key: cord-1021127-atycc3m4
authors: Mhaske, Shubhangi; Yuwanati, Monal; Mhaske, Ashok; Desai, Ami; Sarode, Sachin C.; Sarode, Gargi S.
title: Perspective on oral exfoliative cytology and COVID-19
date: 2020-06-12
journal: Oral Oncol
DOI: 10.1016/j.oraloncology.2020.104858
sha: 8842c1a24ea8665df8966ed67ed92b7efeedb75d
doc_id: 1021127
cord_uid: atycc3m4

nan

WHO has declared novel coronavirus infection (COVID-19) as pandemic diseases due to the spread of the infection across the globe. 1 It is an extremely infective disease characterized by high morbidity and mortality rate. 2 The development of vaccines and drugs is still in the stages of infancy and hence, the best strategy to limit this deadly infection is social distancing, contact tracing and vigorous testing to identify and quarantine the positive cases.

Asymptomatic carrier cases are the major concern for the spread of infection in the community. According to one study, the estimated asymptomatic proportion was 17.9% (95% credible interval (CrI): 15.5-20.2%) 3 and there is a possibility that such patients might not visit the healthcare center for the testing. Moreover, limited financial resources, infrastructure and human resources make it impossible to test every suspected case. 4 These major limitations could exaggerate the spread of infection and hence needs urgent attention.

Angiotensin-converting enzyme II (ACE2) receptor has been identified as the attachment domain for the spike receptor of COVID-19 virus. 5 Once infection enters the host cell, virus replication and shedding lead to relevant clinical manifestations. Intriguingly, attachment of spike receptor also causes depletion of ACE2 receptors, which further leads to various morbidities. 6 Thus, due to changes in the expression, ACE2 expression can be exploited for detection or screening of COVID-19 infection.

Intriguingly, ACE2 receptors have been identified on the stratified squamous epithelium of normal oral mucosal. 7 Literature also supports that oral cavity as one of the routs for the entry of COVID 19. 8 

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SARS-CoV-2 receptor ACE2-dependent implications on the cardiovascular system: From basic science to clinical implications

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

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Immunocytochemistry associated with oral exfoliative cytology: methodological analysis

Conflict of interest: None declared