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Mahmoud MS, Taha MS, Mansour OI, Barakat E, Allah SA, Omran A, Askoura A. Oral mucosal lesions during SARS-CoV-2 infection: a case series and literature review. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [PMCID: PMC8816309 DOI: 10.1186/s43163-022-00203-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract
Background
The most common manifestations of infection with COVID-19 are fever, sore throat, dry cough, headache, and body aches. The available evidence for successful and safe pharmacological therapy against COVID-19 has not yet been identified, and the possible evidence relates to many adverse reactions. Taste disorders, petechiae, desquamative gingivitis, unspecific oral ulcerations, xerostomia, and candidiasis are the oral manifestations related to SARS-CoV-2 infection.
Main body of the abstract
We reviewed the literature regarding the reported oral mucosal lesions in cases with confirmed COVID-19 infection together with presenting five cases with oral mucosal lesions associated with COVID-19 infection. Direct causal association between COVID-19 infection and oral mucosal lesions is still vague, hence further research is required.
Conclusion
Oral examination is mandatory in cases with suspected or confirmed COVID-19 infection.
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Tirelli G, Boscolo-Rizzo P. ENT symptoms in acute COVID-19: a narrative review. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:S14-S19. [PMID: 35763271 PMCID: PMC9137377 DOI: 10.14639/0392-100x-suppl.1-42-2022-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/02/2022] [Indexed: 11/23/2022]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterised by a wide spectrum of disease severity ranging from asymptomatic or oligosymptomatic cases to severe and life-threatening forms. As this new coronavirus is a respiratory virus, it is not surprising that many symptoms caused by SARS-CoV-2 infection are related to the involvement of the upper respiratory tract. In addition the most pathognomonic of symptoms, i.e. the alteration of smell, nasal obstruction, sore throat and cough have been consistently described as early symptoms of the disease. However, for other ENT symptoms, such as oral lesions and audio-vestibular changes, a causal relation is far from proven. The rapid and extensive spread of COVID-19 makes it difficult to demonstrate a causative link between several ENT symptoms and SARS-CoV-2 infection and it is reasonable to assume that at least in some cases this link is actually coincidental in some cases. Moreover, following the phenomenon of the race to publish, there has been an uncontrolled release of poor-quality articles showing the most disparate associations mainly based on a temporal association between SARS-CoV-2 infection and symptoms of various types including those of the ENT area. In this narrative review of the literature, we will critically describe the ENT symptoms of COVID-19.
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Silva PUJ, Oliveira MB, Vieira W, Cardoso SV, Blumenberg C, Franco A, Siqueira WL, Paranhos LR. Oral pigmentation as an adverse effect of chloroquine and hydroxychloroquine use: A scoping review. Medicine (Baltimore) 2022; 101:e29044. [PMID: 35356915 PMCID: PMC10684193 DOI: 10.1097/md.0000000000029044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/23/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Chloroquine and hydroxychloroquine are 2 medications used to treat some systemic diseases. OBJECTIVE The aim of this scoping review was to assess the occurrence of oral pigmentation induced by chloroquine or hydroxychloroquine and to understand the pathogenic mechanism behind this phenomenon. METHODS The review was performed according to the list of PRISMA SrC recommendations and the JBI Manual for Evidence Synthesis for Scoping Reviews. MEDLINE (PubMed), Scopus, EMBASE, SciELO, Web of Science, Lilacs, and LIVIVO were primary sources, and "gray literature" was searched in OpenThesis and Open Access Thesis and Dissertations (OATD). Studies that screened the occurrence of oral pigmentation associated to the use of chloroquine or hydroxychloroquine were considered eligible. No restrictions of year and language of publication were applied. Study selection and data extraction were performed by 2 independent reviewers. The risk of bias was assessed through the JBI tool, depending on the design of the selected studies. RESULTS The initial search resulted in 2238 studies, of which 19 were eligible. Sixteen studies were case reports, 2 had case-control design and 1 was cross-sectional. Throughout the studies, 44 cases of oral pigmentation were reported. The hard palate was the anatomic region most affected with pigmentation (66%). According to the case reports, most of the lesions (44%) were bluish-gray. The minimum time from the beginning of treatment (chloroquine or hydroxychloroquine) to the occurrence of pigmentation was 6 months. The mean treatment time with the medications was 4.9 years, and the mean drug dosage was 244 mg. Most of the studies (63.1%) had low risk of bias (high methodological quality). CONCLUSIONS The outcomes of this study suggest that hyperpigmentation depend on drug dosage and treatment length. Hyperpigmentation was detected after a long period of treatment with chloroquine or hydroxychloroquine.
