Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong.
Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Int Dent J. 2022 Oct;72(5):607-620. doi: 10.1016/j.identj.2022.02.010. Epub 2022 Mar 1.
OBJECTIVES: Studies reviewing orofacial 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. METHODS: 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: We identified 30 articles across 14 countries, which met the inclusion criteria of PRISMA guidelines. These yielded a total of 292 patients with laboratory-confirmed COVID-19, 51.4% (n = 150) of whom presented with oral and maxillofacial fungal infections, mainly comprising candidosis, mucormycosis, and aspergillosis. Candida 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 those with diabetes (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 patients with COVID-19 with diabetes mellitus type 1/2 was about 94% (49/52; 95% confidence interval, 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. CONCLUSIONS: SARS-CoV-2 infection-related immunosuppression, steroid therapy, as well as comorbidities such as diabetic hyperglycemia appear to be the major predisposing factors for the onset of oral and maxillofacial mycoses in patients with COVID-19 across all age groups.
目的:关于由严重急性呼吸综合征 2 型 (SARS-CoV-2) 感染引起的 2019 年冠状病毒病 (COVID-19) 所致口腔颌面部真菌感染的研究很少。在这里,我们回顾了 COVID-19 的主要口腔颌面部真菌感染、相关合并症以及可能的诱发因素。
方法:使用 PubMed、OVID、SCOPUS 和 Web of Science 数据库,使用适当的关键词,搜索 2020 年 3 月至 2021 年 10 月期间发表的英文文献。
结果:我们在 14 个国家/地区共确定了 30 篇符合纳入标准的 PRISMA 指南的文章,共纳入 292 例经实验室确诊的 COVID-19 患者,其中 51.4%(n=150)患者表现出口腔颌面部真菌感染,主要包括念珠菌病、毛霉病和曲霉病。念珠菌感染最为常见,占 64%(n=96),其次是毛霉病,仅发现 1 例曲霉病。口腔颌面部真菌感染主要见于合并症患者,尤其是糖尿病患者(52.4%)。口腔毛霉病占 8.6%(n=13),主要表现为硬腭。1 型/2 型糖尿病 COVID-19 患者口腔/颌面部毛霉病的总发生率约为 94%(49/52;95%置信区间,0.73%-0.89%),这表明糖尿病与毛霉病之间存在很高的关联。所有真菌感染均与 COVID-19 症状同时发生或在疾病恢复期发生。
结论:SARS-CoV-2 感染相关的免疫抑制、类固醇治疗以及糖尿病高血糖等合并症似乎是 COVID-19 患者发生口腔颌面部真菌感染的主要诱发因素,且与年龄无关。
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