COVID-19 appears to have an impact on the oral cavity, according to researchers at the Università Vita Salute San Raffaele in Milan, Italy, who profiled 122 patients with the disease who were hospitalized and then discharged.
With a single referral follow-up visit after a median of 104 days after hospital discharge, the researchers found that oral manifestations, specifically salivary gland ectasia, were unexpectedly common and detectable in 83.9% and 43% of COVID-19 survivors, respectively.
Salivary glands were defined as ectasic when they appeared swollen, with a patent duct, and no pus leaking. Salivary gland ectasia reflected the hyperinflammatory response to SARS-CoV-2, as demonstrated by the significant relationship with C-reactive protein and lactate dehydrogenase (LDH) levels at hospital admission and with the use of antibiotics during acute disease.
Both LDH levels and antibiotic administration survived as independent predictors of salivary gland ectasia in a multivariable analysis. Temporomandibular joint abnormalities, facial pain, and masticatory muscle weakness also were common.
“This retrospective and prospective cohort study of COVID-19 survivors revealed that residual damage of the oral cavity persists in the vast majority of the more severely affected patients far beyond clinical recovery,” said Nicholas Jakubovics, editor in chief of the Journal of Dental Research, which published the study.
“This suggests that the oral cavity represents a preferential target for SARS-CoV-2 infection. Further studies are needed to clarify the connection between SARS-CoV-2 infection and oral disorders,” Jakubovics said.