Oral lesions in COVID‐19 infection: Is long‐term follow‐up important in the affected patients?

Bezerra, Thâmara Manoela Marinho; Feitosa, Sthefane Gomes; Carneiro, Diego Thiers Oliveira; Costa, Fábio Wildson Gurgel; Pires, Fábio Ramôa; Pereira, Karuza Maria Alves

doi:10.1111/odi.13705

Cited by 19 publications

(41 citation statements)

References 9 publications

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“… 33 Patient age was specified in 26 articles (mean age of 42.5 years). SARS‐CoV‐2 infection was confirmed in 94.5% cases by polymerase chain reaction (PCR) ( n = 104), 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 15 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 33 , 34 , 35 , 36 , 37 , 38 in three (2.7%) cases by antibody measurement (IgG), 16 , 39 , 40 and not investigated in the remaining three (2.7%) cases because of the patient's mild symptoms. 11 , 14 In the three cases in which the infection's diagnostic confirmation was not performed, one of the patients had systemic symptoms of COVID‐19 (e.g., fever, asthenia, hyposmia, and dysgeusia), and the second was asymptomatic, but the wife had a confirmed infection.…”

Section: Resultsmentioning

confidence: 99%

“… 14 In the three cases in which the diagnosis was confirmed by antibody measurement (positive IgG), one of the patients had the IgM test performed during the symptoms and the IgG test two weeks before the oral lesions appeared 40 ; the other performed only three weeks before the oral lesions appeared 16 ; and the last one did not mention when the test was performed. 39 However, since these antibodies are produced later during the course of the infection and persist for a longer time, a positive result indicates that the patient had COVID‐19 in the recent past and does not allow us to state that the virus was present when the lesions were reported.…”

Section: Resultsmentioning

confidence: 99%

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An integrative review of oral manifestations in patients with COVID‐19: signs directly related to SARS‐CoV‐2 infection or secondary findings?

et al. 2021

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We conducted an integrative review on oral manifestations in patients with COVID‐19 based on the current available literature evidence. A bibliographic search was carried out on March 11, 2021, among published studies in the years 2019–2021 in the PubMed database and based on the search strategy (“COVID‐19” AND “oral lesions” OR “oral mucositis” OR “oral manifestation”). After applying the inclusion and exclusion criteria, 29 articles were considered suitable for this review. A total of 110 cases of patients with COVID‐19 who had oral manifestations were reported. The presence of ulcerated lesions was the most common finding, having a herpetiform and aphthous clinical pattern observed in most cases. Macules, petechiae, hemorrhagic blisters, pustular enanthem, mucositis, and halitosis were also among the most frequently described oral manifestations. The tongue was the most commonly affected site, followed by the palate and lip. Most of the reported cases were diagnosed only by the clinical aspect of the lesion associated with a positive SARS‐CoV‐2 test or the presence of other COVID‐19 symptoms. Current scientific evidence still could not affirm that most of the oral lesions observed in patients with COVID‐19 are related to the virus's direct or indirect action on the oral mucosa. To confirm this association, prospective and longitudinal studies are further needed, together with a larger number of patients, complemented by histopathological examination of these lesions. Additionally, molecular techniques, such as immunohistochemistry and in situ hybridization, may be necessary to perform the differential diagnosis with other oral lesions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

An integrative review of oral manifestations in patients with COVID‐19: signs directly related to SARS‐CoV‐2 infection or secondary findings?

et al. 2021

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“…The immune dysregulation was suggested as a pathophysiological pathway for the emergence of oral ulcers in COVID-19 patients, especially in the severely affected ones. This hypothesis was supported by several cases where recurrent aphthous stomatitis and traumatic ulcerations were ruled out based on rigorous clinical and laboratory investigation, while herpes simplex virus was detected in the vast majority of the old and immunocompromised patients [ 28 , 51 ]. Reflecting on other immune dysregulation-related oral complications like the opportunistic infections especially those that emerge in the hospital setting, the review of Rawson et al 2020 recommended to develop antimicrobial stewardship protocols for managing COVID-19 patients in order to support the optimal treatment outcomes and prevent the potential bacterial/fungal co-infection in critically ill COVID-19 patients [ 52 ].…”

Section: Discussionmentioning

confidence: 98%

Oral Complications of ICU Patients with COVID-19: Case-Series and Review of Two Hundred Ten Cases

