Letter to the Editor
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Aug 24, 2022; 13(8): 725-728
Published online Aug 24, 2022. doi: 10.5306/wjco.v13.i8.725
COVID-19 and oral cancer: Critical viewpoint
Dharmarajan Gopalakrishnan, Sachin C Sarode, Gargi S Sarode, Namrata Sengupta
Dharmarajan Gopalakrishnan, Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
Sachin C Sarode, Gargi S Sarode, Namrata Sengupta, Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
Author contributions: All the authors have contributed equally to the manuscript.
Conflict-of-interest statement: All the authors associated with the present manuscript declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dharmarajan Gopalakrishnan, MDS, PhD, Dean, Professor, Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune 411018, Maharashtra, India. drgopal@dpu.edu.in
Received: April 9, 2021
Peer-review started: April 9, 2021
First decision: June 28, 2021
Revised: July 2, 2021
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 24, 2022
Abstract

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has marked the beginning of a new pandemic named coronavirus disease 2019 (COVID-19). The World Health Organization has announced it as a health emergency that is of international concern. The disease has been reported to cause respiratory illness, pneumonia and even hinder the immunity of an individual. Individuals with disturbed immune responses have been found to be quite susceptible to this viral infection. Oral cancer patients are also at high risk in this pandemic situation and might encounter severe detrimental outcomes. Angiotensin receptors, documented in studies as the path of entry of this virus, are highly expressed in the epithelial cells of oral mucosa, making the group of individuals with oral cancers even more vulnerable. Extracellular matrix metalloproteinase inducer is another potential target for SARS-CoV-2. An exhaustion of angiotensin converting enzyme 2 cell receptors leads to protumoral effects, whereas a downregulation of extracellular matrix metalloproteinase inducer leads to antitumoral effects. Thus, it causes a variation of the biological behavior of the tumor. This article focusses on the molecular mechanisms, effects and patho-physiology of COVID-19 in oral squamous cell carcinoma patients. The different molecular changes in oral squamous cell carcinoma in the background of COVID-19 will modify various environmental factors for this pathology and have an effect on the carcinogenesis process. Understanding the behavior of the tumor will help plan advanced treatment strategies for oral squamous cell carcinoma patients in the background of COVID-19.

Keywords: COVID-19, SARS-CoV-2, Oral cancer, Head and neck carcinomas, Oral squamous cell carcinoma

Core Tip: The outbreak of coronavirus disease 2019 (COVID-19) has evoked concern worldwide. The rapid spread of the disease during the first and the second waves caused severe respiratory illness. Individuals are facing a suppressed immune response. An impaired immune response has made patients with head and neck cancer highly susceptible to the viral infection. The two potential receptors of severe acute respiratory syndrome coronavirus 2, angiotensin receptors and extracellular matrix metalloproteinase inducer, have contrasting effects on cancer progression. Thus, the molecular mechanisms and the biological behavior of oral squamous cell carcinoma show varying effects in the background of COVID-19.