ABSTRACT

The oral cavity, as the entry point to the body, may play a critical role in the pathogenesis of SARS-CoV-2 infection that has caused a global outbreak of the coronavirus disease 2019 (COVID-19). Available data indicate that the oral cavity may be an active site of infection and an important reservoir of SARS-CoV-2. Considering that the oral surfaces are colonized by a diverse microbial community, it is likely that viruses have interactions with the host microbiota. Patients infected by SARS-CoV-2 may have alterations in the oral and gut microbiota, while oral species have been found in the lung of COVID-19 patients. Furthermore, interactions between the oral, lung, and gut microbiomes appear to occur dynamically whereby a dysbiotic oral microbial community could influence respiratory and gastrointestinal diseases. However, it is unclear whether SARS-CoV-2 infection can alter the local homeostasis of the resident microbiota, actively cause dysbiosis, or influence cross-body sites interactions. Here, we provide a conceptual framework on the potential impact of SARS-CoV-2 oral infection on the local and distant microbiomes across the respiratory and gastrointestinal tracts (‘oral-tract axes’), which remains largely unexplored. Studies in this area could further elucidate the pathogenic mechanism of SARS-CoV-2 and the course of infection as well as the clinical symptoms of COVID-19 across different sites in the human host.

摘要

作为机体的切入点，口腔可能在SARS-CoV-2感染的发病机理中发挥了关键作用，SARS-CoV-2感染已导致2019年冠状病毒疾病（COVID-19）的全球爆发。现有数据表明，口腔可能是感染的活跃部位，并且是SARS-CoV-2的重要储存库。考虑到口腔表面被多样化的微生物群落定殖，病毒很可能与宿主微生物群发生相互作用。被SARS-CoV-2感染的患者的口腔和肠道菌群可能有变化，而在COVID-19患者的肺部发现了口腔菌种。此外，口腔，肺部和肠道微生物组之间的相互作用似乎是动态发生的，由此不良的口腔微生物群落可能会影响呼吸系统和胃肠道疾病。然而，尚不清楚SARS-CoV-2感染是否可以改变驻留微生物的局部稳态，是否主动引起营养不良或影响跨身体部位的相互作用。在这里，我们提供了SARS-CoV-2口腔感染对跨呼吸道和胃肠道的局部和远距离微生物群落的潜在影响的概念框架（'口腔轴'），至今仍未开发。该领域的研究可以进一步阐明SARS-CoV-2的致病机制，感染过程以及人类宿主不同部位的COVID-19的临床症状。