A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults

doi:10.1186/s12903-022-02515-5

. 2022 Nov 19;22(1):513.

doi: 10.1186/s12903-022-02515-5.

A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults

Heba Jafar Sabbagh¹, Wafaa Abdelaziz², Maryam Quritum², Rana Abdullah Alamoudi³, Nada Abu Bakr AlKhateeb⁴, Joud Abourdan⁵, Nafeesa Qureshi⁶, Shabnum Qureshi⁷, Ahmed H N Hamoud⁸, Nada Mahmoud⁹, Ruba Odeh¹⁰, Nuraldeen Maher Al-Khanati¹¹, Rawiah Jaber¹², Abdulrahman Loaie Balkhoyor¹³, Mohammed Shabi¹⁴, Morenike Oluwatoyin Folayan¹⁵, Omolola Alade¹⁶, Noha Gomaa¹⁷, Raqiya Alnahdi¹⁸, Nawal A Mahmoud¹⁹, Hanane El Wazziki²⁰, Manal Alnaas²¹, Bahia Samodien²², Rawa A Mahmoud²³, Nour Abu Assab²⁴, Sherin Saad²⁵, Maha Mohamed Alsayad²⁶, Sondos G Alhachim²⁷, Maha El Tantawi²

Affiliations

¹ Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 80200, Jeddah, 21589, Saudi Arabia. hsabbagh@kau.edu.sa.
² Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561, Egypt.
³ Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
⁴ Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
⁵ Medical Faculty, Istanbul Medipol University, 34230, Istanbul, Turkey.
⁶ City Quay Dental Practice and Implant Centre, Dundee, DD1 3JA, UK.
⁷ Department of Education, University of Kashmir, Srinagar, 190006, India.
⁸ Faculty of Dentistry, Alexandria University, Alexandria, 21561, Egypt.
⁹ Faculty of Dentistry, National Ribat University, 1111, Khartoum, Sudan.
¹⁰ College of Dentistry, Ajman University, Ajman, United Arab Emirates.
¹¹ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, 386, Syria.
¹² General Courses, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
¹³ Faculty of Engineering, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
¹⁴ University of Jeddah, Jeddah, 23218, Saudi Arabia.
¹⁵ Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
¹⁶ Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria.
¹⁷ Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
¹⁸ Department of Dental Surgery, Oman Dental College, 116, Muscat, Oman.
¹⁹ Institute of Creative Art and Design (ICAD), Kuala Lumpur Campus, UCSI University, 56000, Kuala Lumpur, Malaysia.
²⁰ Department of Cereal Plant Pathology, National Institute of Agricultural Research, 10090, Rabat, Morocco.
²¹ Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, DD1 4HN, UK.
²² Western Cape Education Department, Cape Town, 8001, South Africa.
²³ Musculoskeletal Center, International Medical Centre, Jeddah, 21451, Saudi Arabia.
²⁴ Schools of Awqaf, Directorate of Education, Jerusalem, Israel.
²⁵ Department of Pharmacology, Institute of Neuroscience and Physiology, University of Gothenburg, Box 431, 40530, Gothenburg, Sweden.
²⁶ Center of Orthopedics and Spine Technologies, Jeddah, Saudi Arabia.
²⁷ Health Education Services, Ingham County, Lansing, MI, 48933, USA.

PMID: 36402969
PMCID: PMC9675238
DOI: 10.1186/s12903-022-02515-5

A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults

Heba Jafar Sabbagh et al. BMC Oral Health. 2022.

. 2022 Nov 19;22(1):513.

doi: 10.1186/s12903-022-02515-5.

