Study Published In Journal Of Dental Research Adds Xerostomia Or Dry Mouth As New COVID-19 Symptom Especially Infection By Delta Variants
: A new study by researchers from the Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia-Brazil has found that dry mouth or Xerostomia is another new symptom of experienced by those with COVID-19. Dry mouth is also a more common symptom in those infected with the Delta variants according to sources not involved with the study.
The study team conducted a detailed meta-analysis study of 183 past research papers covering data from 64,876 patients with COVID-19 worldwide for the last few months during which the Delta variant was more dominant.
The overall prevalence of taste disorders was 38% (95% CI = 22% to 56%, I2 = 98%). Hypogeusia, dysgeusia, and ageusia were also evaluated by a meta-analysis, and the pooled prevalence was 34% for hypogeusia, 33% for dysgeusia, and 26% for ageusia. Taste disorders were associated with a positive COVID-19 test (odds ratio [OR] = 7.54, 95% CI = 5.24 to 10.86, I2 = 93%, P < 0.00001), showing high certainty of evidence. However, the association between taste disorders and mild/moderate severity of COVID-19 (OR = 1.63, 95% CI = 1.33 to 1.99, I2 = 69%, P < 0.0001) and female patients with COVID-19 (OR = 1.77, 95% CI = 1.26 to 2.48, I2 = 79%, P = 0.001) presented low certainty of evidence.
Interestingly, Xerostomia was a new feature of this update, and the pooled data demonstrated a prevalence of 43% (95% CI = 36% to 50%, I2 = 71%) in patients with COVID-19. Regarding oral mucosal lesions, the most common clinical pattern was aphthous like, followed by herpes-like lesions, candidiasis, glossitis/depapillation/geographic tongue, parotitis, and angular cheilitis. Oral lesions were more frequent in the tongue, lips, and palate, presenting miscellaneous clinical aspects that are more likely to represent coinfections.
The study findings suggests that the triad xerostomia, taste dysfunction, and oral mucosal lesions as common manifestations in patients with COVID-19.
study team however said that the study findings are under discussion, and more studies will be necessary to confirm their association with direct SARS-CoV-2 infection in the oral cavity.
The study findings were published in the peer reviewed In Journal Of Dental Research. https://journals.sagepub.com/doi/10.1177/00220345211029637
The study findings It was reported that many as 40 percent of individuals infected with the SARS-CoV-2 coronavirus may experience symptoms of dry mouth or xerostomia (as it’s known medically) during or after the illness. Some individuals may even develop dry mouth even before any other COVID-19 symptoms.
Kevin M. Byrd, DDS, PhD, Anthony R. Volpe Research Scholar & Manager of Oral & Craniofacial Research, Lab of Oral & Craniofacial Innovation (LOCI); American Dental Association Science & Research Institute told Thailand Medical News, “Interestingly this is even
higher than the number of individuals who report a loss of taste upon being diagnosed with COVID-19 or infected with the SARS-CoV-2 virus.”
Dry mouth, or xerostomia (zeer-o-STOE-me-uh), refers to a condition in which the salivary glands in your mouth don't make enough saliva to keep your mouth wet. Your salivary glands normally produce saliva, which releases into the mouth via ducts.
Xerostomia occurs when saliva production slows down or stops, and it’s more than just a nuisance. It can cause problems with swallowing, speaking, and eating. Some of the conditions associated with dry mouth include a sticky, dry feeling in the mouth, frequent thirst, sores in the mouth; sores or split skin at the corners of the mouth; cracked lips, a dry feeling in the throat, a burning or tingling sensation in the mouth and especially on the tongue, a dry, red, raw tongue, problems speaking or trouble tasting, chewing, and swallowing, hoarseness, dry nasal passages, sore throat and even bad breath.
Saliva also prevents infection by controlling bacteria and fungi in the mouth and teeth. When it is in short supply, you can develop cavities and/or painful mouth infections, including yeast infection or thrush.
Importantly the saliva of individuals with COVID-19 can contain high levels of the virus. This is one of the reasons that Covid-19 saliva tests, including home tests, can help detect the virus.
Thailand Medical News also came across a past study by researchers from Wellcome Sanger Institute in Cambridge, U.K. and other research entities in the U.S. and U.K., that might help explain how the SARS-CoV-2 coronavirus affects the mouth and saliva glands to cause this resulting condition or symptom in those infected.
