Considerations on oral manifestations of COVID‐19

Sousa, Fernando Augusto Cervantes Garcia de; Paradella, Thaís Cachuté

doi:10.1002/jmv.26451

Cited by 28 publications

(46 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to Bezerra et al ( 50 ), it is reasonable to think that COVID-19 systemic immune deregulation may cause a more prolonged immune imbalance, which could predispose these late, secondary oral lesions. In addition, as stated by de Sousa et al ( 13 ), most patients developed oral mucosal injury during the hospitalization period, which supports the hypothesis of coinfections, immunity impairment, and adverse reactions to COVID-19 treatment medications.…”

Section: Discussionsupporting

confidence: 74%

“…The most common skin lesions in these subjects include erythematous rash, urticaria, and vesicle formation, especially localized on the trunk, which seems to be the anatomic region most involved ( 5 , 8 ). Oral lesions, such as unspecific ulceration, desquamative gingivitis, petechiae, and coinfections, such as candidiasis ( 9 – 13 ), have also been reported. Moreover, Xu et al ( 14 ) reported a high level of expression of ACE2 receptors in epithelial cells of the oral mucosa, particularly tongue epithelial cells.…”

Section: Introductionmentioning

confidence: 99%

“…These results suggest that oral mucosa could be a target of SARS-CoV-2 infection. Nevertheless, it is still unclear whether these manifestations are a specific clinical pattern derived from direct SARS-CoV-2 infection or a consequence of systemic involvement because of the possibility of coinfections, a compromised immune system, and adverse reactions to medical treatment ( 13 , 15 , 16 ). Because the prevalence of clinical oral manifestations is still unknown, the range of COVID-19 manifestations in the oral mucosa is of broad and current interest.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association of Viral Infections With Oral Cavity Lesions: Role of SARS-CoV-2 Infection

et al. 2021

View full text Add to dashboard Cite

Different viral agents, such as herpesviruses, human papillomavirus, and Coxsackie virus, are responsible for primary oral lesions, while other viruses, such as human immunodeficiency virus, affect the oral cavity due to immune system weakness. Interestingly, it has been reported that coronavirus disease 2019 (COVID-19) patients can show cutaneous manifestations, including the oral cavity. However, the association between oral injuries and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still unclear. This narrative review aimed to summarize the available literature and provide an overview of oral lesions associated with COVID-19. An online literature search was conducted to select relevant studies published up to November 2020. The results of 17 studies showed variability in oral lesions associated with COVID-19, including ulcerations, aphthous-like lesions, and macules. The tongue, lips, and palate were the most frequent anatomical locations. According to current knowledge, the etiopathogenesis of multiple COVID-19-associated lesions seems to be multifactorial. The appearance of such lesions could be related to the direct or indirect action of SARS-CoV-2 over the oral mucosa cells, coinfections, immunity impairment, and adverse drug reactions. Nevertheless, COVID-19-associated oral lesions may be underreported, mainly due to lockdown periods and the lack of mandatory dispositive protection. Consequently, further research is necessary to determine the diagnostic and pathological significance of oral manifestations of COVID-19. All medical doctors, dentists, and dermatologists are encouraged to perform an accurate and thorough oral examination of all suspected and confirmed COVID-19 cases to recognize the disease's possible early manifestations.

show abstract

Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Viral Infections With Oral Cavity Lesions: Role of SARS-CoV-2 Infection

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 4 , 5 , 6 According to the associated studies, the most frequent oral finding was oral ulceration, and there were distinct clinical patterns observed in different case studies. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 Despite growing literatures investigating oral presentations in COVID-19 patients, few of them provide deep insight into oral ulcerative lesions, the most frequent but diverse one. The detailed clinical features, histological findings, immune profile, and the possible underlying pathogenetic mechanism of the oral ulcerative lesions are still lacking.…”

Section: Introductionmentioning

confidence: 99%

Review of oral ulcerative lesions in COVID-19 patients: A comprehensive study of 51 cases

