ABSTRACT

Background: The ability of coronavirus SARS-CoV-2 to spread is one of the determinants of the COVID-19 pandemic status. Until June 2020, global COVID-19 cases surpassed 10 million. Asymptomatic patients, with no respiratory impairment, are believed to be responsible for more than 80% of the transmission. Other viruses have been consistently detected in periodontal tissues.

Objective: The aim of this study was to investigate the presence of SARS-CoV-2 in periodontal tissue.

Methods: We conducted video-endoscope minimally invasive post-mortem biopsy in seven fatal cases of COVID-19, using a regular endoscope video system associated with a smartphone to locate periodontal tissue. We analyzed the samples using RT-PCR, to identify the SARS-CoV-2 RNA and histopathological analysis.

Results: The seven studied autopsies with positive laboratory tests for COVID-19 included 57.14% of female patients at the average age of 47.4 (range 8 to 74). In five cases, periodontal tissue was positive for SARS-CoV-2 (RT-PCR). Histopathologic analyses showed morphologic alterations in the keratinocytes of the junctional epithelium, a vacuolization of the cytoplasm and nucleus and nuclear pleomorphism.

Conclusion: We presented a biomolecular analysis obtained from minimally invasive autopsies. This is the first study to demonstrate the presence of SARS-CoV-2 in periodontal tissue in COVID-19 positive patients.

摘要

背景：冠状病毒 SARS-CoV-2 的传播能力是 COVID-19 大流行状态的决定因素之一。截至 2020 年 6 月，全球 COVID-19 病例已超过 1000 万例。据信，80%以上的传播是由无呼吸系统损伤的无症状患者造成的。在牙周组织中也一直检测到其他病毒。

目的：本研究的目的是调查牙周组织中 SARS-CoV-2 的存在。

方法：我们使用与智能手机关联的常规内窥镜视频系统来定位牙周组织，对七例 COVID-19 死亡病例进行了视频内窥镜微创尸检活检。我们使用 RT-PCR 分析了样本，以鉴定 SARS-CoV-2 RNA 并进行组织病理学分析。

结果：所研究的 7 例 COVID-19 实验室检测呈阳性的尸检中，女性患者占 57.14%，平均年龄为 47.4 岁（范围 8 至 74 岁）。在 5 例病例中，牙周组织 SARS-CoV-2 (RT-PCR) 呈阳性。组织病理学分析显示交界上皮角质形成细胞的形态改变、细胞质和细胞核空泡化以及核多形性。

结论：我们提出了从微创尸检中获得的生物分子分析。这是第一项证明 COVID-19 阳性患者牙周组织中存在 SARS-CoV-2 的研究。