Hi,
Have researchers/clinicans highlighted a link between parotitis in children and COVID-19 ?
Thanks !
Thomas
Viral parotitis due to SARS-CoV-2 is a theoretical possibility. A questionable case with unilateral non-suppurative parotitis has been described.
However, the SARS-CoV-2 specific IgG antibody was weakly positive with a negative IgM antibody. Salivary RT-PCR was negative. No follow up antibody test for SARS-COV-2 was done later on.
No similar case has been described from other coronavirus epidemics i.e. SARS (caused by SARS-CoV) and Middle East Respiratory Syndrome (caused by MERS-CoV).
This case could have been parotitis due to mumps, as no mumps serology (Mumps IgM antibody test) was done in the quarantine setting.
https://www.entnet.org/sites/default/files/uploads/torretta_acute_parotitis_a_possible_precocious_clinical_manifestation_of_sars-cov-2_infection.pdf
Dear Muhammad Yousuf ,
Thank you for your very clear and interesting answer.
We received two young children with similar signs in a week ... Delfosse Caroline
Best regards
Thomas Marquillier
Hello Thomas. It would be interesting to read your case report once published.
Hello, interesting discussion.
I just saw two patients with parotis sialolithiasis in the last weeks: a 20 years old boy and a 40 years old woman. No of them had symptoms of Covid however, but they come from the part of north Italy where the pandemic has been stronger.
I have not seen them any more.
@ Thomas MARQUILLIER
It would be interesting to read the case report of the cases you are mentioning.
As in children, the commonest cause of non-suppurative parotitis is Mumps, better rule this possibility out by serology (Mumps IgM/IgG antibodies)
@ Thomas MARQUILLIER
Rule out parotitis due to other viruses particularly Mumps.
@ Thomas Marquillier
There have been some recent evidence to suggest a possible causal relationship between Covid-19 and salivary gland disease (Xu, J. et. al., 2020). The oral mucosa which plays a key role in the pathogenesis of Covid-19 has been found to be rich in angiotensin-converting enzyme II (ACE2) receptors which in turn serve as key receptors for viral binding and cell entry. The binding is facilitated by interaction between Covid-19 S-protein RBD domain with the ACE2 receptor molecules (Zhong, H. et. al, 2020; Xu, X. et. al., 2020). The salivary gland epithelial cells of patients infected with SARS-Cov have been found to show high expression of ACE2 receptors and cellular viral entry. Another study demonstrated a high yeild (91.7%) of positive COVID-19 results in patients’ saliva with most of the samples also culturing the live virus (To, et. al., 2020). As coronoravirus can be detected in the saliva even before lungs and nasopharyngeal lesions appear (Wang, et. al., 2020; To, K.K.W, 2017), this could suggest that the salivary glands (parotid inclusive) may be potential targets for the virus much earlier in the disease. Capaccio et. al. (2020) and Fisher et. al. (2020) observed in separate case reports the presence of a unilateral, diffused parotid enlargement with features of acute inflammatory/infective non-suppurative parotitis in patients with SARS-CoV-2. In another case series, only intraglandular lynphadinitis with relatively normal glands were noted in Covid-19 infected patients exhibiting parotitis like symptoms (Lechien et. al., 2020). Whether Covid-19 associated parotitis is primarily from glandular or lymphatic pathology is yet unascertained. It will be good to further investigate for example if just as seen with other parotitis-causing viruses, the viral replication in covid-19 infected parotid glands also causes perivascular or interstitial mononuclear cell infiltration, haemorrhage, oedema or necrosis of acinar and epithelial duct cells. But at the moment most of the evidences linking Covid-19 to parotitis have been at best anecdotal.
Capaccio, P., Pignataro, L., Corbellino, M., Popescu-Dutruit, S., & Torretta, S. (2020) 'Acute Parotitis: A Possible Precocious Clinical Manifestation of SARS-CoV-2 Infection?', Otolaryngology–Head and Neck Surgery, 163(1), pp. 182–183. doi: 10.1177/0194599820926992.
Fisher, J., Monette, D. L., Patel, K. R. et al. (2020) 'COVID-19 associated Parotitis: A case report' American Journal of Emergency Medicine, doi: 10.1016/j.ajem.2020.06.059.
Lechien, J.R. et. al. (2020) 'Parotitis-like Symptoms Associated with COVID-19', Emerg Infect Dis. doi: 10.3201/eid2609.202059.
To, K. K. et. al. (2020) Consistent Detection of 2019 Novel Coronavirus in Saliva. Clin Infect Dis , ciaa149. doi: 10.1093/cid/ciaa149.
To, K. K. W., et al. (2017) :Additional molecular testing of saliva specimens improves the detection of respiratory viruses', Emerg Microbes Infect, 6, pp. 1-7. doi: 10.1038/emi.2017.35.
Wang, W. K. et. al. (2004) Detection of SARS-associated coronavirus in throat wash and saliva in early diagnosis. Emerging infectious diseases, 10(7), pp. 1213–1219. doi: 10.3201/eid1007.031113.
Xu, X. et. al. (2020) 'Evolution of the Novel Coronavirus from the Ongoing Wuhan Outbreak and Modeling of its Spike Protein for Risk of Human Transmission', Sci China Life Sci , 63. doi: 10.1007/s11427-020-1637-5.
Xu, H., Zhong, L., Deng, J. et al. (2020) High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci, 12(8). doi: 10.1038/s41368-020-0074-x.
Xu, J., Li, Y., Gan, F., Du, Y., & Yao, Y. (2020). Salivary Glands: Potential Reservoirs for COVID-19 Asymptomatic Infection, Journal of Dental Research, doi: 10.1177/0022034520918518.
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