Authors

Affiliations

¹ Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 80200, Jeddah, 21589, Saudi Arabia. hsabbagh@kau.edu.sa.
² Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561, Egypt.
³ Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
⁴ Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
⁵ Medical Faculty, Istanbul Medipol University, 34230, Istanbul, Turkey.
⁶ City Quay Dental Practice and Implant Centre, Dundee, DD1 3JA, UK.
⁷ Department of Education, University of Kashmir, Srinagar, 190006, India.
⁸ Faculty of Dentistry, Alexandria University, Alexandria, 21561, Egypt.
⁹ Faculty of Dentistry, National Ribat University, 1111, Khartoum, Sudan.
¹⁰ College of Dentistry, Ajman University, Ajman, United Arab Emirates.
¹¹ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, 386, Syria.
¹² General Courses, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
¹³ Faculty of Engineering, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
¹⁴ University of Jeddah, Jeddah, 23218, Saudi Arabia.
¹⁵ Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
¹⁶ Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria.
¹⁷ Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
¹⁸ Department of Dental Surgery, Oman Dental College, 116, Muscat, Oman.
¹⁹ Institute of Creative Art and Design (ICAD), Kuala Lumpur Campus, UCSI University, 56000, Kuala Lumpur, Malaysia.
²⁰ Department of Cereal Plant Pathology, National Institute of Agricultural Research, 10090, Rabat, Morocco.
²¹ Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, DD1 4HN, UK.
²² Western Cape Education Department, Cape Town, 8001, South Africa.
²³ Musculoskeletal Center, International Medical Centre, Jeddah, 21451, Saudi Arabia.
²⁴ Schools of Awqaf, Directorate of Education, Jerusalem, Israel.
²⁵ Department of Pharmacology, Institute of Neuroscience and Physiology, University of Gothenburg, Box 431, 40530, Gothenburg, Sweden.
²⁶ Center of Orthopedics and Spine Technologies, Jeddah, Saudi Arabia.
²⁷ Health Education Services, Ingham County, Lansing, MI, 48933, USA.

PMID: 36402969
PMCID: PMC9675238
DOI: 10.1186/s12903-022-02515-5

Abstract

Background: Oral diseases are features of COVID-19 infection. There is, however, little known about oral diseases associated with COVID-19 in adolescents and young adults (AYA). Therefore, the aim of this study was to assess oral lesions' association with COVID-19 infection in AYA; and to identify if sex and age will modify these associations.

Methodology: Data was collected for this cross-sectional study between August 2020 and January 2021 from 11-to-23 years old participants in 43-countries using an electronic validated questionnaire developed in five languages. Data collected included information on the dependent variables (the presence of oral conditions- gingival inflammation, dry mouth, change in taste and oral ulcers), independent variable (COVID-19 infection) and confounders (age, sex, history of medical problems and parents' educational level). Multilevel binary logistic regression was used for analysis.

Results: Complete data were available for 7164 AYA, with 7.5% reporting a history of COVID-19 infection. A significantly higher percentage of participants with a history of COVID-19 infection than those without COVID-19 infection reported having dry mouth (10.6% vs 7.3%, AOR = 1.31) and taste changes (11.1% vs 2.7%, AOR = 4.11). There was a significant effect modification in the association between COVID-19 infection and the presence of dry mouth and change in taste by age and sex (P = 0.02 and < 0.001).

Conclusion: COVID-19 infection was associated with dry mouth and change in taste among AYA and the strength of this association differed by age and sex. These oral conditions may help serve as an index for suspicion of COVID-19 infection in AYA.

Keywords: Adolescents; COVID-19 infection; Multi-country; Oral conditions.

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Conflict of interest statement

The authors declare that they have no competing interests.

Cited by

Oral hygiene influence on the incidence and severity of oral manifestations in Coronavirus Disease 2019.
Yılmaz Çınar B, Türkoğlu O, Becerik S. Yılmaz Çınar B, et al. BMC Oral Health. 2025 May 21;25(1):755. doi: 10.1186/s12903-025-06075-2. BMC Oral Health. 2025. PMID: 40399926 Free PMC article.

