Relationship between oral lesions and severe SARS-CoV-2 infection in intensive care unit patients

Oral Dis. 2024 Apr;30(3):1296-1303. doi: 10.1111/odi.14515. Epub 2023 Feb 5.

Abstract

Objective: Oral lesions received increased attention as likely new signs or secondary manifestations of COVID-19. Therefore, we clinically examined oral cavity of patients with COVID-19 and investigated oral lesions and patient comorbidities as possible risk factors of COVID-19 disease outcome.

Methods: From January to March 2022, a prospective study was conducted by recruiting all COVID-19 patients admitted to the Intensive Care Unit and Respiratory Intensive Care Unit of Maxi-Emergencies Hospital in Bari, Italy.

Results: From the enrolled 103 COVID-19 patients, 46.6% were females and 53.4% were males. Findings show that risk of presenting with severe COVID-19 disease was higher in patients who developed oral lesions related to COVID-19 than those with no oral lesions (RR = 7.998, p = .002). Next, patients with concomitant autoimmune diseases were at higher risk of a negative COVID-19 disease outcome than those without comorbidities (OR = 8.838, p = .026).

Conclusions: COVID-19-related lesions of oral mucosa should not be ignored as they can be early and easily detectable signs of severe COVID-19 disease condition, thus, serving as a prevention measure for any potential unfortunate event. Findings of this study, without implying causation, offer a direction for future investigations that aim to confirm the presence of specific oral lesions in COVID-19 patients as signs of severe disease progression.

Keywords: COVID‐19; Sars‐CoV‐2; oral lesions; oral manifestations; relationship.

MeSH terms

  • Adult
  • Aged
  • COVID-19* / complications
  • Comorbidity
  • Female
  • Humans
  • Intensive Care Units*
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Mouth Diseases* / etiology
  • Prospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index