These study findings were published in the peer reviewed journal: Nature.
The researchers from that study identified the angiotensin-converting enzyme 2 receptor, or ACE2 receptor, in cells of the salivary glands and tissues lining the mouth. This is the protein that SARS-CoV-2, the virus that causes Covid-19, locks into for entry into the body.
These researchers also found that the SARS-CoV-2 virus can multiply in the cells of the salivary glands. The researchers exposed saliva from eight people with asymptomatic COVID-19 to healthy cells grown in a dish. This experiment led to the infection of the healthy cells.
The British and American study team also gathered saliva from a separate group of 35 volunteers with mild or asymptomatic Covid-19. Those symptomatic individuals with higher levels of the virus in their saliva were more likely to report a loss of taste and smell than those with lower levels in their saliva
Blake M. Warner, DDS, PhD, an assistant clinical investigator and chief of the salivary disorders unit at the National Institute of Dental and Craniofacial Research of the National Institutes of Health in Bethesda, Maryland commented, “Saliva dumps into the mouth, which is that largest gateway into the body, and is a place where you can not only can be exposed to COVID-19, but can expose others.”
It should be noted that Messrs Warner was a senior investigator on the research published in Nature Medicine, along with Messrs Byrd.
This helps explain some of the oral symptoms of Covid-19, such as loss of taste, blistering, and dry mouth.
The research team warned, “When infected saliva is swallowed or tiny particles of it are inhaled, we think it can potentially transmit SARS-CoV-2 further into our throats, our lungs, or even our guts.”
This research finding also stresses the importance and also provides another piece of evidence that shows that wearing masks in public spaces can help stave off the spread of COVID-19, he says.
The research team added, “It not just respiratory droplets that enter the lung upper airway through the nose. Particles may be generated in the mouth, and talking with each other may spread COVID-19. The oral cavity is not an offsite target. It’s a primary site and is very frequently infected with COVID-19.”
Another study by scientists from the University of São Paulo's Medical School-Brazil and the University of Michigan-USA also confirmed that the SARS-CoV-2 virus infects and replicates in the salivary glands of the human host. The study also confirmed that the mouth is also a point of direct entry for the novel coronavirus. https://www.thailandmedical.news/news/breaking-covid-19-news-study-confirms-that-sars-cov-2-infects-and-replicates-in-the-salivary-glands-and-that-the-mouth-is-also-a-point-of-direct-entry
There are also other studies confirming the same findings.
Yet an important study in peer reviewed journal: Future Virology found that dry mouth may be among the first symptoms of COVID-19, opening up a window to prevent transmission. https://www.futuremedicine.com/doi/10.2217/fvl-2020-0334
A total of about 60 percent of individuals reported dry mouth three to four days before any other COVID-19 symptoms. Others said their mouth was dry simultaneously or for one to two days after the onset of other COVID-19 symptoms. Dry mouth tended to improve with treatment for COVID-19.
As the Delta virus has been found to be able to replicate faster resulting in higher viral loads, oral infections with resulting dry mouth conditions have become more apparent.
Some of the proposed treatments for dry mouth include
chewing sugarless gum with xylitol can add moisture back and may even stave off cavities. Interestingly xylitol was also found to be able to inhibit the SARS-CoV-2 coronavirus in the oral cavities and tissues. https://www.thailandmedical.news/news/covid-19-research-american-led-study-shows-that-nasal-sprays-with-xylitol-and-iota-carrageenan-might-help-protect-against-covid-19
Mouth washes also helps with dry mouth and again some have been found to be useful for COVID-19. https://www.thailandmedical.news/news/covid-19-research-in-vitro-studies-show-that-cetylpyridinium-chloride-found-in-most-mouthwashes-inhibits-sars-cov-2-coronavirus-
Importantly even with the slightest onset of dry mouth and despite the absence of other symptoms, an individual should immediately go and get tested for COVID-19 just to be on safe side.
Thailand Medical News strongly recommends constant wearing of mask, the usage of budesonide nasal sprays and xylitol based mouthwashes for both vaccinated and unvaccinated individuals especially during the coming surges in fall and winter. Do consult a medical doctor prior to using both budesonide nasal sprays and xylitol mouthwashes in case you have any underlying medical conditions that may be further aggravated.
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