SARS-CoV-2 infection tied with oral and maxillofacial mycoses: study

Studies reviewing oro-facial mycoses in Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2) infection are sparse. Here we review the major oral and maxillofacial mycoses of COVID-19, the associated comorbidities, and the probable precipitating factors.

English language manuscripts published between March 2020 and October 2021 were searched using PubMed, OVID, SCOPUS, and Web of Science databases, using appropriate keywords.

Results:

They identified 30 articles across 14 countries, which met the inclusion criteria of PRISMA guidelines. These yielded a total of 292 laboratory-confirmed COVID-19 patients, 51.4% (n=150) of whom presented with oral and maxillofacial fungal infections, mainly comprising candidosis, mucormycosis, and aspergillosis. Candidal infections were the most prevalent, present in 64% (n = 96), followed by mucormycosis, and only a single case of aspergillosis was noted. Oral and maxillofacial mycoses were predominantly seen in those with comorbidities, especially in diabetics (52.4%). Oral mucormycosis was noted in 8.6% (n=13) and mainly manifested on the hard palate. An overall event rate of oral/maxillofacial mucormycosis manifestation in COVID-19 patients with diabetes mellitus Type 1/2 was around 94% (49/52; 95% CI: 0.73%-0.89%), implying a very high association between diabetes mellitus and the latter condition. All fungal infections appeared either concurrently with COVID-19 symptoms or during the immediate recovery period.

Thus, the researchers concluded that SARS-CoV-2 infection-related immunosuppression, steroid therapy, as well as co-morbidities such as diabetic hyperglycemia appear to be the major predisposing factors for the onset of oral and maxillofacial mycoses in COVID-19 patients across all age groups.

Reference:

Oro-facial Mycoses in Coronavirus Disease-2019 (COVID-19): A Systematic Review by LP Samaranayake et al. published in the International Dental Journal.

https://www.sciencedirect.com/science/article/pii/S0020653922000351?v=s5

Keywords: Oro-facial Mycoses, Oro-facial Mycoses in Covid-19, Oro-facial Mycoses and covid-19, impact of Oro-facial Mycoses, covid-19 oral complication, covid-19 fungal complication, black fungus disease, International Dental Journal, LP Samaranayake, KS Fakhruddin H, CN Bandara,Y Leung, COVID-19, systematic review, candidiasis, aspergillosis, Mucormycosis