ABSTRACT
Objectives This cross-sectional study aimed to determine the prevalence of oral signs, manifestations, and symptoms in hospitalized patients with SARS-CoV-2. Study Design The study sample included 179 hospital patients with COVID-19 confirmed by reverse transcriptase polymerase chain reaction. Sociodemographic and medical variables were obtained through questionnaires and medical records, and oral signs, manifestations, and symptoms were assessed by clinical examination. Results Most of the cases were male patients (n = 98;54.7%), and the mean age across all participants was 51.4 ± 18.6 years. Oral lesions were observed in 117 patients(65.3%). Of these, 73 were primary signs of SARS-CoV-2 infection (62.4%), 12 opportunistic infections (10.3%), and 32 autoimmune and inflammatory lesions (27.3%). In relation to primary lesions, 3 patterns were observed: aphthous-like ulcerations (n = 38;52%), hemorrhagic ulcers (n = 14;19.2%), and petechiae (n = 21;28.8%). Symptoms of taste disorders were observed in 94 patients (52.5%), including dysgeusia (n = 43;45.7%), hypogeusia (n = 22;23.4%), and ageusia (n = 29;30.8%). Additionally, 81 patients reported dry mouth symptoms (45.2%). Conclusions Oral manifestations of COVID-19 in hospitalized patients are relatively common and may represent primary signs and symptoms of the disease, thus highlighting the importance of dentists in the hospital setting or intensive care units to manage patients with COVID-19.
ABSTRACT
Oral manifestations have been related to COVID-19 patients with COVID-19, classified as necrotic/hemorrhagic ulcers, aphthous-like ulcerations, and petechiae. Here we report a series of 9 patients hospitalized with COVID-19 with one of the oral signs of COVID-19. Multiple erythema/petechiae were diagnosed in the palate of 3 patients with moderate symptoms of COVID-19, without reports of pain or discomfort. Three other patients with moderate symptoms of COVID-19 related discomfort on palpation and intraoral examination revealed multiple superficial aphthous-like ulcers with irregular margins and many sizes covered with a mucopurulent membrane in the buccal mucosa and palate. In the intensive care unit, 3 patients with COVID-19 with critical symptoms presented necrotic/hemorrhagic ulcers affecting the lip mucosa, alveolar ridge, and dorsal and lateral tongues, characterized by bleeding and focal areas of shallow necrosis. All cases were followed up by dentists of the multidisciplinary team at the hospitals.
ABSTRACT
BACKGROUND: Most of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID-19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID-19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID-19 patients and their associations with the incidence of adverse COVID-19 outcomes. METHODS: We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID-19 in this prospective observational study. Dental and periodontal status was assessed using in-hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID-19 symptoms, and hospitalization endpoints were tested using chi-square test and incidence rate ratio (IRR) estimation using a generalized linear model with log-Poisson regression. The regression models used a block-wise selection of predictors for oral health-related variables, comorbidities, and patients' ages. RESULTS: Overall, poor oral health conditions were highly prevalent and associated with critical COVID-19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07-1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44-4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12-3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission. CONCLUSION: There was a positive association between deleterious oral health-related conditions, especially periodontitis, and severe COVID-19 outcomes in hospitalized COVID-19 patients.
ABSTRACT
OBJECTIVES: To assess the accuracy of three immunochromatographic rapid tests for salivary detection of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens and the reliability of these tests comparing saliva with plasma samples. MATERIALS AND METHODS: Plasma and saliva samples from 62 patients diagnosed with coronavirus disease 2019 (COVID-19) and 20 healthy volunteers were assayed. IgM/IgG antibody against SARS-COV-2 was detected using three immunochromatographic rapid tests and compared with real-time reverse transcription-polymerase chain reaction (qRT-PCR). RESULTS: The tests' overall accuracy for detecting anti-SARS-CoV-2 antibodies ranged from 75.6 to 79.3 for saliva and 86.6-87.8 for plasma tests. The sensitivity of saliva and plasma tests increased with the severity of COVID-19 signs and symptoms. The chance of a positive plasma test in participants with a positive qRT-PCR test was 2.27 greater than a positive saliva test. CONCLUSIONS: Although rapid immunochromatographic tests are more accurate using plasma than saliva, which was expected considering its original use, our findings support the use of saliva as a straightforward supplementary method to assess seroconversion in patients with COVID-19, with important sensitivity and sensibility, especially in severe and critical cases.