Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Braz Oral Res. 2020;34:e048. doi: 10.1590/1807-3107bor-2020.vol34.0048. Epub 2020 May 15.
In less than four months, an unprecedented pandemic changed the world scenario, closing institutions and commerce, paralyzing sports championships, blocking frontiers, and putting almost all populations in a house quarantine regimen. Immunocompromised patients are within the high-risk group to severe outcomes from COVID-19. However, there is no clear evidence of the association between impaired immune host status and complications from SARS-CoV-2 infection so far. The virus is transmitted by inhalation or direct contact with infected secretions, and therefore the dental office is a highly susceptible environment for such transmission. Here, we review the literature and discuss immunological COVID-19 related issues. We also make suggestions for immunocompromised patients' support in this new emerging context of clinical dental practice. Until comprehensive findings are published, individuals with impaired immunity should be considered as high-risk. Cross infection control procedures for the clinical care of immunocompromised patients should follow the same guidelines that are being proposed for immunocompetent ones. However, during the active outbreak, people under immunosuppressive conditions should not receive elective procedures, even if they do not have symptoms or exposure history to COVID-19, and in case of emergence, care must be done in a separate airborne room. In the pos-pandemic phase, the dental care general recommendations should be the same for all subjects. Changes in the current guidelines have been proposed to SARS-CoV-2 infection control in order to provide the best and safe dental practice. However, they still need to be validated by future studies.
在不到四个月的时间里，一场前所未有的大流行改变了世界格局，关闭了机构和商业场所，使体育锦标赛停摆，边境关闭，几乎所有的人口都被隔离在家中。免疫功能低下的患者属于 COVID-19 重症高风险人群。然而，迄今为止，尚无明确证据表明免疫宿主状态受损与 SARS-CoV-2 感染的并发症之间存在关联。该病毒通过吸入或直接接触受感染的分泌物传播，因此牙科诊室是这种传播的高度易感环境。在这里，我们回顾了文献并讨论了与免疫相关的 COVID-19 问题。我们还针对免疫功能低下患者在这一新出现的临床牙科实践背景下的支持提出了建议。在全面的研究结果公布之前，免疫功能受损的个体应被视为高风险人群。针对免疫功能低下患者的临床护理的交叉感染控制程序应遵循与免疫功能正常患者相同的指南。然而，在疫情爆发期间，处于免疫抑制状态的人不应接受选择性手术，即使他们没有 COVID-19 的症状或暴露史，并且在出现症状时，必须在单独的空气传播房间中进行护理。在后疫情阶段，所有患者的牙科护理一般建议应相同。为了提供最佳和安全的牙科治疗，已经针对 SARS-CoV-2 感染控制提出了当前指南的更改，但仍需要未来的研究来验证。
