Mucosal lesions and taste disorders common in COVID-19 patients, reports study

It has now been well established that coronavirus invades human cells via the receptor angiotensin-converting enzyme 2 (ACE2). Cells with ACE2 receptor distribution may become host cells for the virus and cause inflammatory response in related organs and tissues, such as the tongue mucosa and salivary glands. SARS-CoV-2 interaction with ACE2 receptors may also impair taste bud sensitivity,which could induce dysfunctional gustatory responses.

However,it is still uncertain whether these manifestations could be a typically clinical pattern resulting from the direct SARS-CoV-2 infection or a systemic consequence, given the possibility of coinfections, impaired immune system, and adverse reactions of medical treatment.

The recent study aimed to summarize evidence on the prevalence of oral signs and symptoms in patients with COVID-19. For the study design,Studies published in any language mentioning oral symptoms and signs in patients with COVID-19 were included. After a 2-step selection, 40 studies were included: 33 cross-sectional and 7 case reports. Overall, 10,228 patients (4,288 males, 5,770 females, and 170 unknown) from 19 countries were assessed.

Results revealed some key facts.

• Gustatory impairment was the most common oral manifestation, with a prevalence of 45%. The pooled eligible data for different taste disorders were 38% for dysgeusia and 35% for hypogeusia, while ageusia had a prevalence of 24%.
• Taste disorders were associated with COVID-19, mild/moderate severity , and female patients .
• Oral mucosal lesions presented multiple clinical aspects, including white and erythematous plaques, irregular ulcers, small blisters, petechiae, and desquamative gingivitis.
• Tongue, palate, lips, gingiva, and buccal mucosa were affected. In mild cases, oral mucosal lesions developed before or at the same time as the initial respiratory symptoms; however, in those who required medication and hospitalization, the lesions developed approximately 7 to 24 d after onset symptoms. Therefore, taste disorders may be common symptoms in patients with COVID-19 and should be considered in the scope of the disease's onset and progression.
• Oral mucosal lesions are more likely to present as coinfections and secondary manifestations with multiple clinical aspects.

Observing the results, the team concluded that, "Our results suggest different susceptibility or response to SARS-CoV-2 symptoms from different populations, given that the North American population presented a taste disorder prevalence of 53%, European 50%, and Asians 27%.

The Asian population also presented a lower prevalence than the world- wide pooled prevalence (45%), affirming the fact that that Asians presented a distinct expression of ACE2 receptor as compared with Americans. The oral examination in patients with COVID-19 should not be neglected but rather encourage a multidisciplinary approach that includes dentist professionals."

For full article follow the link: Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca Canto G, Sugaya N, Santos-Silva AR, Guerra ENS. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res. 2021 Feb;100(2):141-154. doi: 10.1177/0022034520957289. Epub 2020 Sep 11. PMID: 32914677.

Source: Journal of Dental Research