Unusual Case of Painful Glossitis and Xerostomia Following Vaccination with Pfizer-BioNTech SARS-CoV-2 (BNT162b2).

BACKGROUND Adverse events following immunization (AEFIs) remain under recognized, particularly when the symptoms experienced are uncommon and mimic natural disease. In the context of the worldwide effort to provide protection against SARS-CoV-2 using multiple doses of vaccination and with the availability of multiple vaccines, the early recognition and prompt treatment of AEFIs has increased importance, as does the ability to carefully select an alternative after an AEFI occurs. CASE REPORT A 60-year-old woman presented for clinical immunology review with a 9-month history of glossitis and xerostomia. Onset of symptoms occurred following her first vaccination with a COVID-19 vaccine (BNT162b2). After partial interval improvement, her symptoms progressively worsened after a second vaccination and third booster vaccination with BNT162b2. While undergoing reviews from multiple specialists for possible underlying connective tissue disease, and with other causes of her symptoms being excluded, the patient's symptoms progressed, with worsening tongue swelling with new fissuring and xerostomia. The patient experienced an unintentional weight loss of 8 kg due to oral discomfort. It was only after this time that an AEFI was considered the cause of her presentation, after all other diagnostic considerations were considered unlikely. Targeted, symptomatic, localized treatment with topical oral corticosteroids was initiated, followed by a gradual tapering regimen, with excellent response. CONCLUSIONS This case highlights the need to consider AEFIs early in the differential diagnosis of unusual presentations and the importance of considering a trial of targeted symptomatic treatment for patients, even if diagnostic uncertainty remains.

TASTE DISORDERS AND XEROSTOMIA ARE HIGHLY PREVALENT IN PATIENTS WITH COVID-19.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: J. Amorim dos Santos, A.G.C. Normando, R.L.Carvalho da Silva, A.C. Acevedo G. De Luca Canto, N. Sugaya, A.R. Santos-Silva , E.N.S. Guerra (2021). ``Oral Manifestations in Patients with COVID-19: A Living Systematic Review.'' J Dent Res 100(2): 141-154. SOURCE OF FUNDING: Non-profit, Foundations, etc.? National Council for Scientific and Technological Development, Ministry of Education, Brazil and the Department of Research and Innovation, University of Brasilia, Brazil. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Evaluation of the xerostomia, taste and smell impairments after Covid-19.

BACKGROUND: The purpose of this study was to explore the effects of coronavirus disease 19 (Covid-19) on the oral cavity by evaluating the oral findings in the patients who recovered after treatment. MATERIAL AND METHODS: This study involved confirmed Covid-19 patients whose treatment completed at least two weeks ago. A questionnaire consist of eight parts was applied to explore the oral findings after Covid-19. Also stimulated salivary flow rate was evaluated with a salivary flow test. RESULTS: 177 patients reached and 107 of them participate in the study. Regarding gender significant differences were found in terms of the presence of taste impairment after treatment (p=0.007), the degree of taste (p=0.021) and smell (p=0.010) impairment. 18 % (5/27) of the patients evaluated were showed hyposalivation. No significant differences were observed regarding salivary flow between males (mean±SD: 1.14±0.65) and females (mean±SD: 1.12±0.43), (p=0.928); among the patients having treatment at home (mean±SD: 1.03±0.48) or hospital (mean±SD: 1.33±0.65), (p=0.187). In some of the patients' taste [15], smell [23] impairment, and xerostomia [43] still observed at least two weeks after the treatment is completed. CONCLUSIONS: The most frequent finding in patients after the treatment was xerostomia. Taste and smell impairments were more frequently observed in females.