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• W3087667726 abstract "The current pandemic by the zoonotic cross-species SARS-CoV-2 virus has caused 640016 deaths worldwide as on July 26, 2020.1 The virus has high transmission rate and spreads through contaminated surfaces and direct aerosol inhalation. Recently, it was reported that the SARS-CoV-2 virus is persistent on inanimate objects of various surfaces and showed that it remains for few hours to days providing clues for disinfection in the environment, medical and dental practices.2 A worldwide survey on maxillofacial practice showed that protocols varies between countries in dealing with trauma and oncology surgical procedures.3 Also, the expertise from dental specialists and dental laboratories could contribute in 3D printing of many breathing devices to be used in this pandemic.4 Maxillofacial experts from teaching institutions analyzed the various surgical procedures and the residents training requirements and adapted changing strategies in response to this pandemic due to continuously evolving evidences.5 Hence, it is important Hence, it is important to diagnosis COVID-19 and for containment of the transmission. Clinicians should be aware of the symptoms of the infection for screening and early diagnosis. Symptoms of SARS-CoV-2 infection (COVID-19) are sore throat, cough, fever, breathing difficulty, myalgia, fatigue, runny nose, headache, nausea and diarrhea. Chemosensory disturbances like anosmia and dysgeusia are widely reported and analyzed in SARS-CoV-2 infection and found to be present commonly in the early stages of the disease.6–8 The Center for Disease Control and Prevention (CDC) and World Health Organization also included that sudden onset of either one or both these symptoms are suggestive of SARS-CoV-2 infection. Still, the reason for these sensory changes is not clear and this communication briefly explores the possible mechanisms for dysgeusia in COVID-19 patients, which are as follows. 1. Single cell RNA-seq profile studies revealed that the expression of angiotensin- converting enzyme-2 (ACE2) receptors is high in the oral cavity epithelial cells and more so in the tongue epithelium which is the suggested cell entry process for SARS-CoV-2.9 Thus, more viral binding to the tongue epithelium and the taste bud regions might affect the taste sensation. 2. Studies in mice showed that renin, angiotensinogen and ACE-1 are available in the taste buds of circumvallate and fungiform papillae and are also co-expressed with epithelial sodium channel α-subunit (αENaC), an amiloride-sensitive salt taste receptor or taste receptor type 1 member 3 (T1R3), a sweet taste receptor. This shows that the locally- produced Angiotensin II (AngII) may also regulate the taste function.10 Hence, there is a possibility that the conversion of angiotensin is affected by the ACE2 receptor - SARS-CoV-2 binding, which might be modulating the taste in COVID-19 patients. 3. Gustatory nerve recording studies in mice have shown that amiloride-sensitive taste responses to NaCl were suppressed by AngII, while enhancing the sweet responses. Angiotensin II type 1 receptor (AT1) antagonist CV11974 blocked these effects of AngII on nerve taste responses. AT1 proteins are co-expressed with αENaC or T1R3 in the taste cells.11 Hence, these results clearly show that the taste organ is a peripheral target of AngII which could be affected by SARS-CoV-2 binding to ACE2 receptor altering the gustatory nerve responses. 4. Sialic acid binding to the S1 spike protein in SARS-CoV-2 infection is critical for the virus to engage the host cells.12 Sialic acid protects the glycoproteins which passes the gustatory molecules inside the taste pores and the reduction of salivary sialic acid levels are associated with an increase in the gustatory threshold.13 Such binding to sialic acid could increase the degradation of the gustatory particles leading a taste disorders. 5. Wang et al. showed that Toll-like receptors (TLRs) and type I and II interferon (IFN) receptors are present in the taste buds and also confirmed the presence of TLRs 1, 2, 3, 4, 6 and 7 receptor proteins by immunohistochemistry. Stimulation of TLR receptor ligands in the oral cavity by viral pathogens activates the IFN signaling pathways and down-regulates the expression of c-fos in the taste buds. Thus, it's possible that IFN and TLR pathways together help in recognition of the pathogens and in mediating the inflammatory responses in taste buds. This process leads to taste disorders by interfering taste bud cell turnover and taste transduction.14 As SARS-CoV-2 infection creates severe inflammatory response, cytokines like the IFNs in taste buds might activate the above pathway contributing to the taste disturbance in COVID-19. 6. Another common possibility is the simultaneous presence of olfactory disturbances which prevents the taste sensation, due to the close functional relation between these two chemosenses.15 Yet, many patients report only changes in taste without any smell disorder. Hence, it is expected that a single or multiple mechanisms could happen together, while a more detailed taste disorder analysis and postmortem studies of COVID-19 deaths will help in exploring the molecular mechanisms involved in dysgeusia. Maxillofacial surgeons should be aware of this chemosensory disturbance in COVID-19 and its possible causes as this early symptom emanates from the oral cavity." @default.
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• W3087667726 date "2020-09-08" @default.
• W3087667726 modified "2023-09-23" @default.
• W3087667726 title "Etiogenic Mechanisms for Dysgeusia in SARS-CoV-2 Infection" @default.
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• W3087667726 doi "https://doi.org/10.1097/scs.0000000000007021" @default.
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