Oral Manifestations of COVID-19 Patients: A Systematic Review

Abstract

Introduction: The emergence of coronavirus disease 2019 (COVID-19) crisis has evoked an exigent need to explicate the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and oral mucosal lesions. The present systematic review aims to elucidate the recent literature on oral manifestations related to COVID-19 so as to help the dental professionals for better screening and early diagnosis of the disease. Materials and Methods: A comprehensive literature search on PubMed, Science direct, Scopus, and Embase databases was carried out from December 2019 to March 2021 using keywords “Coronavirus,” “COVID-19,” “SARSCoV-2,” “Oral mucosal lesions,” and “Oral manifestation.” Additional information was obtained from Cochrane, World Health Organization, and Medscape. The full text articles of case reports and cross-sectional studies were analyzed and included. The review included 25 articles. Results: Four most common oral manifestations were found: gustatory and olfactory dysfunction, xerostomia, oral mucosal lesions, and salivary gland diseases. Vasculitis, opportunistic infections, drug eruption secondary to administration of Non-Steroidal Anti-inflammatory Drugs (NSAIDs), stress, immunosuppression, and hyperinflammatory immune response secondary to COVID-19 might be some of the relevant predisposing factors responsible for the onset of oral manifestations in patients with COVID-19. Conclusion: The early detection of oral symptoms of SARS-CoV-2 infection could help the clinicians to perform a better screening, and in recognizing early manifestations of the disease. However, the oral manifestations might be misdiagnosed due to subsequent challenge of undergoing oral examinations, hence diverse studies should be undertaken by the researchers to gain a better insight into the topic.