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奥密克戎(Omicron)变异株及其对口腔诊疗的潜在影响

Omicron Variant of SARS-CoV-2 and Its Potential Impact on Dental Practice

  • 摘要: 严重急性呼吸系统综合征冠状病毒2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)感染引起的2019冠状病毒病(coronavirus disease 2019, COVID-19,我国通称新型冠状病毒肺炎,简称新冠肺炎)疫情已经在全世界蔓延超过两年,每日的新增感染人数及死亡人数仍在持续增长。最新出现的奥密克戎(Omicron)变异株因其刺突蛋白出现多位点突变,导致病毒传染性与致病性发生显著变化,给公共卫生带来了新的挑战。WHO将Omicron变异株列为“需要关注的变异株” (variants of concern, VOC)。SARS-CoV-2及其变异株的传播扰乱了世界范围内的口腔诊疗工作。口腔诊疗过程中,近距离面对面交流、飞沫、气溶胶、接触唾液、血液等,增加了口腔诊疗机构中的传播风险,特别是Omicron等新发变异株的流行,对口腔诊疗带来新的挑战。口腔舌部、黏膜等组织可高表达血管紧张素转换酶2(angiotensin converting enzyme 2, ACE2),ACE2是SARS-CoV-2的结合受体,因此口腔也是SARS-CoV-2感染部位之一。SARS-CoV-2感染可导致味觉丧失等口腔疾病。然而,Omicron等变异株对口腔疾病及其诊疗的影响还鲜有报道,本文将介绍最新出现的Omicron变异株及其致病性、免疫逃逸等特点,以及对口腔诊疗带来的潜在影响,并提出针对Omicron变异株的感染控制措施,以降低其在口腔诊疗服务中的传播风险。

     

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been raging across the world for over two years, but the daily reported numbers of new infections and deaths are still increasing. The newly identified Omicron variant has significant changes in its transmissibility and pathogenicity due to the multiple mutations in the spike protein, posing new challenges to the global public health. World Health Organization has categorized Omicron as a variant of concern (VOC). The spread of SARS-CoV-2 and its variants has caused disruptions to the dental practice worldwide. During the course of diagnosis and treatment of dental care, face-to-face communication at close quarters, droplets, aerosols, and exposure to saliva and blood increase the risks of SARS-CoV-2 transmission. The emergence of new variants, especially the Omicron variant, has formed new challenges to dental healthcare provision. In addition, oral tissues, including the tongue and oral mucosa, can overexpress the angiotensin converting enzyme 2 (ACE2), which is also the binding receptors of SARS-CoV-2. As a result, the oral cavity is one of the target sites of SARS-CoV-2 infection. SARS-CoV-2 infection in oral cavity may cause different oral complications, such as loss of taste. However, there are few reports about Omicron and the other variants of SARS-CoV-2 and their impacts on dental healthcare provision. Herein we made an overview of the Omicron variant and its characteristics, including its pathogenicity and immune evasion, and its potential impact on dental practice. We also proposed some control measures with the aim of reducing the possible transmission of SARS-CoV-2 and its variants during dental care.

     

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