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Oral Manifestations of COVID-19 in Hospitalized Patients: A Systematic Review

Author

Listed:
  • Giulia Orilisi

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy
    Equal contribution.)

  • Marco Mascitti

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy
    Equal contribution.)

  • Lucrezia Togni

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy)

  • Riccardo Monterubbianesi

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy)

  • Vincenzo Tosco

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy)

  • Flavia Vitiello

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy)

  • Andrea Santarelli

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy
    Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, Via Tronto 10, 60126 Ancona, Italy)

  • Angelo Putignano

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy)

  • Giovanna Orsini

    (Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy)

Abstract

Background: COVID-19 disease first appeared in 2019 and quickly spread worldwide, causing a global pandemic. The oral cavity represents a target of SARS-CoV-2, and oral lesions are observed in both non-hospitalized and hospitalized patients. This systematic review aims to investigate the frequency of oral manifestations in COVID-19 hospitalized patients. Methods: An electronic search was conducted in PubMed, Scopus, and Web of Science databases, including articles published up to September 2021. The review protocol was based on PRISMA-P. The risk of bias of the studies was assessed using the Joana Briggs Institute. The certainty of evidence was assessed using the GRADE instrument. Results: Fifty-nine articles were included: 19 case reports, 17 case series, 2 case-control studies, 13 cross-sectional studies, 4 observational studies, and 4 retrospective studies. Oral ulcers, cheilitis, and tongue lesions were more common in patients before hospitalization, while perioral pressure ulcers, macroglossia, blisters, and oral candidiasis were more recurrent in patients during hospitalization. The first could be related directly to COVID-19, while the latter could be caused by medical devices, treatments, prone position, and immunological impairment. Conclusions: An accurate oral examination during the hospital admission of all confirmed COVID-19 cases is encouraged to recognize oral early manifestations and to apply appropriate treatments.

Suggested Citation

  • Giulia Orilisi & Marco Mascitti & Lucrezia Togni & Riccardo Monterubbianesi & Vincenzo Tosco & Flavia Vitiello & Andrea Santarelli & Angelo Putignano & Giovanna Orsini, 2021. "Oral Manifestations of COVID-19 in Hospitalized Patients: A Systematic Review," IJERPH, MDPI, vol. 18(23), pages 1-19, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12511-:d:689761
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Fan Wu & Su Zhao & Bin Yu & Yan-Mei Chen & Wen Wang & Zhi-Gang Song & Yi Hu & Zhao-Wu Tao & Jun-Hua Tian & Yuan-Yuan Pei & Ming-Li Yuan & Yu-Ling Zhang & Fa-Hui Dai & Yi Liu & Qi-Min Wang & Jiao-Jiao , 2020. "A new coronavirus associated with human respiratory disease in China," Nature, Nature, vol. 579(7798), pages 265-269, March.
    3. Fan Wu & Su Zhao & Bin Yu & Yan-Mei Chen & Wen Wang & Zhi-Gang Song & Yi Hu & Zhao-Wu Tao & Jun-Hua Tian & Yuan-Yuan Pei & Ming-Li Yuan & Yu-Ling Zhang & Fa-Hui Dai & Yi Liu & Qi-Min Wang & Jiao-Jiao , 2020. "Author Correction: A new coronavirus associated with human respiratory disease in China," Nature, Nature, vol. 580(7803), pages 7-7, April.
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    2. Federica Di Spirito & Alessandra Amato & Maria Pia Di Palo & Maria Contaldo & Francesco D’Ambrosio & Roberto Lo Giudice & Massimo Amato, 2022. "Oral Lesions Following Anti-SARS-CoV-2 Vaccination: A Systematic Review," IJERPH, MDPI, vol. 19(16), pages 1-18, August.
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    4. Federica Di Spirito & Alfredo Iandolo & Alessandra Amato & Mario Caggiano & Annunziata Raimondo & Serena Lembo & Stefano Martina, 2022. "Prevalence, Features and Degree of Association of Oral Lesions in COVID-19: A Systematic Review of Systematic Reviews," IJERPH, MDPI, vol. 19(12), pages 1-15, June.

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