Department of Dentistry, Health and Biological Sciences Institute, Universidade Federal de Sergipe (UFS), Rua Cláudio Batista, s/n, Santo Antônio, Aracaju, Sergipe, 49060-102, Brazil.
School of Dentistry of Piracicaba, Department of Restorative Dentistry, Endodontics Division, University of Campinas (UNICAMP), Av. Limeira, 901, Areião, Piracicaba, SP, 13414-903, Brazil.
J Stomatol Oral Maxillofac Surg. 2022 Oct;123(5):e241-e250. doi: 10.1016/j.jormas.2022.05.005. Epub 2022 May 10.
This systematic review purposed to investigate reports of oral lesions in confirmed COVID-19 patients summarizing clinical characteristics, histological findings, treatment and correlation of oral lesions and COVID-19 severity. Electronic search was conducted on November 2021 using seven databases to identify case reports/series describing lesions in oral mucosa in COVID-19 confirmed cases. A total of 5,179 studies were found, being 39 eligible from 19 countries, totalling 116 cases. It was observed only COVID-19 non-vaccinated cases and no sex or age predilection. The oral lesions presentation was mostly single location (69.8%), commonly in the tongue, lips, and palate, being ulcer the main clinical presentation. According to severity index for COVID-19, the reports were more frequent in patients with mild and moderate symptoms, being 75.8% in acute phase. The oral lesion appearance in post-acute COVID-19 were described after 14 to two months after patient recovery. Histologically, keratinocytes with perinuclear vacuolization, thrombosis and mononuclear inflammatory infiltrate were also described with the presence of the virus in keratinocytes, endothelial cells, and minor salivary glands. In conclusion, health care professionals should consider COVID-19 association when patient present ulcerated oral lesions and mild to moderate symptoms for COVID-19 or had acute-COVID-19.
这篇系统综述旨在调查已确诊 COVID-19 患者口腔病变的报告，总结其临床特征、组织学发现、治疗方法以及口腔病变与 COVID-19 严重程度的相关性。2021 年 11 月，我们通过七个数据库进行了电子检索，以确定描述 COVID-19 确诊病例口腔黏膜病变的病例报告/系列。共发现 5179 项研究，其中 19 个国家的 39 项研究符合纳入标准，共纳入 116 例患者。这些研究均为 COVID-19 未接种疫苗的病例，无性别或年龄偏好。口腔病变表现多为单部位（69.8%），常见于舌、唇和腭，主要临床表现为溃疡。根据 COVID-19 严重程度指数，报告更常见于轻症和中度症状患者，急性期为 75.8%。急性 COVID-19 后，患者康复后 14 至 2 个月出现口腔病变。组织学上，还描述了具有核周空泡化、血栓形成和单核炎症浸润的角质形成细胞，以及角质形成细胞、内皮细胞和小唾液腺中的病毒存在。总之，当患者出现溃疡性口腔病变和 COVID-19 轻症至中度症状，或出现急性 COVID-19 时，医护人员应考虑 COVID-19 的相关性。
