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BMC Oral Health
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Research

Oral manifestations of COVID-19 in unvaccinated patients: a cross-sectional study

Authors: Tatiana Jorge Fernandes, Maria Ogrzewalska, Ezequias Batista Martins, Marilda Agudo Mendonça Teixeira de Siqueira, Patrícia Brasil, Guilherme Amaral Calvet

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Early studies have highlighted the possible development of dysgeusia and anosmia in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and these manifestations should be considered a potential indication of coronavirus disease 19 (COVID-19). As potential contributors to these symptoms, dentists should perform careful oral and oropharyngeal examinations and document suspicious oral lesions in patients with COVID-19, especially in those who complain of loss of taste and smell. The study’s objective was to assess the prevalence of oral manifestations among ambulatory unvaccinated symptomatic patients with suspected COVID-19 during the acute phase of the disease.

Methods

This cross-sectional study evaluated oral manifestations in adults (aged ≥ 18 years) with suspected and confirmed SARS-CoV-2 infection. Chi-square and Fisher’s exact tests were used to compare data between the groups (rRT-PCR-positive and rRT-PCR-negative patients).

Results

One hundred thirty-six participants were included. Most were female (n = 79; 58.1%), with a mean age of 39.53 (± 14.17) years. Of these, 54 (39.7%) had a positive rRT-PCR test, and 82 (60.3%) had negative rRT-PCR results. Oral manifestations were observed in 40 participants (74.1%) in the rRT-PCR-positive group and 67 participants (81.7%) in the rRT-PCR-negative group. The most common oral manifestations were xerostomia (n = 85; 62.5%) and dysgeusia/ageusia (n = 57; 41.9%). Different rates of gingivitis (n = 12; 22.2% vs. n = 5; 6.1%; p = 0.005) and halitosis (n = 7; 13.0% vs. n = 1; 1.2%; p = 0.007) were observed between the rRT-PCR-positive and -negative groups, respectively. Mouth ulcers, glossitis, tongue coating, and petechiae were reported in both groups without significant differences.

Conclusions

A high prevalence of oral manifestations was observed in symptomatic patients with suspected or confirmed COVID-19.

