with zinc deficiency. Acta Otolaryngol. 2002, 134–141. [Google Scholar] [CrossRef]
- Ishii, K.; Sato, M.; Akita, M.; Tomita, H. Localization of zinc in the rat submandibular gland and the effect of its deficiency on salivary secretion. Ann. Otol. Rhinol. Laryngol. 1999, 108, 300–308. [Google Scholar] [CrossRef]
- Goto, T.; Komai, M.; Bryant, B.P.; Furukawa, Y. Reduction in carbonic anhydrase activity in the tongue epithelium and submandibular gland in zinc-deficient rats. Int. J. Vitam. Nutr. Res. 2000, 70, 110–118. [Google Scholar] [CrossRef]
- Parkkila, S.; Kaunisto, K.; Rajaniemi, L.; Kumpulainen, T.; Jokinen, K.; Rajaniemi, H. Immunohistochemical localization of carbonic anhydrase isoenzymes VI, II, and I in human parotid and submandibular glands. J. Histochem. Cytochem. 1990, 38, 941–947. [Google Scholar] [CrossRef]
- Redman, R.S.; Bandyopadhyay, B.C. Immunohistochemical localization of carbonic anhydrase IV in the human parotid gland. Biotech. Histochem. 2021, in press. [Google Scholar] [CrossRef]
- Milovanovic, B.; Djajic, V.; Bajic, D.; Djokovic, A.; Krajnovic, T.; Jovanovic, S.; Verhaz, A.; Kovacevic, P.; Ostojic, M. Assessment of autonomic nervous system dysfunction in the early phase of infection with SARS-CoV-2 virus. Front. Neurosci. 2021, 15, 640835. [Google Scholar] [CrossRef] [PubMed]
- Finsterer, J.; Scorza, F.A.; Scorza, C.; Fiorini, A. COVID-19 associated cranial nerve neuropathy: A systematic review. Bosn. J. Basic Med. Sci. 2021, in press. [Google Scholar] [CrossRef] [PubMed]
- Gilchrist, J.M. Seventh cranial neuropathy. Semin. Neurol. 2009, 29, 5–13. [Google Scholar] [CrossRef] [Green Version]
- Saniasiaya, J. Xerostomia and COVID-19: Unleashing pandora’s box. Ear Nose Throat J. 2021, 100, 139S. [Google Scholar] [CrossRef]
- Proctor, G.B. The physiology of salivary secretion. Periodontol. 2000 2016, 70, 11–25. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Belchior Fontenele, M.N.; Pedrosa, M.D.S. Xerostomia and taste alterations in COVID-19. Ear Nose Throat J. 2021, 100 (Suppl. S2), 186S–187S. [Google Scholar] [CrossRef]
- Htun, Y.M.; Win, T.T.; Aung, A.; Latt, T.Z.; Phyo, Y.N.; Tun, T.M.; Htun, N.S.; Tun, K.M.; Htun, K.A. Initial presenting symptoms, comorbidities and severity of COVID-19 patients during the second wave of epidemic in Myanmar. Trop. Med. Health 2021, 49, 62. [Google Scholar] [CrossRef] [PubMed]
- Sreebny, L.M.; Yu, A.; Green, A.; Valdini, A. Xerostomia in diabetes mellitus. Diabetes Care 1992, 15, 900–904. [Google Scholar] [CrossRef] [PubMed]
- Han, P.; Suarez-Durall, P.; Mulligan, R. Dry mouth: A critical topic for older adult patients. J. Prosthodont. Res. 2015, 59, 6–19. [Google Scholar] [CrossRef] [PubMed]
- Turner, M.D. Hyposalivation and xerostomia: Etiology, complications, and medical management. Dent. Clin. North Am. 2016, 60, 435–443. [Google Scholar] [CrossRef] [PubMed]
- Chainani-Wu, N.; Gorsky, M.; Mayer, P.; Bostrom, A.; Epstein, J.B.; Silverman, S., Jr. Assessment of the use of sialogogues in the clinical management of patients with xerostomia. Spec. Care Dentist. 2006, 26, 164–170. [Google Scholar] [CrossRef] [PubMed]
- Aframian, D.J.; Helcer, M.; Livni, D.; Robinson, S.D.; Markitziu, A.; Nadler, C. Pilocarpine treatment in a mixed cohort of xerostomic patients. Oral Dis. 2007, 13, 88–92. [Google Scholar] [CrossRef] [PubMed]
- Goto, T.; Shirakawa, H.; Furukawa, Y.; Komai, M. Decreased expression of carbonic anhydrase isozyme II, rather than of isozyme VI, in submandibular glands in long-term zinc-deficient rats. Br. J. Nutr. 2008, 99, 248–253. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lane, H.W.; Warren, D.C.; Squyres, N.S.; Cotham, A.C. Zinc concentrations in hair, plasma, and saliva and changes in taste acuity of adults supplemented with zinc. Biol. Trace Elem. Res. 1982, 4, 83–93. [Google Scholar] [CrossRef]
- Kim, Y.J.; Jo, Y.; Lee, Y.H.; Park, K.; Park, H.K.; Choi, S.Y. Zn2+ stimulates salivary secretions via metabotropic zinc receptor ZnR/GPR39 in human salivary gland cells. Sci. Rep. 2019, 9, 17648. [Google Scholar] [CrossRef]