References

1. Lynch DP. Oral manifestations of viral dieases. In: Tyring S, editor. Mucosal Immunology and Virology. Cham: Springer; 2006. pp. 99–156.
1. Villanueva-Vilchis MD, López-Ríos P, García IM, Gaitán-Cepeda LA. Impact of oral mucosa lesions on the quality of life related to oral health. An etiopathogenic study. Med Oral Patol Oral Cir Bucal. 2016;21(2):e178–e184. doi: 10.4317/medoral.20866. - DOI - PMC - PubMed
1. Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca CG, Sugaya N, et al. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res. 2021;100(2):141–154. doi: 10.1177/0022034520957289. - DOI - PubMed
1. Fidan V, Koyuncu H, Akin O. Oral lesions in Covid 19 positive patients. Am J Otolaryngol. 2021;42(3):102905. doi: 10.1016/j.amjoto.2021.102905. - DOI - PMC - PubMed
1. Chen A, Huang JX, Liao Y, Liu Z, Chen D, Yang C, et al. Differences in Clinical and Imaging Presentation of Pediatric Patients with COVID-19 in Comparison with Adults. Radiol Cardiothorac Imaging. 2020;2(2):e200117. doi: 10.1148/ryct.2020200117. - DOI - PMC - PubMed

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[1] Lynch DP. Oral manifestations of viral dieases. In: Tyring S, editor. Mucosal Immunology and Virology. Cham: Springer; 2006. pp. 99–156.

[2] Lynch DP. Oral manifestations of viral dieases. In: Tyring S, editor. Mucosal Immunology and Virology. Cham: Springer; 2006. pp. 99–156.

[3] Villanueva-Vilchis MD, López-Ríos P, García IM, Gaitán-Cepeda LA. Impact of oral mucosa lesions on the quality of life related to oral health. An etiopathogenic study. Med Oral Patol Oral Cir Bucal. 2016;21(2):e178–e184. doi: 10.4317/medoral.20866. - DOI - PMC - PubMed

[4] Villanueva-Vilchis MD, López-Ríos P, García IM, Gaitán-Cepeda LA. Impact of oral mucosa lesions on the quality of life related to oral health. An etiopathogenic study. Med Oral Patol Oral Cir Bucal. 2016;21(2):e178–e184. doi: 10.4317/medoral.20866. - DOI - PMC - PubMed

[5] Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca CG, Sugaya N, et al. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res. 2021;100(2):141–154. doi: 10.1177/0022034520957289. - DOI - PubMed

[6] Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, Acevedo AC, De Luca CG, Sugaya N, et al. Oral Manifestations in Patients with COVID-19: A Living Systematic Review. J Dent Res. 2021;100(2):141–154. doi: 10.1177/0022034520957289. - DOI - PubMed

[7] Fidan V, Koyuncu H, Akin O. Oral lesions in Covid 19 positive patients. Am J Otolaryngol. 2021;42(3):102905. doi: 10.1016/j.amjoto.2021.102905. - DOI - PMC - PubMed

[8] Fidan V, Koyuncu H, Akin O. Oral lesions in Covid 19 positive patients. Am J Otolaryngol. 2021;42(3):102905. doi: 10.1016/j.amjoto.2021.102905. - DOI - PMC - PubMed

[9] Chen A, Huang JX, Liao Y, Liu Z, Chen D, Yang C, et al. Differences in Clinical and Imaging Presentation of Pediatric Patients with COVID-19 in Comparison with Adults. Radiol Cardiothorac Imaging. 2020;2(2):e200117. doi: 10.1148/ryct.2020200117. - DOI - PMC - PubMed

[10] Chen A, Huang JX, Liao Y, Liu Z, Chen D, Yang C, et al. Differences in Clinical and Imaging Presentation of Pediatric Patients with COVID-19 in Comparison with Adults. Radiol Cardiothorac Imaging. 2020;2(2):e200117. doi: 10.1148/ryct.2020200117. - DOI - PMC - PubMed

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A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults

Affiliations

A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults

Authors

Affiliations

Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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