The Post-COVID-19 syndrome: diagnostic criteria, mechanisms of pathogenesis and mucosal immune response
Literature review
DOI:
https://doi.org/10.11603/2311-9624.2023.4.14502Keywords:
COVID-19, post-COVID-19 syndrome, inflammatory diseases, oral mucosa, immune responses, cytokine stormAbstract
Summary. The COVID-19 pandemic is still in the spotlight of the world's scientific community today, as it has had an unprecedented impact on the world with its negative consequences. The potential routes of infection and the pathogenesis of COVID-19 remain unclear, so further studies could help in the prevention and treatment of coronavirus infection.
The aim of the study – to analyze data from scientific literature sources on the manifestations of post-COVID syndrome, mechanisms of pathogenesis of coronavirus infection, including the immune response of mucous membranes, in particular the oral mucosa, diagnostic methods using saliva as a promising diagnostic tool for COVID-19 in the dental practice.
Materials and Methods. The bibliosemantic method was used to clarify the state of the problem, and to study the analysis of the results of previous scientific research based on the sources of literature and electronic resources.
Results and Discussion. Today, it remains important to fully investigate and understand the immunological aspects of the long-term course of COVID-19, a phenomenon that occurs when people continue to experience a range of symptoms and consequences even after the acute phase of COVID-19 infection has been overcome. The post-COVID syndrome is a new phenomenon that is troubling both doctors and patients and is becoming an emerging global problem. The recurrent symptom pattern of the “long tail” of COVID-19-related diseases includes a range of complaints from different organs and systems, including changes in the state of oral health (teeth, gums, mucous membranes). Potential pathways of 2019-nCov infection on the oral mucosa have been reported, with ACE2 being expressed in the oral cavity, including epithelial cells, T cells, B cells, and fibroblasts. Among the different oral sites, ACE2 expression was found to be higher in the epithelial cells of the tongue than in the mucous membranes of the cheeks and gums. These findings provide a preliminary explanation for the underlying mechanism that makes the oral cavity a potentially high-risk zone for 2019-nCoV infection and provide evidence for future prevention strategies in dental clinical practice.
Conclusions. The results of the literature review showed that data on the clinical progression of COVID-19 after the acute phase is very limited, and little is known about the medium and long-term outcomes. Therefore, a multidisciplinary approach and the development and organization of comprehensive individual rehabilitation plans are extremely important and crucial in assessing the condition of patients with post-COVID syndrome.
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