Long COVID Oral Cavity Symptoms Based on Selected Clinical Cases

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is characterized by variable clinical features, different durations, and several previously unheard-of late complications. Knowledge about this infection is constantly evolving.The aim of the study is to present selected cases of the most common symptoms of long COVID in the oral cavity.Among the 1,256 studied patients, 32% of them had discoloration, ulceration, and hemorrhagic changes on the oral mucosa, 29.69% had mycosis located on the tongue, 25.79% of patients had aphthous-like lesions on the hard palate, and in 12.5% atrophic cheilitis was observed. During the anamnesis, approximately 60% of patients reported salivary secretory disorders in the initial period of infection, which is 6.68% prolonged up to 4 months after systemic symptoms disappeared. In an extreme case, an aphthous-like lesion was located on the hard palate, which persisted for 6 months. Approximately 36% of patients did not agree to the proposed treatment. As a result, they only received recommendations on the use of oral hygiene products and received weekly check-ups. In this group of patients, most pathological changes spontaneously cleared after 3 weeks. The elderly with coexisting diseases, persons with a more severe SARS-CoV-2, and hospitalized patients had more extensive and severe lesions in the oral cavity that persisted for a long time after infection.In patients after the SARS-CoV-2 infection and suspected of this infection, a detailed intraoral examination should be performed, and the patient must be obligatorily monitored for a minimum period of 6 months. Depending on the patient's clinical condition, changes in the oral cavity require observation, basic or specialist treatment. In the case of changes in the cavity without pain symptoms, observation should be made for approximately 4 weeks and wait for the spontaneous regression of the changes. However, when pain occurs, a good solution is to use laser biostimulation. In the case of complex pathological changes occurring in the oral cavity, the patient should be directed for specialist treatment.

Alterations of the fecal microbiota in relation to acute COVID-19 infection and recovery

“…Prevotellaceae family members can induce periodontitis [51] which has been associated with increased risk of COVID-19 complications [52]. Prolonged changes in Prevotellaceae relative abundance may explain persistent oral manifestations observed in people with long COVID, or post-COVID conditions [53]. Taken together, these findings suggest impact of COVID-19-associated depletion of particular commensal populations on disease course and long-term recovery.…”

Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review

“…Two studies contain data from multiple European countries [ 18 , 70 ]. The remaining countries—Denmark [ 14 ], France [ 24 ], Qatar [ 32 ], Romania [ 8 ], the United Kingdom [ 6 ], Colombia [ 61 ], Norway [ 63 ], Indonesia [ 69 ], Afghanistan [ 73 ], the Czech Republic [ 76 ], Ukraine [ 78 ], and Poland [ 82 ]—each contributed 1 study, respectively.…”

“…Most of the 79 studies were cross-sectional studies ( n =41) [ 5 , 12 − 26 , 29 − 31 , 33 , 34 , 37 − 46 , 48 − 51 , 53 − 55 , 84 − 86 ] followed by case reports ( n =20) [ 9 , 61 − 75 , 78 − 81 ], case series ( n =11) [ 6 , 8 , 56 − 60 , 76 , 77 , 82 , 83 ], retrospective studies ( n =6) [ 27 , 28 , 35 , 36 , 47 , 52 ], and case-control studies ( n =1) [ 32 ].…”

“…Eighteen studies reported red and white lesions in COVID-19-positive patients [ 8 , 24 − 26 , 29 , 33 , 36 , 37 , 39 , 43 , 49 , 51 , 53 , 57 , 61 , 68 , 80 , 82 ].…”

“…In total, 33 studies reported patients who complained of redness and burning sensation [ 5 , 6 , 22 , 26 , 28 , 30 , 31 , 33 , 34 , 38 − 44 , 46 , 48 , 50 − 55 , 57 , 59 , 60 , 69 , 78 , 79 , 81 , 82 , 85 ].…”