Clinical Relevance

This study highlights the importance of routine oral examinations by dentists as part of the multidisciplinary care of COVID-19 patients.
Literature
1.
2.
3.
4.
Sharma S, Kumar V, Chawla A, Logani A. Rapid detection of SARS-CoV-2 in saliva: can an endodontist take the lead in point-of-care COVID-19 testing? Int Endod J. 2020;53(7):1017–9.CrossRefPubMedPubMedCentral
5.
6.
7.
McPhillips L, MacSharry J. Saliva as an alternative specimen to nasopharyngeal swabs for COVID-19 diagnosis: review. Access Microbiol. 2022;4(5):acmi000366.CrossRefPubMedPubMedCentral
8.
Azzi L, Maurino V, Baj A, Dani M, d’Aiuto A, Fasano M, Lualdi M, Sessa F, Alberio T. Diagnostic salivary tests for SARS-CoV-2. J Dent Res. 2021;100(2):115–23.CrossRefPubMed
9.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13.CrossRefPubMedPubMedCentral
10.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.CrossRefPubMedPubMedCentral
11.
Nuno-Gonzalez A, Martin-Carrillo P, Magaletsky K, Martin Rios MD, Herranz Manas C, Artigas Almazan J, Garcia Casasola G, Perez Castro E, Gallego Arenas A, Mayor Ibarguren A, et al. Prevalence of mucocutaneous manifestations in 666 patients with COVID-19 in a field hospital in Spain: oral and palmoplantar findings. Br J Dermatol. 2021;184(1):184–5.CrossRefPubMedPubMedCentral
12.
Iranmanesh B, Khalili M, Amiri R, Zartab H, Aflatoonian M. Oral manifestations of COVID-19 disease: a review article. Dermatol Ther. 2021;34(1):e14578.CrossRefPubMed
13.
Nijakowski K, Wyzga S, Singh N, Podgorski F, Surdacka A. Oral manifestations in SARS-CoV-2 positive patients: a systematic review. J Clin Med 2022, 11(8).
14.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.CrossRefPubMed
15.
Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208.CrossRefPubMedPubMedCentral
16.
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;16:4357–85.CrossRefPubMedPubMedCentral
17.
Soares CD, Souza LL, de Carvalho MGF, Pontes HAR, Mosqueda-Taylor A, Hernandez-Guerrero JC, do Nascimento Medeiros SD, de Oliveira Sales A, Alves FA, Lopes Pinto CA, et al. Oral manifestations of Coronavirus Disease 2019 (COVID-19): a comprehensive clinicopathologic and immunohistochemical study. Am J Surg Pathol. 2022;46(4):528–36.CrossRefPubMed
18.
Limongelli L, Favia G, Maiorano E, D’Amati A, Pispero A, Ingravallo G, Barile G, Tempesta A, Dell’Olio F, Siciliani RA et al. Oral lesions with immunohistochemical evidence of Sars-CoV-2 in swab-negative post-COVID syndrome. Oral Dis 2023.
19.
Biadsee A, Biadsee A, Kassem F, Dagan O, Masarwa S, Ormianer Z. Olfactory and oral manifestations of COVID-19: sex-related Symptoms-A potential pathway to early diagnosis. Otolaryngol Head Neck Surg. 2020;163(4):722–8.CrossRefPubMedPubMedCentral
20.
Christofoli BR, Rios FS, Costa RSA, Wagner TP, Goergen J, Izquierdo C, Jardim JJ, Maltz M, Haas AN. Changes in gingivitis and protective factors among adults: a 4-year prospective population-based study. Community Dent Oral Epidemiol. 2021;49(5):437–44.CrossRefPubMed
21.
22.
Hayata M, Watanabe N, Tamura M, Kamio N, Tanaka H, Nodomi K, Miya C, Nakayama E, Ueda K, Ogata Y, et al. The Periodontopathic Bacterium Fusobacterium nucleatum Induced Proinflammatory Cytokine production by human respiratory epithelial cell lines and in the Lower Respiratory Organs in mice. Cell Physiol Biochem. 2019;53(1):49–61.CrossRefPubMed
23.
Manzalawi R, Alhmamey K, Abdelrasoul M. Gingival bleeding associated with COVID-19 infection. Clin Case Rep. 2021;9(1):294–7.CrossRefPubMed
24.
Diaz Rodriguez M, Jimenez Romera A, Villarroel M. Oral manifestations associated with COVID-19. Oral Dis. 2022;28(Suppl 1):960–2.CrossRefPubMed
25.
Pang W, Zhang D, Zhang J, Li N, Zheng W, Wang H, Liu C, Yang F, Pang B. Tongue features of patients with coronavirus disease 2019: a retrospective cross-sectional study. Integr Med Res. 2020;9(3):100493.CrossRefPubMedPubMedCentral
26.
Eita AAB. Parosmia, Dysgeusia, and Tongue Features Changes in a Patient with Post-Acute COVID-19 Syndrome. Case Rep Dent 2021, 2021:3788727.
27.
Jimenez-Cauhe J, Ortega-Quijano D, de Perosanz-Lobo D, Burgos-Blasco P, Vano-Galvan S, Fernandez-Guarino M, Fernandez-Nieto D. Enanthem in patients with COVID-19 and skin Rash. JAMA Dermatol. 2020;156(10):1134–6.CrossRefPubMedPubMedCentral
28.
Gutierrez-Camacho JR, Avila-Carrasco L, Martinez-Vazquez MC, Garza-Veloz I, Zorrilla-Alfaro SM, Gutierrez-Camacho V, Martinez-Fierro ML. Oral lesions Associated with COVID-19 and the participation of the buccal cavity as a key player for establishment of immunity against SARS-CoV-2. Int J Environ Res Public Health 2022, 19(18).
29.
Lima FET, Albuquerque NLS, Florencio SSG, Fontenele MGM, Queiroz APO, Lima GA, Figueiredo LM, Amorim SMC, Barbosa LP. Time interval between onset of symptoms and COVID-19 testing in brazilian state capitals, August 2020. Epidemiol Serv Saude. 2020;30(1):e2020788.CrossRefPubMed
30.
Floriano I, Silvinato A, Bernardo WM, Reis JC, Soledade G. Accuracy of the polymerase chain reaction (PCR) test in the diagnosis of acute respiratory syndrome due to coronavirus: a systematic review and meta-analysis. Rev Assoc Med Bras (1992). 2020;66(7):880–8.CrossRefPubMed
Metadata
Title
Oral manifestations of COVID-19 in unvaccinated patients: a cross-sectional study
Authors
Tatiana Jorge Fernandes
Maria Ogrzewalska
Ezequias Batista Martins
Marilda Agudo Mendonça Teixeira de Siqueira
Patrícia Brasil
Guilherme Amaral Calvet
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03325-z

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