Oral mucosal lesions and oral symptoms of the SARS-CoV-2 infection

Abstract

INTRODUCTION: SARS-CoV-2 develops well in the oral mucosa because, it is the first contact area with the virus. The oral mucosa is highly expressed with angiotensin-converting enzyme 2 (ace2) and makes the virus replicated in the epithelial cells and produce both oral lesions and oral symptoms. this review aimed to describe the oral mucosal symptoms and lesions related to SarS-coV-2-infected patients that have been reported around the world. eViDeNce acQUiSitiON: a literature search was performed on PubMed, ScienceDirect and Google Scholar, from February to October 5, 2020, focusing on cOViD-19 (SarS-coV-2) oral lesions and oral symptoms. EVIDENCE SYNTHESIS: Eighteen studies were identified with a total of 25 cases describing the oral symptoms and oral mucosal lesions of the SarS-coV-2 infection. the oral symptoms related to the SarS-coV-2 infection included dysgeusia, ageusia, a burning mouth sensation, a dry mouth and severe halitosis. the oral mucosal lesions varied from ulceration and depapilation to pseudomembranous, maculae, nodules and plaque. the mucosal lesions related to the skin lesions were in the form of crusty lips, multiple ulcerations and rashes, targeted lesions, blisters and vesiculobullous lesions. CONCLUSIONS: The manifestations of the SARS-CoV-2 infection in the oral cavity are non-specific. The oral mucosal lesions that occur mimic the Herpes zoster virus infection, the Herpes simplex virus infection, Varicella and hand, foot and mouth disease, and the oral mucosal lesions with the skin manifestations (e.g. erythema multiforme).

Comparative evaluation of Oral lesions: “Tale - the Covid 19 Tells”

“…Various oral manifestation seen by various authors were in congruence with our study observations such as inflammation of the papillae of Wharton’s Duct hyposalivation 12 , herpetiform eruption comprising vesicles and erosions on the lips 13 , aphthous-like ulcers & persistent white plaque 14 , multiple pinpoint yellowish ulcers, nodule on the lower lip 15 Various factors leading to oral lesions of covid patients are reviewed systematically 16,17,18 but few major are, Immune system suppression, deteriorating general health, coinfections, opportunistic candidiasis, adverse reactions from medications to COVID-19 treatments, neglected oral hygiene, & drug hypersensitivity and urticaria may be related to the COVID-19 induced cytokine storm.…”

“…Various oral manifestation seen by various authors were in congruence with our study observations such as inflammation of the papillae of Wharton's Duct hyposalivation 12 , herpetiform eruption comprising vesicles and erosions on the lips 13 , aphthous-like ulcers & persistent white plaque 14 , multiple pinpoint yellowish ulcers, nodule on the lower lip 15 Various factors leading to oral lesions of covid patients are reviewed systematically 16,17,18 Covid -19 has been described as vascular disease as SARS-CoV-2 leads to multisystem dysfunction with SARS-CoV-2-mediated endothelial injury, which is an important effector of the virus. 20 It has also been related to thrombotic alterations produced by the virus itself.…”

Characteristics of Oral Manifestations in Symptomatic Non-Hospitalized COVID-19 Patients: A Cross-Sectional Study on a Sample of the Saudi Population

“…However, there were nonspecific symptoms, such as taste alteration, loss of taste, burning sensation in the mouth, mucosal ulceration, dry mouth and halitosis, or even pseudomembranous nodules, maculae or plaque mucosal lesions. 30 Crusted lips, multiple rashes, targeted lesions, blisters and vesiculobullous lesions were reported in some cases. 30 …”

“… 30 Crusted lips, multiple rashes, targeted lesions, blisters and vesiculobullous lesions were reported in some cases. 30 …”

Changes in the organs and tissues of the oral cavity in the new coronavirus infection (COVID-19): A review

“…В обзоре индонезийских авторов [23] указывается, что оральные симптомы, связанные с инфекцией SARS-CoV-2, включали дисгевзию, агевзию, ощущение жжения во рту, сухость во рту и тяжелый неприятный запах изо рта. Поражения слизистой оболочки полости рта варьировали от изъязвлений и депапиляции до псевдомембранозных пятен, узелков и бляшек.…”