Abstract
Different viral agents, such as herpesviruses, human papillomavirus, and Coxsackie virus, are responsible for primary oral lesions, while other viruses, such as human immunodeficiency virus, affect the oral cavity due to immune system weakness. Interestingly, it has been reported that coronavirus disease 2019 (COVID-19) patients can show cutaneous manifestations, including the oral cavity. However, the association between oral injuries and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still unclear. This narrative review aimed to summarize the available literature and provide an overview of oral lesions associated with COVID-19. An online literature search was conducted to select relevant studies published up to November 2020. The results of 17 studies showed variability in oral lesions associated with COVID-19, including ulcerations, aphthous-like lesions, and macules. The tongue, lips, and palate were the most frequent anatomical locations. According to current knowledge, the etiopathogenesis of multiple COVID-19-associated lesions seems to be multifactorial. The appearance of such lesions could be related to the direct or indirect action of SARS-CoV-2 over the oral mucosa cells, coinfections, immunity impairment, and adverse drug reactions. Nevertheless, COVID-19-associated oral lesions may be underreported, mainly due to lockdown periods and the lack of mandatory dispositive protection. Consequently, further research is necessary to determine the diagnostic and pathological significance of oral manifestations of COVID-19. All medical doctors, dentists, and dermatologists are encouraged to perform an accurate and thorough oral examination of all suspected and confirmed COVID-19 cases to recognize the disease's possible early manifestations.
Highlights
The oral cavity is susceptible to viral infections because of its conformation, its soft tissue and salivary glands
Xu et al [14] reported a high level of expression of Angiotensin-converting enzyme 2 (ACE2) receptors in epithelial cells of the oral mucosa, tongue epithelial cells. These results suggest that oral mucosa could be a target of SARS-CoV-2 infection
We decided to include only those with laboratory-confirmed COVID-19 when evaluating the reported cases; suspected COVID-19 were excluded
Summary
The oral cavity is susceptible to viral infections because of its conformation, its soft tissue and salivary glands. Several viruses, including herpes simplex virus (HSV) and human papillomavirus (HPV), are associated with oral disease-causing primary lesions. Oral mucosa can be affected by the secondary pathological processes of a bacterial or fungal nature due to viral immunosuppression, such as the human immunodeficiency virus (HIV). The oral cavity could be considered a “biological barometer” of the viral immunosuppression advancement. An implication of certain viral agents has been seen in dysplastic and neoplastic transformations of squamous epithelium (i.e., HPV) [1, 2]. General and specialist dentists play a crucial role in evaluating, diagnosing, and managing such lesions, considering the impacts of oral diseases on overall health and quality of life
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