Wu¹,

Wu²,

Lang³

et al. 2021

Journal of Dental Sciences

View full text Add to dashboard Cite

Numerous oral manifestations of COVID-19 have been reported in the literatures. Common oral lesions in COVID-19 patients included ulcerations, xerostomia, dysgeusia, gingival inflammation, and erythema. Among them, oral ulceration is the most frequent finding and is present as various but distinct patterns. Thus, we conducted a comprehensive review of 51 COVID-19 patients with oral ulcerative lesions to further analyze the various oral ulcerative lesions in COVID-19 patients. There were a median age of 41.4 years and a slight female predilection in these patients. Most oral lesions manifested as an aphtha-like ulceration but lack of an evidence of recurrent aphthous stomatitis. Some of them were present as herpetiform ulcerations without HSV infection. Widespread ulcerations accompanied with necrosis were observed in the more severe and immunosuppressed older patients. Although some reported patients were asymptomatic, most of them had systemic symptoms concurring or slightly preceding the oral ulcerative lesions and the latency from the onset of systemic symptoms to oral ulcerative lesions were under 10 days, suggesting that oral ulceration was one of the early symptoms of COVID-19. Therefore, the oral ulcerative lesions may be considered as oral markers for early diagnosis of the underlying COVID-19 infection in the asymptomatic patients.

show abstract

“…The etiology of oral lesions in patients with COVID‐19 is still uncertain and seems to be multi‐factorial. The appearance of such lesions may be related to the direct or indirect action of SARS‐CoV‐2 on the oral mucosa cells, hypersensitivity of drugs used in the treatment of COVID‐19,downgrading of the general state of health of the patient due to the disease and long period of hospitalization [ 15 ]. There may be a link between COVID-19 and oral manifestations, but these signs may often go undetected due to a lack of intraoral examination during hospital admission [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Tongue ulcer in a patient with COVID-19: a case presentation

et al. 2021

View full text Add to dashboard Cite

Background The emergence of COVID-19 has devastated many parts of the world. From asymptomatic to symptomatic, the virus causes a wide spectrum of presentations. COVID-19 patients may present with oral manifestations. In Afghanistan, where COVID-19 has severely strained the health care system, much of the population lacks proper oral hygiene. This makes the oral cavity a perfect site for SARS-CoV-2 to manifest clinical signs. Case presentation A 62-year-old male was evaluated in the Dentistry Teaching Clinic of Kabul University of Medical Sciences for a painful erosive lesion on dorsal surface of his tongue. He also complained of fever, cough, and taste alteration. He was referred to Afghan Japan Hospital for COVID-19 testing and tested positive. He was followed on for the treatment of SARS-CoV2. After 2 weeks, the patient tested negative and returned to the dentistry clinic for follow-up. Although there were no other signs of COVID-19, the painful erosive lesion on his tongue persisted. Oral evaluation were performed and the patient was advised to practice good hygiene. After 10 days, we observed an asymptomatic geographic tongue without fever and myalgias and the lesion of dorsal surface of tongue improved from severe condition to moderate. Conclusion In conclusion, patients with suspected or confirmed SARS-CoV-2 should be screened for symptoms and physical findings in the oral mucosa To prevent such an outcome, awareness programs need to be implemented for the diagnosis and management of clinical symptoms among patients.

show abstract

Considerations on oral manifestations of COVID‐19

Abstract: Since the first confirmed cases in the end of 2019 in the city of Wuhan, Hubei province in China, COVID‐19 has spread around the world, totaling, until July 25th, 2020, 15.785.641 confirmed cases and 640.016 deaths [1] . This article is protected by copyright. All rights reserved.

Cited by 28 publications

References 16 publications

Association of Viral Infections With Oral Cavity Lesions: Role of SARS-CoV-2 Infection

Association of Viral Infections With Oral Cavity Lesions: Role of SARS-CoV-2 Infection

Review of oral ulcerative lesions in COVID-19 patients: A comprehensive study of 51 cases

Tongue ulcer in a patient with COVID-19: a case presentation

Contact Info

Product

Resources

About