Epidemiological profile of patients with oral alterations during the COVID-19 infection – an integrative review
DOI:
https://doi.org/10.33448/rsd-v14i3.48306Keywords:
COVID-19; Pandemics; Antibody testing, COVID-19; Oral manifestations.Abstract
COVID-19, first identified in Wuhan, China, in December 2019, rapidly escalated into a global pandemic, causing significant health and economic crises. In addition to systemic symptoms, several oral manifestations have been reported in infected patients, given the high presence of the SARS-CoV-2 receptor (ACE-2) in oral tissues. This study aimed to conduct an integrative literature review to analyze oral alterations associated with COVID-19, compiling cases from the PubMed database up to February 26, 2021. A total of 19 studies encompassing 266 patients were included. The most common oral manifestations were dysgeusia, ageusia, hypogeusia, aphthous and hemorrhagic ulcers, burning sensation, and xerostomia. Oral co-infections, such as herpes simplex and candidiasis, were also observed. Results indicate that patients with systemic conditions (e.g., hypertension, diabetes, obesity) tend to develop more severe symptoms and require hospitalization, particularly individuals over 60 years old. The study highlights the importance of dental professionals in the multidisciplinary management of COVID-19 patients, as oral symptoms may serve as early indicators of infection. Standardization of data reporting in future studies is essential to enhance the understanding of oral involvement in COVID-19.
References
Amorim dos Santos, J., Normando, A. G. C., Carvalho da Silva, R. L., et al. (2020). Oral mucosal lesions in a COVID-19 patient: New signs or secondary manifestations? International Journal of Infectious Diseases, 97, 326-328. https://doi.org/10.1016/j.ijid.2020.06.012
Bemquerer, L. M., Arruda, J. A. A. de, Soares, M. P. D., Mesquita, R. A., & Silva, T. A. (2021). The oral cavity cannot be forgotten in the COVID-19 era: Is there a connection between dermatologic and oral manifestations? J Am Acad Dermatol, 27;84(3), e143–e145.
Brandão, T. B., Gueiros, L. A., Melo, T. S., et al. (2021). Oral lesions in patients with SARS-CoV-2 infection: Could the oral cavity be a target organ? Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, 131(2), e45-e51. https://doi.org/10.1016/j.oooo.2020.07.014
Chen, L., Zhao, J., Peng, J., et al. (2020). Detection of SARS-CoV-2 in saliva and characterization of oral symptoms in COVID-19 patients. Cell Proliferation, 53(12), e12923. https://doi.org/10.1111/cpr.12923
Cirillo, N., & Colella, G. (2021). Self-reported smell and taste alteration as the sole clinical manifestation of SARS-CoV-2 infection. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, 131(4), e95-e99. https://doi.org/10.1016/j.oooo.2020.11.016
Corchuelo, J., & Ulloa, F. C. (2020). Oral manifestations in a patient with a history of asymptomatic COVID-19: Case report. International Journal of Infectious Diseases, 100, 154-157. https://doi.org/10.1016/j.ijid.2020.08.071
Dima, M., Enatescu, I., Craina, M., Petre, I., Iacob, E. R., & Iacob, D. (2020). First neonates with severe acute respiratory syndrome coronavirus 2 infection in Romania: Three case reports. Medicine (United States), 99(33), e21284. https://doi.org/10.1097/MD.0000000000021284
Governo Federal do Brasil, Ministério da Saúde. (2021, October 14). https://www.gov.br/saude/pt-br
Halepas, S., Lee, K. C., Myers, A., Yoon, R. K., Chung, W., & Peters, S. M. (2021). Oral manifestations of COVID-19–related multisystem inflammatory syndrome in children: A review of 47 pediatric patients. Journal of the American Dental Association, 152(3), 202-208. https://doi.org/10.1016/j.adaj.2020.11.014
Ho, B. E., Ho, A. P., Ho, M. A., & Ho, E. C. (2020). Case report of familial COVID-19 cluster associated with high prevalence of anosmia, ageusia, and gastrointestinal symptoms. IDCases, 22, e00975. https://doi.org/10.1016/j.idcr.2020.e00975.
