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Kot WY, Li JW, Chan AKY, Zheng LW. A reflection on COVID-19 and oral mucosal lesion: a systematic review. FRONTIERS IN ORAL HEALTH 2023; 4:1322458. [PMID: 38169876 PMCID: PMC10759230 DOI: 10.3389/froh.2023.1322458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction The aim of this systematic review is to provide a clinical update of the current knowledge on COVID-19 and oral mucosal lesions, to analyze the types and prevalence of oral mucosal lesions in patients with COVID-19, and to clarify the potential association between COVID-19 and oral mucosal lesions. Methods The literature search was conducted using PubMed, Web of Science, Scopus and the Cochrane Library, as well as literatures via manual searches of the reference lists of included studies. Studies published in English that mentioned oral mucosal lesions in patients with COVID-19 were included, resulting in a total of 31 studies. Results Most of the included studies were considered to have a moderate to high risk of bias according to the Joanna Briggs Institute bias assessment tools. Based on COVID-19 severity, the characteristics and patterns of oral mucosal lesions in COVID-19 patients were described, analyzed and synthesized. Overall, ulcers without specific diagnosis had the highest prevalence in COVID-19 patients, followed by traumatic ulcers, candidiasis, petechiae and aphthous-like lesions. Homogeneity of data cannot be achieved in statical analysis, indicating randomness of outcome (ulcers without specific diagnosis, 95% CI: 28%-96%, I2 = 98.7%). Discussion Given the limited evidence from currently available studies, the association between COVID-19 and oral mucosal lesions remains difficult to clarify. Healthcare professionals should be aware of the possible association between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.
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Affiliation(s)
- Wai Ying Kot
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jing Wen Li
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Alice Kit Ying Chan
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Li Wu Zheng
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Gupta A, Shrivastav K, Agrawal A, Purohit A, Chanchlani R. Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review. Osong Public Health Res Perspect 2023; 14:388-417. [PMID: 37920896 PMCID: PMC10626325 DOI: 10.24171/j.phrp.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/09/2023] [Accepted: 07/10/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Patients with coronavirus disease 2019 (COVID-19) present with a variety of oral manifestations. Therefore, we conducted a systematic review to estimate the prevalence of oral lesions among COVID-19 patients. METHODS An extensive literature search of several electronic bibliographic databases (PubMed, Scopus, Science Direct, Litcovid) was conducted to retrieve all articles published in the English language from January 1, 2020 to March 31, 2023 that reported the prevalence of oral manifestations among COVID-19 patients. A meta-analysis of pooled prevalence was performed using Jamovi ver. 2.3 (2022). The I2 and Q statistics were used to assess heterogeneity between studies, and p-values <0.01 were considered statistically significant. RESULTS In total, 79 studies with data from 13,252 patients were included. The articles were predominantly published in 2020 (n=33), and Italy was the most common country (n=14). Most of the affected patients more than 50 years old and women (56.6%). The most common sites of involvement were the tongue (n=65), followed by the oral mucosa (n=37) and lips (n=19). High heterogeneity was found between studies. The most common oral manifestation was taste alteration, followed by xerostomia and ulceration, showing pooled prevalence rates of 48%, 35%, and 21%, respectively. CONCLUSION COVID-19 patients show various oral manifestations that may help clinicians identify the disease promptly. Recognition of the signs and symptoms of COVID-19 is critical for an early diagnosis and better prognosis.
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Affiliation(s)
- Ankita Gupta
- Department of Public Health Dentistry, Rishiraj College of Dental Sciences, Bhopal, India
| | - Kriti Shrivastav
- Department of Oral Medicine and Radiology, Rishiraj College of Dental Sciences, Bhopal, India
| | - Amit Agrawal
- Department of Pediatrics, Gandhi Medical College and Hamidia Hospital, Bhopal, India
| | - Abhishek Purohit
- Department of Dentistry, Regional Training Center for Oral Health Promotion, All India Institute of Medical Sciences, Bhopal, India
| | - Roshan Chanchlani
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhopal, India
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Paszynska E, Gawriolek M, Hernik A, Otulakowska-Skrzynska J, Winiarska H, Springer D, Roszak M, Slebioda Z, Krahel A, Cofta S. Prevalence of oral complications in the course of severe SARS-CoV-2 infection under mechanical non-invasive ventilation. Eur J Med Res 2023; 28:293. [PMID: 37608339 PMCID: PMC10463896 DOI: 10.1186/s40001-023-01273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in hospital. Understanding the cause-and-effect relationships may allow for individual adjustment of oral care recommendations during Covid-19 disease. The study's objective was to assess Covid-19 patients' oral health status under hospital treatment due to pulmonary adverse Covid-19 outcomes. MATERIAL AND METHODS Covid-19 patients (mean age 74.4 ± 15.4; n = 120, male n = 50/female n = 70) were admitted to hospital in the acute phase of Covid-19 between January and March 2022 who required oxygen therapy due to pneumonia, rapid respiratory failure, low saturation. Blood and radiological tests were taken according to National Health Fund guidelines. The condition of teeth (Decayed, Missing, Filled teeth as DMFT index), dental hygiene (Plaque Control Record as PCR index), periodontal status (probing depth PD, clinical attachment CAL, bleeding on probing BOP) and oral mucosa (BRUSHED and Beck scores) were examined. RESULTS Charateristics of the teeth (dental caries 35.2%, DMFT Median 22), plaque retention (83.4%), advanced periodontitis (48.3%), xerostomia (74.2%), oral mucosa inflammation (80.8%), angular cheilitis (53.3%), hemorrhagic (21.7%) showed a high incidence of harmful oral conditions. BRUSHED model and Beck score indicated moderate oral dysfunction and need for oral care every 8 h. Spearman's analysis revealed a significant positive correlation between pneumonia and neutrophile, interleukin-6 IL-6, C-reactive protein CRP (p = 0.01, p < 0.001, p < 0.001), negative to lymphocyte count (p < 0.001). Multiple and logistic regressions selected the following risk predictors for pneumonia as IL-6, CRP, obesity and for severe COVID-19 symptoms D-dimer level and a lack of targeted vaccination (p < 0.001). Among oral predictors, the PCR index and Beck score were significant for both outcomes (respectively p < 0.001, p < 0.012). Patients who received oxygen therapy with face masks had more often angular heilitis and debris (p = 0.025, p = 0.035). CONCLUSIONS COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland.
