Background: The critically ill patients suffering from coronavirus disease (COVID-19) and admitted to the intensive care units (ICUs) are susceptible to a wide array of complications that can be life-threatening or impose them to long-term complications. The COVID-19 oral mucocutaneous complications require multidisciplinary management and research for their pathophysiological course and epidemiological significance; therefore, the objective of this study was to evaluate the prevalence and characteristics of the critically ill COVID-19 patients with oral complications. Methods: We described the clinical and microbiological characteristics of the critically ill COVID-19 patients in our ICU department (Banska Bystrica, Slovakia). In addition, we reviewed the current body of evidence in Ovid MEDLINE®, Embase, Cochrane Library, and Google Scholar for the oral mucocutaneous complications of ICU patients with COVID-19. Results: Three out of nine critically ill patients (33.3%) in our ICU department presented with oral complications including haemorrhagic ulcers and necrotic ulcers affecting the lips and tongue. The microbiological assessment revealed the presence of opportunistic pathogens, confirming the possibility of co-infection. On reviewing the current literature, two hundred ten critically ill patients were reported to have oral complications due to their stay in the ICU setting. Perioral pressure ulcers were the most common complication, followed by oral candidiasis, herpetic and haemorrhagic ulcers, and acute onset macroglossia. The prolonged prone positioning and mechanical ventilation devices were the primary risk factors for those oral complications, in addition to the immunosuppressive drugs. Conclusions: The multidisciplinary approach is strongly advocated for monitoring and management of COVID-19 patients, thus implying that dermatology and oral healthcare specialists and nurses should be integrated within the ICU teams.
mRNA-based COVID-19 vaccines such as BNT162b2 have recently been a target of anti-vaccination campaigns due to their novelty in the healthcare industry; nevertheless, these vaccines have exhibited excellent results in terms of efficacy and safety. As a consequence, they acquired the first approvals from drug regulators and were deployed at a large scale among priority groups, including healthcare workers. This phase IV study was designed as a nationwide cross-sectional survey to evaluate the post-vaccination side effects among healthcare workers in Slovakia. The study used a validated self-administered questionnaire that inquired about participants’ demographic information, medical anamneses, COVID-19-related anamnesis, and local, systemic, oral, and skin-related side effects following receiving the BNT162b2 vaccine. A total of 522 participants were included in this study, of whom 77% were females, 55.7% were aged between 31 and 54 years, and 41.6% were from Banska Bystrica. Most of the participants (91.6%) reported at least one side effect. Injection site pain (85.2%) was the most common local side effect, while fatigue (54.2%), headache (34.3%), muscle pain (28.4%), and chills (26.4%) were the most common systemic side effects. The reported side effects were of a mild nature (99.6%) that did not require medical attention and a short duration, as most of them (90.4%) were resolved within three days. Females and young adults were more likely to report post-vaccination side effects; such a finding is also consistent with what was previously reported by other phase IV studies worldwide. The role of chronic illnesses and medical treatments in post-vaccination side effect incidence and intensity requires further robust investigation among large population groups.
The emerging evidence on oral manifestations of the coronavirus disease (COVID-19) has provoked large debates about their etiology, prognosis, and significance; however, these symptoms may have been underreported and discovered by accidental diagnosis due to the inability of the COVID-19 patients to seek oral health care and the low fatality of the oral mucocutaneous lesions. Larger case series following rigorous reporting guidelines are highly required to enhance evidence robustness; therefore, we aim to demonstrate the characteristics of 26 laboratory-confirmed COVID-19 patients with tongue ulcers according to the CARE guidelines (Gagnier et al., 2013;Riad, Klugar, & Krsek, 2020).The demographic, clinical, and laboratory characteristics of the patients who visited our department with tongue ulcers in April -June 2020 were retrospectively extracted from the hospital records.
The immune dysregulation triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been hypothesized as a causal pathway for the increasingly reported oral manifestations associated with coronavirus diseases (COVID-19), especially the ones of fungal origin. [1][2][3] As a result of this, we aim to report according to the CARE guidelines, three COVID-19 cases who sought teleconsultations from our private practice (Cairo, Egypt) from July to September 2020. In addition, we have performed a literature search in Ovid MEDLINE®, EMBASE, Cochrane Library, and Epistemonikos from inception until November 30, 2020, with a combination of keywords (COVID-19 or SARS-CoV-2) and oral candidiasis.
Bacterial/fungal coinfection is a suggested etiological theory for the COVID‐19 related oral manifestations that may trigger overprescribing of broad‐spectrum antibiotics for COVID‐19 patients, especially for the ones who experience a longer course of the infection. Rigorous reporting of the clinical scenarios of fungal complications such as oropharyngeal candidiasis (OPC) which could cause life‐threatening candidemia may help in understanding the ongoing pandemic and the potential role of dentists in frontline teams. 1,2 Therefore, we aim to describe a non‐severe COVID‐19 case with oral candidiasis according to the CARE guidelines. 3
Dentists play a key role in the primary prevention of oral diseases and related systemic complications; therefore, their views on behavioural interventions need to be aligned with the current agendas for oral health. Likewise, dental students’ oral health-related knowledge, attitudes, and behaviours (KAB) are of practical importance, as they are the future opinion leaders for oral health in their respective communities. A cross-sectional survey-based study was designed to evaluate the oral health KAB of dental students in both the Czech Republic and Slovakia. The study utilized translated versions of the Hiroshima University Dental Behavioural Inventory (HU-DBI), and it aimed to recruit students from all Czech and Slovak dental schools. A total of 487 students were included in this study, out of which 372 (76.4%) were females, 271 (55.6%) were enrolled in preclinical years, 68 (14%) reported smoking tobacco at least once a week, and 430 (88.3%) reported problematic internet use. The mean HU-DBI score of Czech and Slovak dental students (8.18 ± 1.80) was comparable with the previously reported scores of dental students in Nordic and Western European countries. Czech students (9.34 ± 1.29) had a significantly higher score than their Slovak counterparts (7.56 ± 1.73). In both countries, preclinical students (8.04 vs. 8.35), the students who reported tobacco smoking (7.63 vs. 8.27), and those who reported problematic internet use (8.11 vs. 8.70) had significantly lower HU-DBI scores than their counterparts, respectively. In the Czech Republic, the significant increases in HU-DBI scores occurred after the first academic year when the students received preventive dentistry courses; therefore, one can put forward that early implementation of preventive elements in undergraduate dental curricula may yield better and more sustainable oral health gains for the students. Future research on Czech and Slovak dental curricula need to re-evaluate the oral hygiene and anti-smoking components and their impact on students’ views and attitudes.
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