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Affiliation(s)
| | | | | | | | | | | | - Walter Luiz Siqueira
- Correspondence: Walter Luiz Siqueira, University of Saskatchewan, College of Dentistry, Saskatoon, Canada (e-mail: ).
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COVID-19 and Its Repercussions on Oral Health: A Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111189. [PMID: 34833407 PMCID: PMC8619825 DOI: 10.3390/medicina57111189] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 12/14/2022]
Abstract
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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Novozhilova NE, Pianzina AV, Korol VA. Oral Health In Patients With COVID-19: A Literature Review. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This article reviews the most common oral health problems, which could be associated with coronavirus disease 2019 (COVID-19). Several reports were published, which described various oral manifestations of COVID, including dysgeusia, petechiae, candidiasis, traumatic ulcers, herpesvirus infection, geographic tongue, thrush like ulcers, among others. Alterations of smell and taste seem to be the most common manifestations of COVID in the orofacial area, which could be directly related to the effect of the virus. Other oral conditions seem to be secondary to the decrease of host defense, or else caused by the drugs and intensive care used in the treatment of COVID-19.
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Riofrio G, Castillo S, Salcedo G, Alvitez-Temoche D, Watanabe R, Mayta-Tovalino F. Future Challenges of Covid-19 and Oral Manifestations in Daily Dental Practice: A Literature Review. J Int Soc Prev Community Dent 2021; 11:242-247. [PMID: 34268185 PMCID: PMC8257013 DOI: 10.4103/jispcd.jispcd_21_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/25/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Some patients reportedly present with oral manifestations of coronavirus disease 2019 (Covid-19). It is unknown if this is due to the virus itself or a side effect of treatment; however, severe acute respiratory syndrome coronavirus 2 has been shown to have a predilection for angiotensin-converting enzyme receptors that are present in the respiratory tract, oral mucosa, tongue, and salivary glands, causing alterations in taste and smell. Therefore, the objective of this review was to present the future challenges of Covid-19 and oral manifestations in daily dental practice through a literature review. MATERIALS AND METHODS Scientific evidence in the databases Scopus and PubMed was searched using the Boolean operators. Articles published in Spanish and English between January and December 2020 were included. RESULTS Of the 89 articles found in Scopus, 69 were of the open access type and 20 were in the "others" category; only 22 scientific articles were found in PubMed. CONCLUSION It is important to take into account these clinical manifestations such as loss of taste and smell in order to detect the disease. Good oral hygiene is also recommended as a preventive measure to reduce viral load, which considerably reduces the probability of infecting other people who are in contact with the infected patient.
