Oral manifestations of Covid-19-A literature review

Abstract

Initially, it was reported that coronavirus 2019 disease (Covid-19) affects respiratory, gastrointestinal and neurological systems, but the oral, olfactory and integumentary systems are also involved. This review discusses various oral manifestations of Covid-19 reported in the literature along with possible underlying mechanisms. The reported manifestations include taste impairment, oral mucosal changes (petechiae, ulcers, plaque-like lesions, reactivation of herpes simplex virus 1(HSV1), geographical tongue and desquamative gingivitis) and dry mouth. The prominent location for mucosal lesions are tongue, palate and labial mucosa. The exact pathogenesis of these oral symptoms is not known. Angiotensin-converting enzyme 2 (ACE2) cell receptors are expressed in abundance on oral mucosa allowing severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) to infect them. Gustatory impairment along with olfactory changes is now listed as a symptom of Covid-19 by the World Health Organization, but further research is needed to confirm a link between reported additional oral symptoms and Covid-19. Dental professionals may encounter individuals with Covid-19 and be called upon to identify various oral manifestations of this disease.

Keywords: Covid-19; dry mouth; gustatory changes; mucosal lesions; oral manifestations.

FIGURE 1

Literature search flowchart

FIGURE 2

Proposed mechanisms for taste alteration in Covid‐19. ACE2, angiotensin‐converting enzyme 2; SARS‐CoV‐2, severe acute respiratory virus syndrome coronavirus 2

FIGURE 3

Proposed mechanisms of oral mucosal lesion due to Covid‐19. SARS‐CoV‐2, severe acute respiratory virus syndrome coronavirus 2; TNF, tumour necrosis factor