There is growing evidence that mouth ulcers and altered taste sensations might be seen in patients with COVID.
Since the identification of SARS COV-2, we have seen its manifestations in various forms in our bodies.
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Role of ACE-2 receptors in COVID infections
ACE-2 receptors are small extensions present on human cells. They are exclusively found in few regions of our body.
It is well documented that the virus finds its way into our body through the ACE-2 receptors, abundant in the nose and mouth.
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Symptoms of COVID
The common findings in patients with COVID are fever, dry cough, myalgia, sore throat, breathless difficulties, and respiratory complications.
Apart from the classic symptoms, we find new signs and symptoms in these patients, and it is a never-ending story. For example, loss of smell is a new feature that has become the primary diagnostic feature in COVID.
Reason for loss of smell (Hyposmia / Anosmia)
Recent studies revealed that a significant group of patients suffered from Hyposmia (decrease in smell sensation) or Anosmia (loss of smell sensation).
Usually, SARS COV-2 enters the human body with the help of ACE-2 (Angiotensin-converting enzyme -2) receptors present on human cells.
Unfortunately, ACE-2 receptors are in abundance in the skin of the nose (olfactory epithelium). Hence the patient with COVID has his skin damaged in the nose which results in loss of smell.
In simple words, the infection of this skin in the nose (Olfactory epithelium) can directly or indirectly lead to loss of smell.
Viral ulcers in the mouth
Several studies found that virus-like herpes, cytomegalovirus, and Zika virus can infect and replicate in the oral mucosa, leading to painful ulcers.
All these viruses have one thing in common. They produce fluid-filled bubbles, which later turn into ulcers.
Moreover, these ulcers later fuse to form more extensive ulcers.
But, what could be the leading cause of ulcers in COVID patients? How is SARS COV-2 infecting the patient’s mouth?
To know the answers, we have to dig deep into the literature.
Oral finding in patients with SARS COV-2
A study done by Thais Biance Brandao and his colleagues has revealed some fascinating facts about COVID and our mouth.
They have reported 8 cases of COVID 19 infections with oral ulcers. The following findings were observed from their report.
Patients with COVID have developed oral or mouth ulcers, which look similar to aphthous ulcers or canker sores.
These ulcers developed in the early stage of the disease, followed by altered taste sensations on the tongue and affecting the lips and throat.
Reason for oral ulcers in COVID patients
Like the skin in the nose (Olfactory epithelium), the so-called ACE-2 receptors are also present on the tongue, salivary glands, and some parts of the mouth.
Hence at the time of COVID infection, the skin or epithelium on the tongue might be destroyed by the virus leading to multiple ulcerations.
Reasons for an altered taste sensation in COVID patients
The density of ACE-2 receptors is more in salivary glands. Hence in COVID infection, if the virus attacks the same cells, we can suspect damage to the salivary glands. It can further lead to decreased salivary production.
There is no medium for the food to be dissolved when there is no saliva in the mouth. As a result, our taste buds find it difficult to taste the food leading to altered taste sensation or dysgeusia.
Conclusion
There are numerous reasons for mouth ulcers. All mouth ulcers might not be a sign of COVID. But patients with covid often report mouth ulcers.
The mere presence of mouth ulcers might not be the sole diagnostic criteria for COVID. Symptoms such as fever, sour mouth, loss of smell, dry cough, malaise, and accurate investigative reports are the prime source for diagnosing COVID.
Always consult your physician before concluding the diagnosis.
Stay safe and protect your loved ones.
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