Oral care and Covid-19 infection : keeping a low viral load in the mouth and nose is a key strategy to avoid contracting the Covid-19 infection. Use of an effective antiviral throat gargle at least three or four times a day, particularly these days since Covid-19 is declared as aerosol transmitted airborne viral disease may be helpful.
The highly virulent infectious SARS-CoV-2 RNA virus and its variants are causing the Covid-19 pandemic with humongous negative impact on public health, economy and social life. Everything from academics, social events, work life to routine life is thrown out-of-gear. Economic, business and social activity is semi paralyzed by this public health problem. Marriage negotiations and seeking life partners through arranged marriage or ‘love marriage’ systems are all disrupted.
And all this because of the respiratory tract viral infection called Covid-19. This virus causes maximum 3.0% mortality, meaning if there are 100 infected people, around 3 people die. But just imagine if there are 100 lakh or 1 crore infected people (both asymptomatic and symptomatic), the number of deaths is 3 lakh. The hospitalization rate is about 5% to 10% or 5 cases to 10 cases per 100 infected cases. So if in any city, 10000 Covid-19 cases are there, at least 500 cases to 1000 cases will require hospitalization, and this is in addition to other diseases.
So just imagine the condition if there are about 10000 Covid-19 positive cases per day! Thus, hospitals are over full and demand for drugs like remdesivir and medical oxygen is zooming beyond supply capacity. Such is the impact of SARS-CoV-2 that is devastating economic, social and family life in India and across the world.
Economic impact
The Covid-19 pandemic situation has had adverse impact on job creation and growth in economy. There has been negative GDP growth – indications of a pandemic induced economic depression are strong. Hence, this is also called the economic contagion period. All this has adverse effect on public health. Anxiety and mental issues gain traction and access to good nutrition is hit badly. This increases incidence of hidden hunger (or subclinical malnutrition). Psychosomatic basis of disease is well established and Covid-19 worsens expressions of disease.
Oral care for protection from Covid-19
The nose and mouth are the chief portals of entry to the SARS-CoV-2 RNA virus that causes the viral disease Covid-19. Hence, there is so much emphasis on using double mask covering the nose and mouth. There are specific binding sites in the entire respiratory system, mouth and throat, with which the SARS-CoV-2 virus binds. These binding sites located on the outer surface of the cell membrane are called ACE2 receptors, which as reiterated earlier are located in the mouth, throat and nose, and generally in the respiratory epithelium or lining. The novel coronavirus SARS-CoV-2 uses its surface spike protein and docks onto the human cell ACE receptor, injects the RNA into the human cell.
The viral RNA has the property to take over human DNA activity in the cell,the viral RNA controls the human cellular machinery and creates umpteen copies of the virus. Thus, viral multiplication takes place. The ACE2 receptor is present across the respiratory system from nose to lungs and in the mouth (including the tongue) and throat tissues. ACE2 receptor is the critical structure on outer cell membrane with which the SARS-CoV-2 virus binds. Hence, keeping a low viral load in the mouth and nose is a key strategy to avoid contracting the Covid-19 infection.
Immune cell activity in the lungs
The lung is the chief organ of Covid-19 infection as there is a profusion of ACE2 receptors in the lung tissue. The virus starts multiplying in the lung tissue causing lung cell death, consequently, a harder fibrous tissue devoid of blood vessels regrows in the damaged area of the lung. The damaged lung area is no longer a functional area of the lung. In fact, in the autopsy conducted on a Covid-19 patient’s dead body in Bangalore, the forensic medicine specialist Dr. Dinesh Rao noted that normally the healthy lung is soft and spongy, however, in the Covid-19 patient’s dead body the lungs were larger and a like a hard leather ball. The two lungs in adults normally weigh 600 g to 700 g (to 1000 g), but in the dead Covid-19 patient, the two lungs weighed 2.1 kg (and was hard plus leathery).
To counteract viral diseases, there are two important immune cells: T lymphocytes and B lymphocytes. And there are two main types of T-cells (T lymphocytes): helper T-cells and killer T-cells. Helper T-cells stimulate B-cells to make antibodies and help killer cells develop. Killer T-cells directly kill cells that have already been infected by a foreign invader. Thus, T cell activity and B cell productivity is very essential for protection from viral disease including Covid-19. In the lungs and elsewhere, the effective activity of immune cells and quantity of the fighter cells is a key to well – being.
Oral care support to respiratory immunity function
The respiratory system and oral tissues have several physical and cell-based self-defense systems. However, if the pathogenic or disease causing viral load is higher that the threshold level of the individual, then signs and symptoms of the disease start. Further, in the oral cavity, if the gums are not in good condition, if there is gum infection and inflammation, then the chance of pathogens going into the main blood circulation increases and there is breakthrough generalized infection. It is seen in various studies that gum disease is associated with more severe Covid-19. Hence, it is prudent to keep low viral load in oral (or mouth) tissue through use of an effective antiviral throat gargle at least three or four times a day, particularly these days since Covid-19 is declared as aerosol transmitted airborne viral disease challenge.
Sunil S Chiplunkar
VP – Business Development
Group Pharmaceuticals, Bangalore
E mail: 1969sunilchiplunkar@gmail.com
Ph: 6364578669