Hocková, B., Riad, A., Valky, J., et al. (2021). Oral complications of ICU patients with COVID-19: Case-series and review of two hundred ten cases. Journal of Clinical Medicine, 10(4), 581. https://doi.org/10.3390/jcm10040581
Iranmanesh, B., Khalili, M., Amiri, R., Zartab, H., & Aflatoonian, M. (2021). Oral manifestations of COVID-19 disease: A review article. Dermatologic Therapy, 34(1). https://doi.org/10.1111/dth.14578
Kitakawa, D., Oliveira, F. E., Neves de Castro, P., & Carvalho, L. F. C. S. (2021). Short report – Herpes simplex lesion in the lip semimucosa in a COVID-19 patient. Oral Diseases, 27(S3), 710-712. https://doi.org/10.1111/odi.13382
Maia, C. M. F., Marques, N. P., de Lucena, E. H. G., de Rezende, L. F., Martelli, D. R. B., & Martelli-Júnior, H. (2021). Increased number of herpes zoster cases in Brazil related to the COVID-19 pandemic. International Journal of Infectious Diseases, 104, 732-733. https://doi.org/10.1016/j.ijid.2021.02.033
Maniaci, A., Iannella, G., Vicini, C., et al. (2020). A case of COVID-19 with late-onset rash and transient loss of taste and smell in a 15-year-old boy. American Journal of Case Reports, 21, 1-6. https://doi.org/10.12659/AJCR.925813
Mascitti, H., Bonsang, B., Dinh, A., et al. (2020). Clinical cutaneous features of patients infected with SARS-CoV-2 hospitalized for pneumonia: A cross-sectional study. Open Forum Infectious Diseases, 7(11), ofaa394. https://doi.org/10.1093/ofid/ofaa394
Organização Mundial de Saúde. (2021, June 16). OMS - Brasil. https://www.who.int/eportuguese/countries/bra/pt/
Ramires, M. C. C. H., Mattia, M. B., Tateno, R. Y., Palma, L. F., & Campos, L. (2021). A combination of phototherapy modalities for extensive lip lesions in a patient with SARS-CoV-2 infection. Photodiagnosis and Photodynamic Therapy, 33, 102196. https://doi.org/10.1016/j.pdpdt.2021.102196
Riad, A., Gad, A., Hocková, B., & Klugar, M. (2022). Oral candidiasis in non-severe COVID-19 patients: Call for antibiotic stewardship. Oral Surgery, 15(3), 465-466. https://doi.org/10.1111/ors.12561
Riad, A., Kassem, I., Hocková, B., Badrah, M., & Klugar, M. (2021). Halitosis in COVID-19 patients. Special Care in Dentistry, 41(2), 282-285. https://doi.org/10.1111/scd.12547
Riad, A., Kassem, I., Hocková, B., Badrah, M., & Klugar, M. (2022). Tongue ulcers associated with SARS-CoV-2 infection: A case series. Oral Diseases, 28(S1), 988-990. https://doi.org/10.1111/odi.13635
Rodríguez, M. D., Jimenez Romera, A., & Villarroel, M. (2022). Oral manifestations associated with COVID-19. Oral Diseases, 28(S1), 960-962. https://doi.org/10.1111/odi.13555
Schirinzi, A., Cazzolla, A. P., Lovero, R., et al. (2020). New insights in laboratory testing for COVID-19 patients: Looking for the role and predictive value of human epididymis secretory protein 4 (HE4) and the innate immunity of the oral cavity and respiratory tract. Microorganisms, 8(11), 1718. https://doi.org/10.3390/microorganisms8111718
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of business research, 104, 333-339.
Sinjari, B., D'ardes, D., Santilli, M., et al. (2020). SARS-CoV-2 and oral manifestation: An observational, human study. Journal of Clinical Medicine, 9(10), 3218. https://doi.org/10.3390/jcm9103218
Taques, L., Bortoluzzi, M. C., Karpinski, B. C., et al. (2020). Alterações do sistema estomatognático frente à COVID-19. Brazilian Journal of Health Review, 3(6), 18600-18615. https://doi.org/10.34119/bjhrv3n6-252
Zarch, R. E., & Hosseinzadeh, P. (2021). COVID-19 from the perspective of dentists: A case report. Dermatology and Therapy, 34(1), e14717. https://doi.org/10.1111/dth.14717
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ana Clara Gomes; Karoline de Borba; Jussara Maria Gonçalves
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