Patients and Diagnosis | Disease Severity | Country or Ethnicity | Number of Patients | Age (Year), Mean or Median (Range) | Female (%) | Oral Symptoms | Prevalence (%) | Comorbidities | Reference |
---|---|---|---|---|---|---|---|---|---|
Patients diagnosed by RT-PCR test | NR | Italy (European 88%, Asian 12%) | 50 | 37.7 (18–65) | 40.0 | Xerostomia Taste dysfunction in the early phase Xerostomia Taste dysfunction after 15 days from RT-PCR test negativity | 32.0 70.0 2.0 8.0 | DM (6.0%) HT (16.0%) CRD (10.0%) TD (8.0%) Asthma (14.0%) | Freni et al. [6] |
Non-hospitalized patients diagnosed by RT-PCR test | Mild | Israel | 128 | 36.3 (18–73) | 54.7 | Dry mouth Taste dysfunction in the early phase Changes in Sweet taste Salty taste Sour taste | 56.3 52.3 47.7 42.2 41.4 | DM (2.3%) HT (6.3%) TD (3.1%) Asthma (1.6%) | Biadsee et al. [7] |
Patients diagnosed by real-time RT- PCR test | Mostly mild to moderate | Italy | 111 | 57 (48–67) | 47.7 | Xerostomia Dysgeusia in the early phase | 45.9 59.5 | DM (9.0%) HT (26.1%) CPD (9.9%) | Fantozzi et al. [14] |
Hospitalized patients | NR | Italy | 20 | 69.2 | 45.0 | Xerostomia Taste impairment Swallowing difficulty Burning sensation during hospitalization | 30.0 25.0 20.0 15.0 | DM (15%) HT (40%) TD (25%) | Sinjari et al. [15] |
Hospitalized patients diagnosed according to the official guideline and by SARS-CoV-2 nucleic acid detection | NR | China | 108 | 52.0 (one female, age data missed) | 51.9 | Dry mouth Amblygeustia in the early phase | 46.3 47.2 | NR | Chen et al. [8] |
Hospitalized patients diagnosed by real-time RT- PCR test | Moderate to severe | Italy | 122 | 62.5 | 24.6 | Dry mouth Salivary gland ectasia Taste alteration after 95–132 days from hospital discharge | 24.6 37.7 42 | DM (26.7%) HT (40.0%) CPD (20.0%) CKD (6.7%) | Gherlone et al. [16] |
Non-hospitalized patients diagnosed by PCR test | Mild to moderate | Egypt | 573 | 36.2 (19–50) | 71.2 | Xerostomia Halitosis Ulcerations in patients recovered from COVID-19 | 47.6 10.5 20.4 | Medically free and not suffering from any oral manifestations before disease onset | AbuBakr et al. [17] |
Patients diagnosed by PCR test who completed treatment at hospital or home at least 2 weeks ago | Mild to moderate | Turkey | 107 | 34.5 (13–70) | 47.7 | Xerostomia Hyposalivation Taste impairment after 2–4 weeks from hospital discharge | 40.2 18.5 56.1 | Neither comorbidities nor medications to affect saliva flow/amount | Omezli & Torul [18] |
Hospitalized patients diagnosed by RT-PCR test and lung CT scan | NR | Iran | 10 | 42.6 (19–49) | 50 | Xerostomia 3–4 days before prodromal symptoms such as fever and respiratory complications | 60 | GD (30%) | Fathi et al. [19] |
Non-hospitalized patients diagnosed by RT-PCR test | Mild | Israel | 97 | 37.5 (19–74) | 55.7 | Xerostomia Taste dysfunction at the first survey Xerostomia Taste dysfunction after 191–253 days from RT-PCR test negativity | 61.9 67.0 14.4 25.8 | NR | Biadsee et al. [20] |
Hospitalized patients diagnosed by RT-PCR test | NR | Egypt | 58 | 18–46 | 46.6 | Dry mouth Taste dysfunction during disease | 39.7 34.5 | NR | El Kady et al. [21] |
Patients diagnosed by PCR test | Ambulatory (35.0%), severe (41.0%), Critical (24.0%) | Colombia | 100 | 49 (37.8–55.3) | 53.0 | Xerostomia Ageusia after 219 days from symptom onset | 26.0 53.0 | DM (15.0%) HT (17.0%) CPD (1.0%) TD (12.0%) CKD (3.0%) | Anaya et al. [22] |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Tsuchiya, H. Characterization and Pathogenic Speculation of Xerostomia Associated with COVID-19: A Narrative Review. Dent. J. 2021, 9, 130. https://doi.org/10.3390/dj9110130
Tsuchiya H. Characterization and Pathogenic Speculation of Xerostomia Associated with COVID-19: A Narrative Review. Dentistry Journal. 2021; 9(11):130. https://doi.org/10.3390/dj9110130
Chicago/Turabian StyleTsuchiya, Hironori. 2021. "Characterization and Pathogenic Speculation of Xerostomia Associated with COVID-19: A Narrative Review" Dentistry Journal 9, no. 11: 130. https://doi.org/10.3390/dj9110130