Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review

Abstract

Objectives: 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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“…Approximately 32% and 35% of COVID-19 related oral symptoms are associated with salivary gland involvement and xerostomia, respectively (Gupta et al, 2023). We also found that salivary glands, especially serous acini, were susceptible to SARS-CoV-2 (Figures 2, 3).…”

“…COVID-19 mainly manifests as acute respiratory distress syndrome (Huang et al, 2020), but accumulating evidence has shown that oral symptoms have a relatively high incidence. A research involving 79 studies with data from 13,252 patients showed that taste disorders (48%), dry mouth (35%), and oral ulceration (21%) have been identified as the prevalent symptoms of COVID-19 (Tan et al, 2022;Gupta et al, 2023). Although COVID-19-related dysgeusia is usually transient, approximately 5% of patients develop taste disorders that persist for more than four weeks.…”