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While pre\u2010existing inflammatory oral diseases provides a conducive environment for the virus, acute infection and persistence of SARS\u2010CoV\u20102 can also results in oral microbiome dysbiosis that further worsens poor oral mucosal health. Indeed, oral PASC includes periodontal diseases, dysgeusia, xerostomia, pharyngitis, oral keratoses, and pulpitis suggesting significant bacterial contributions to SARS\u2010CoV\u20102 and oral tissue tropism. Dysbiotic microbiome\u2010induced inflammation can promote viral entry via angiotensin\u2010converting enzyme receptor\u20102 (ACE2), serine transmembrane TMPRSS2 and possibly other non\u2010canonical pathways. Additionally, metabolites derived from a dysbiotic microbiome can alter the physiological and biochemical pathways related to the metabolism of lipids, carbohydrates, and amino acids. This may promote a pro\u2010inflammatory microenvironment, leading to immune exhaustion, loss of tolerance, and susceptibility to a variety of oral pathogens, causing acute and later chronic inflammation. Microbial release of mimics of host metallopeptidases related to furin, ADAM17 (A disintegrin and metalloproteinase 17), and glycoprotein metabolites can further aid viral attachment to T cell immunoglobulin\u2010like (TIMs), enhancing viral entry while simultaneously depressing oral mucosal immune resistance and clearance. Membrane reorganization characterised by neuroproteins, such as neuropilins, also functionally assists with SARS\u2010CoV\u20102 entry and extends the pathogenesis of PASC from the oral cavity to the brain, gut, or other non\u2010oral tissues. Thus, poor oral health, characterised by disrupted oral microbiomes can promote viral tropism, weaken antiviral resistance, and heightens susceptibility to SARS\u2010CoV\u20102 infection. This immune dysfunction also increases the risk of additional viral infections, exacerbating oral conditions like periodontal and endodontic diseases. These persistent oral health issues can contribute to systemic inflammation, creating bidirectional effects between oral and non\u2010oral tissues, potentially leading to Post\u2010Acute Sequelae of COVID\u201019 (PASC).<\/jats:p>","DOI":"10.1002\/rmv.70029","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T23:44:38Z","timestamp":1741823078000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Oral SARS\u2010CoV\u20102 Infection and Risk for Long Covid"],"prefix":"10.1002","volume":"35","author":[{"given":"Joel","family":"Schwartz","sequence":"first","affiliation":[{"name":"Department of Oral Medicine and Diagnostic Sciences University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristelle","family":"Capistrano","sequence":"additional","affiliation":[{"name":"Department of Periodontics University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine Faculty of Dentistry Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avin","family":"Hafedi","sequence":"additional","affiliation":[{"name":"Department of Periodontics University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology University of Illinois Chicago  Chicago Illinois USA"},{"name":"Department of Ophthalmology and Visual Sciences University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7436-3056","authenticated-orcid":false,"given":"Afsar","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Department of Periodontics University of Illinois Chicago  Chicago Illinois USA"},{"name":"Department of Microbiology and Immunology University of Illinois Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_2_12_2_1","article-title":"Fine\u2010Grained Forecasting of COVID\u201019 Trends at the County Level in the United States","author":"Song T. 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