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International journal of odontostomatology

versão On-line ISSN 0718-381X

Int. J. Odontostomat. vol.15 no.1 Temuco mar. 2021

http://dx.doi.org/10.4067/S0718-381X2021000100002 

LETTER TO THE EDITOR

Dysgeusia and COVID-19: the Importance of the Dentist in the Diagnostic

Disgeusia y COVID-19: La Importancia del Dentista en el Diagnóstico

Wilson Gustavo Cral1 

Mariane Michels2 

Carlos Augusto Souza Lima3 

Dagmar de Paula Queluz1 

1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.

2 Department of Oral Diagnosis, Division of Oral Radiology, Dental School of University of Sorocaba (UNISO), Sorocaba, São Paulo, Brazil.

3 Faculdade São Leopoldo Mandic, Instituto de Pesquisas, São Leopoldo Mandic, Division of Oral Radiology and Department of Stom atology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.

ABSTRACT:

Dysgeusia is understood as changes in the perception of taste in patients infected with COVID-19 and has been frequently observed in the early stages of the disease. Along with the causes of dysgeusia, we can mention the correlation with infectious conditions, being of importance for the differential diagnosis. Dysgeusia can be considered one of the first manifestations of COVID-19, being an important contribution in the search for solutions regarding early diagnosis and treatment, in addition to its hospital and laboratory application.

Keywords: COVID-19; Diagnostic; Dysgeusia; Taste disorders

RESUMEN:

La disgeusia se entiende como cambios en la percepción del gusto en pacientes infectados por COVID-19 y se ha observado con frecuencia en las primeras etapas de la enfermedad. Junto a las causas de la disgeusia, podemos mencionar la correlación con patologías infecciosas, siendo de importancia para el diagnóstico diferencial. La disgeusia se puede considerar como una de las primeras manifestaciones del COVID-19, siendo un aporte importante en la búsqueda de soluciones en cuanto al diagnóstico y tratamiento precoces, además de su aplicación hospitalaria y de laboratorio.

PALABRAS CLAVE: COVID-19; diagnóstico; disgeusia; transtornos del gusto

Cover Letter

Sir, the new coronavirus pandemic was declared a state of public health emergency of international interest by the World Health Organization and, subsequently, called COVID-19 (Meng et al., 2020).

Among the symptoms of this disease, changes in the perception of taste in infected patients, which is also called dysgeusia (Giacomelli et al., 2020), have frequently been observed in early stages.

Along with the causes of dysgeusia, we can mention the correlation with infectious conditions, such as influenza, tonsillitis, and sinusitis, in addition to the relationship with systemic diseases, such as diabetes mellitus. Recently, authors have reported its occurrence as an adverse effect of cancer therapy (Hovan, et al., 2010).

Studies indicate that disorders of the olfactory system may be related to taste disorders in a concomitant way. According to Giacomelli et al., in the Department of Infectious Diseases of Hospital L. Sacco, Milan, Italy, of 88 patients, 33.9 % reported at least one taste or olfactory disorder and, 18.6 %, both. Taste changes were more frequent (91%) before hospitalization. Thus, the report of changes in the perception of taste by patients can be considered the first oral manifestation of SARS-CoV-2 infection (Vinayachandran & Balasubramanian, 2020).

Recent studies indicate the presence of viral load in the saliva collected from most infected patients (Sabino-Silva et al., 2020). Saliva is the main fluid component of the external environment of taste receptor cells (Xu et al., 2020). According to the study by Xu et al., there is a potentiated expression of the angiotensin-converting enzyme 2 (ACE2), responsible for the entry of the virus into the host cell through binding with SARS-CoV-2, in the mucosa of the oral cavity, more specifically in the epithelial cells of the tongue, where there are taste buds, responsible for the identification of flavors.

However, it is important to note that, previously to the diagnosis of dysgeusia as a symptom inherent to the infection of the new coronavirus, clinical condition of xerostomia and other viral or bacterial infections should be investigated, since the quantity and quality of the patient's saliva are also considered factors involved in taste sensitivity (Matsuo, 2020).

Therefore, dysgeusia can be considered an oral manifestation of COVID-19, being an important contribution in the search for resolutions regarding early diagnosis and treatment, in addition to its application in the hospital and laboratory.

REFERENCES

Giacomelli, A.; Pezzati, L.; Conti F.; Bernacchia, D.; Siano, M.; Oreni, L.; Rusconi, S.; Gervasoni, C.; Ridolfo, A. L.; Rizzardini, G.; et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study. Clin. Infect. Dis., 71(15):889-90, 2020. [ Links ]

Hovan, A. J.; Williams, P. M.; Stevenson-Moore, P.; Wahlin, Y. B.; Ohrn, K. E. O.; Spijkervet, F. D. L.; Brennan, M. T. & Dysgeusia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer, 18(8):1081-7, 2010. [ Links ]

Matsuo, R. Role of saliva in the maintenance of taste sensitivity. Crit. Rev. Oral Biol. Med., 11(2):216-29, 2020. [ Links ]

Meng, L.; Hua, F. & Bian, Z. Coronavirus Disease 2019 (COVID- 19): emerging and future challenges for dental and oral medicine. J. Dent. Res., 99(5):481-7, 2020. [ Links ]

Sabino-Silva, R.; Jardim, A. C. G. & Siqueira, W. L. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis. Clin. Oral Investig., 24(4):1619-21, 2020. [ Links ]

Vinayachandran, D. & Balasubramanian, S. Is gustatory impairment the first report of an oral manifestation in COVID-19? Oral Dis., 2020. DOI: https://www.doi.org/10.1111/odi.13371Links ]

Xu, H.; Zhong, L.; Deng, J.; Peng, J.; Dan, H.; Zeng, X.; Li, T. & Chen, Q. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int. J. Oral Sci., 12:8, 2020. [ Links ]

Received: September 16, 2020; Accepted: September 28, 2020

*Correspondence to: Email: wgcral@gmail.com

Corresponding author: Wilson Gustavo Cral Av. Limeira, 901 Areião Piracicaba - SP 13414-903 - BRAZIL.

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