Hocková

Riad

Války³

et al. 2021

JCM

124

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Background: The critically ill patients suffering from coronavirus disease (COVID-19) and admitted to the intensive care units (ICUs) are susceptible to a wide array of complications that can be life-threatening or impose them to long-term complications. The COVID-19 oral mucocutaneous complications require multidisciplinary management and research for their pathophysiological course and epidemiological significance; therefore, the objective of this study was to evaluate the prevalence and characteristics of the critically ill COVID-19 patients with oral complications. Methods: We described the clinical and microbiological characteristics of the critically ill COVID-19 patients in our ICU department (Banska Bystrica, Slovakia). In addition, we reviewed the current body of evidence in Ovid MEDLINE®, Embase, Cochrane Library, and Google Scholar for the oral mucocutaneous complications of ICU patients with COVID-19. Results: Three out of nine critically ill patients (33.3%) in our ICU department presented with oral complications including haemorrhagic ulcers and necrotic ulcers affecting the lips and tongue. The microbiological assessment revealed the presence of opportunistic pathogens, confirming the possibility of co-infection. On reviewing the current literature, two hundred ten critically ill patients were reported to have oral complications due to their stay in the ICU setting. Perioral pressure ulcers were the most common complication, followed by oral candidiasis, herpetic and haemorrhagic ulcers, and acute onset macroglossia. The prolonged prone positioning and mechanical ventilation devices were the primary risk factors for those oral complications, in addition to the immunosuppressive drugs. Conclusions: The multidisciplinary approach is strongly advocated for monitoring and management of COVID-19 patients, thus implying that dermatology and oral healthcare specialists and nurses should be integrated within the ICU teams.

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“…Bezerra et al [54] reported a case of a 33-year-old male patient, treated with ivermectin and azithromycin for suspicion of COVID-19, who developed a painful mouth ulceration in the floor of mouth. After 10 days of topical application of corticosteroids, the lesion showed full remission.…”

Section: Oral Lesions Related To Covid-19mentioning

confidence: 99%

COVID-19 and Its Repercussions on Oral Health: A Review

et al. 2021

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In 2019, a new type of coronavirus, SARS-CoV-2, the causing agent of COVID-19, was first detected in Wuhan, China. On 11 March 2020, the World Health Organization declared a pandemic. The manifestations of COVID-19 are mostly age-dependent and potentially more severe in cases with involved co-morbidities. The gravity of the symptoms depends on the clinical stage of the infection. The most common symptoms include runny nose and nasal congestion, anosmia, dysgeusia or hypogeusia, diarrhea, nausea/vomiting, respiratory distress, fatigue, ocular symptoms, diarrhea, vomiting, and abdominal pain. These systemic conditions are often accompanied by skin and mucosal lesions. Oral lesions reported in patients with COVID-19 include: herpex simplex, candidiasis, geographic tongue, aphthous-like ulcers, hemorrhagic ulcerations, necrotic ulcerations, white hairy tongue, reddish macules, erythematous surfaces, petechiae, and pustular enanthema. It is still unclear if these manifestations are a direct result of the viral infection, a consequence of systemic deterioration, or adverse reactions to treatments. Poor oral hygiene in hospitalized or quarantined COVID-19 patients should also be considered as an aggravating condition. This narrative review is focused on presenting the most relevant data from the literature regarding oral manifestations related to SARS-CoV-2, as well as the challenges faced by the dental system during this pandemic. A routine intraoral examination is recommended in COVID-19 patients, either suspected or confirmed, as, in certain cases, oral manifestations represent a sign of severe infection or even of a life-threatening condition. It is our belief that extensive knowledge of all possible manifestations, including oral lesions, in cases of COVID-19 is of great importance in the present uncertain context, including new, currently emerging viral variants with unknown future impact.

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Oral lesions in COVID‐19 infection: Is long‐term follow‐up important in the affected patients?

Cited by 19 publications

References 9 publications

An integrative review of oral manifestations in patients with COVID‐19: signs directly related to SARS‐CoV‐2 infection or secondary findings?

An integrative review of oral manifestations in patients with COVID‐19: signs directly related to SARS‐CoV‐2 infection or secondary findings?

Oral Complications of ICU Patients with COVID-19: Case-Series and Review of Two Hundred Ten Cases

COVID-19 and Its Repercussions on Oral Health: A Review

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