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Justyna Otulakowska-Skrzynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Hanna Winiarska
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
| | - Daria Springer
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences (PUMS), Rokietnicka st. 7, 60-806 Poznan, Poland
| | - Zuzanna Slebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, 60-812 Poznan, Bukowska st. 70, Poland
| | - Anna Krahel
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Szczepan Cofta
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
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Sarasati A, Agustina D, Surboyo MDC. The Oral Lesion in the COVID-19 Patient: Is It True Oral Manifestation or Not? Infect Drug Resist 2023; 16:4357-4385. [PMID: 37424667 PMCID: PMC10329433 DOI: 10.2147/idr.s411615] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Many previously reported publications mentioned that oral lesion in COVID-19 patients was varied. The term oral manifestations refer to pathognomonic features that are found consistently with a specific cause and effect. In this context, the oral manifestation of COVID-19 was inconclusive. This systematic review aimed to analyse previously reported publications related to oral lesions in COVID-19 patients to define as oral manifestations or not. The PRISMA guidelines were implemented in this review. Methods All umbrella reviews, systematic reviews, systematic reviews and meta-analyses, comprehensive reviews, and original and non-original studies were included. Twenty-one of systematic review, 32 original studies and 68 non-original studies reported the oral lesion in COVID-19 patients. Results Most of the publications mentioned that ulcers, macular, pseudomembranes and crusts were frequent oral lesions. The reported oral lesions in COVID-19 patients did not show any pathognomonic features and might be unrelated directly to COVID-19 infections, however, more likely due to gender, age, underlying diseases, and medication. Conclusion The oral lesions found in previous studies do not have pathognomonic features and are inconsistent. Therefore, the reported oral lesion, in present time, cannot be defined as an oral manifestation.
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Affiliation(s)
- Andari Sarasati
- Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Dewi Agustina
- Department of Oral Medicine, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
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Mobile RZ, Warnawin SVSC, Kojo TK, Rodrigues JAP, Cavilha AMDQ, Zerbinati RM, Adamoski D, Oliveira JCD, Conzentino MS, Huergo LF, Gradia DF, Braz-Silva PH, Schussel JL. SARS-CoV-2 in saliva, viremia and seroprevalence for COVID-19 surveillance at a single hematopoietic stem cell transplantation center: a prospective cohort study. Rev Inst Med Trop Sao Paulo 2022; 64:e39. [PMID: 35674637 PMCID: PMC9173687 DOI: 10.1590/s1678-9946202264039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022] Open
Abstract
This prospective cohort study aims to analyze the surveillance of COVID-19 at a single hematopoietic stem cell transplantation (HSCT) center in Brazil, in 29 patients undergoing allogeneic HSCT and 57 healthcare workers (nurses and dentists), through viral shedding of SARS-CoV-2 in saliva and plasma and seroprevalence of anti-SARS-CoV-2 IgG. In addition, we report two cases with prolonged persistent detection of SARS-CoV-2 without seroconversion. The sample collection was performed seven times for patients and five times for healthcare workers. Only two patients tested positive for SARS-CoV-2 in their saliva and plasma samples (6.9%) without seroconversion. All healthcare workers were asymptomatic and none tested positive. Two patients (6.9%) and four nurses (8%) had positive serology. No dentists had positive viral detection or positive serology. Our results reflect a low prevalence of positive RT-PCR and seroprevalence of SARS-CoV-2 in patients and healthcare workers at a single HSCT center. Results have also corroborated how the rigorous protocols adopted in transplant centers were even more strengthened in this pandemic scenario.
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