key: cord-1001876-r4uj9a44
authors: Afsal, Abdul Salam; Musthafa, Najma; Fathima, Mundekattil Sulaiman; Lakshmi, Geetha Gopalakrishnan
title: Inflammation of papillae of Wharton's duct in COVID‐19 patients: A debatable entity
date: 2020-10-07
journal: Spec Care Dentist
DOI: 10.1111/scd.12526
sha: fd63b48d73d91e6cb25a31c87558cab5ff8d8b3c
doc_id: 1001876
cord_uid: r4uj9a44

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cate potential infectious route. 1 A high expression of ACE2 in oral cavity especially tongue, floor of mouth, and salivary gland might provide possible routes of entry for the 2019-nCoV. 2 Liu et al analyzed rhesus macaques and found expression of ACE2 in epithelial cell lining on minor salivary gland ducts. 3 Chen et al revealed the expression of ACE2 receptor in human granular cells in salivary glands, which can actually be a target site for 2019-nCoV. 4 Fisher et al reported parotitis in a diagnosed case of COVID-19. 5 Here, we describe the inflammation of papillae of Wharton's duct seen in three patients diagnosed with COVID-19. About six patients with mild symptoms like fever, Spec Care Dentist. 2020;1-2.

wileyonlinelibrary.com/journal/scd 1

Pronounced inflammation of papillae of Wharton's duct myalgia, and throat pain were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by RT-PCR at Kadakkal Government Taluk Hospital, Kerala by June 11, 2020. A thorough oral examination with the aid of intra oral photography revealed that three cases showed moderate inflammation of papillae of Wharton's duct ( Figure 1 ).The submandibular salivary glands were nontender on palpation, and there was no other associated salivary gland pathology, which may present as inflammation of Wharton's duct except for hypo salivation. These three patients slowly improved and recovered completely within 2 weeks period. By the time mentioned, the inflammation of papillae of Wharton's duct seemed to be more pronounced ( Figure 2 ). Recent studies have proved the presence of SARS-CoV-2 RNA copies in the saliva of asymptomatic and symptomatic cases. 6 Wang et al suggested the possibilities of acute and chronic sialadenitis in patients infected with SARS-CoV-2. 7 Being able to promptly recognize and diagnose oral lesions is critical as it may help us to better understand the disease process. Further studies need to be carried out in larger cohorts of patients.

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

A. S. Afsal, Najma Musthafa, M. S. Fathima, and G. G. Lakshmi collected and analyzed clinical data, wrote the manuscript, and revised the article.

All procedures followed were in accordance with the 1964 Helsinki declaration and its later amendments.

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

High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa

Epithelial cells lining salivary gland ducts are early target cells of severe acute respiratory syndrome coronavirus infection in the upper respiratory tracts of rhesus macaques

Detection of 2019-nCoV in Saliva and Characterization of Oral Symptoms in COVID 19 Patients

COVID-19 associated parotitis: a case report

Saliva or nasopharyngeal swab specimens for detection of SARS-CoV-2

Does infection of 2019 novel coronavirus cause acute and/or chronic sialadenitis