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Affiliation(s)
- Grecia Riofrio
- Academic Department, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Stephanny Castillo
- Academic Department, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Gabriela Salcedo
- Academic Department, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Romel Watanabe
- Department of Rehabilitative Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Frank Mayta-Tovalino
- CHANGE Research Working Group, Postgraduate Department, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
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Oral lesions in Covid 19 positive patients. Am J Otolaryngol 2021; 42:102905. [PMID: 33497914 PMCID: PMC7826088 DOI: 10.1016/j.amjoto.2021.102905] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
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Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca Canto G, Sugaya N, Santos-Silva AR, Guerra ENS. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res 2020; 100:141-154. [PMID: 32914677 DOI: 10.1177/0022034520957289] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This living systematic review aims to summarize evidence on the prevalence of oral signs and symptoms in patients with COVID-19. The review was reported per the PRISMA checklist, and the literature search was conducted in 6 databases and in gray literature. Studies published in any language mentioning oral symptoms and signs in patients with COVID-19 were included. The risk of bias was assessed by the Joanna Briggs Institute appraisal tools. The certainty of evidence was evaluated through GRADE assessment. After a 2-step selection, 40 studies were included: 33 cross-sectional and 7 case reports. Overall, 10,228 patients (4,288 males, 5,770 females, and 170 unknown) from 19 countries were assessed. Gustatory impairment was the most common oral manifestation, with a prevalence of 45% (95% CI, 34% to 55%; I2 = 99%). The pooled eligible data for different taste disorders were 38% for dysgeusia and 35% for hypogeusia, while ageusia had a prevalence of 24%. Taste disorders were associated with COVID-19 (odds ratio [OR], 12.68; 95% CI, 6.41 to 25.10; I2 = 63%; P < 0.00001), mild/moderate severity (OR, 2.09; 95% CI, 1.25 to 3.49; I2 = 66%; P = 0.005), and female patients (OR, 1.64; 95% CI, 1.23 to 2.17; I2 = 70%; P = 0.0007). Oral mucosal lesions presented multiple clinical aspects, including white and erythematous plaques, irregular ulcers, small blisters, petechiae, and desquamative gingivitis. Tongue, palate, lips, gingiva, and buccal mucosa were affected. In mild cases, oral mucosal lesions developed before or at the same time as the initial respiratory symptoms; however, in those who required medication and hospitalization, the lesions developed approximately 7 to 24 d after onset symptoms. Therefore, taste disorders may be common symptoms in patients with COVID-19 and should be considered in the scope of the disease's onset and progression. Oral mucosal lesions are more likely to present as coinfections and secondary manifestations with multiple clinical aspects (PROSPERO CRD42020184468).
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Affiliation(s)
- J Amorim Dos Santos
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - A G C Normando
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil.,Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - R L Carvalho da Silva
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - A C Acevedo
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
| | - G De Luca Canto
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - N Sugaya
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - A R Santos-Silva
- Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - E N S Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil
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Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, De Paula RM, Cembranel AC, Santos-Silva AR, Guerra ENS. Oral mucosal lesions in a COVID-19 patient: New signs or secondary manifestations? Int J Infect Dis 2020; 97:326-328. [PMID: 32526392 PMCID: PMC7280113 DOI: 10.1016/j.ijid.2020.06.012] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023] Open
Abstract
Some oral manifestations have been observed in patients with coronavirus disease 2019 (COVID-19). However, there is still a question about whether these lesions are due to coronavirus infection or secondary manifestations resulting from the patient's systemic condition. Thus, this article aims to report an additional case of an oral condition in a patient diagnosed with COVID-19. Our patient, a sixty-seven-year-old Caucasian man, tested positive to coronavirus and presented oral manifestations such as recurrent herpes simplex, candidiasis, and geographic tongue. We support the argument that some oral conditions could be secondary to the deterioration of systemic health or due to treatments for COVID-19. The present case report highlights the importance of including dentists in the intensive care unit multi-professional team to improve oral health in critical patients, not only COVID-19 patients, but also, to contribute to evidence-based and decision-making in managing infectious diseases.
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Affiliation(s)
- Juliana Amorim Dos Santos
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia (UnB), Brasilia, Brazil
| | - Ana Gabriela Costa Normando
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia (UnB), Brasilia, Brazil; Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Rainier Luiz Carvalho da Silva
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia (UnB), Brasilia, Brazil; Hospital Alvorada Brasília, Brasilia, Federal District, Brazil
| | | | | | - Alan Roger Santos-Silva
- Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia (UnB), Brasilia, Brazil.
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