Oral mucosal lesions in a COVID-19 patient: New signs or secondary manifestations?

Abstract

Some oral manifestations have been observed in patients with coronavirus disease 2019 . 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-sevenyear-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 multiprofessional 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.

Oral manifestations in a patient with a history of asymptomatic COVID-19: Case report

“…Taking into account that Candida albicans is part of the oral microbiome and that there were favorable events for its pathological development, such as the decrease in salivation manifested in the patient by the sensation of dry mouth, in addition to the frequent use of antibiotics and a mild predisposing factor such as the female sex( Zegarelli 1993 ) and the successful response to nystatin treatment, we can clinically confirm candida infection ( Figs.1 B,G). Recent literature has reported few cases of oral manifestations of patients with COVID-19, but it is still unknown if it is the result of direct action of the virus or product of systemic deterioration that increases the probability of opportunistic injuries( Carreras‐Presas et al, 2020 , Ciccarese et al, 2020 , dos Santos et al, 2020 ). The presence of petechiae at the cutaneous level and at the level of the oral mucosa could be related to thrombocytopenia problems because of SARS-CoV-2 infection( Ciccarese et al 2020 ).…”

COVID-19 Pandemic: Oral Repercussions and its Possible Impact on Oral Health

“…Oral ulcers, petechiae and reddish macules, mainly in palate [15], besides desquamative gingivitis, and blisters in lower lip and buccal mucosa have been described. It is important to highlight that the acute condition caused by COVID-19 may predispose to other opportunistic infections, such as herpes simplex, candidiasis [16], which may have a similar clinical appearance. Since there is no standard treatment for COVID-19, many different drugs are administered to patients, especially those who experience respiratory complications.…”

“…Since there is no standard treatment for COVID-19, many different drugs are administered to patients, especially those who experience respiratory complications. In addition to medications that can cause oral side effects, the length of hospital stay, with the possible need for orotracheal intubation, can also produce changes in the oral mucosa [16]. We should also consider other endemic infectious diseases, especially in developing countries like Brazil, which may have similar oral lesions [17].…”

Oral Manifestations of Coronavirus Disease-19: A Mini-review

“…The novel coronavirus (CoV) disease 2019 (COVID) (severe acute respiratory syndrome-CoV-2 [SARS-CoV-2] or COVID-19) presents as a serious public health concern and urgent threat to global health [1].…”

“…The current CoV outbreak is the third epidemic viral infection in the 21 st century [3]. The lungs are the primary site of infection for COVID-19, with patients presenting symptoms ranging from mild flu-like symptoms to fulminant pneumonia and potentially lethal respiratory distress [1].…”