Covid-19 Symptomatic Patients with Oral Lesions: Clinical and Histopathological Study on 123 Cases of the University Hospital Policlinic of Bari with a Purpose of a New Classification.

Gianfranco Favia,Lucilla Crudele,Eugenio Maiorano,Vito Procacci,Maria Concetta Vestito,Luisa Limongelli,Saverio Capodiferro,Angela Tempesta,Giuseppe Ingravallo,Nicola Brienza,Giuseppe Barile

doi:10.3390/jcm10040757

Gianfranco Favia, Lucilla Crudele + Show 9 more

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https://doi.org/10.3390/jcm10040757

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Abstract

The aim of this study is to report on the oral lesions detected in 123 patients diagnosed at the University Hospital of Bari from October 2020 to December 2020, focusing on the correlation of clinical and pathological features in order to purpose a new classification. Methods. General and specialistic anamnesis were achieved and oral examination was performed. The following data were collected: age/gender, general symptoms and form of Covid-19, presence and features of taste disorders, day of appearance of the oral lesions, type and features of oral lesions and day of beginning of therapies. If ulcerative lesions did not heal, biopsy was performed. Results. Many types of oral lesions were found and classified into four groups considering the timing of appearance and the start of the therapies. Early lesions in the initial stages of Covid-19 before the start of therapies was observed in 65.9% of the patients. In the histopathological analysis of four early lesions, thrombosis of small and middle size vessels was always noticed with necrosis of superficial tissues. Conclusion. The presence of oral lesions in early stages of Covid-19 could represent an initial sign of peripheral thrombosis, a warning sign of possible evolution to severe illness. This suggests that anticoagulant therapies should start as soon as possible.

Highlights

Since the identification of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in December 2019 in Wuhan, China, millions of cases have been diagnosed worldwide, with mortality rates ranging from 3% to 12% [1,2]
The aim of this study is to report on the oral lesions detected in 123 patients diagnosed at the University Hospital of Bari from October 2020 to December 2020, focusing on the correlation of clinical and pathological features in order to purpose a new classification
Patients included in the current study followed these inclusion criteria: (1) The presence of SARS-CoV-2 confirmed by reverse transcription polymerase chain reaction (RT-PCR) after nasal and oropharyngeal swabs; (2) Adult patients hospitalized at the University Hospital Policlinic of Bari from October 2020 to December 2020

Summary

Introduction

Since the identification of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in December 2019 in Wuhan, China, millions of cases have been diagnosed worldwide, with mortality rates ranging from 3% to 12% [1,2]. The Centers for Disease Control and Prevention in the clinical course of the Coronavirus Disease 19 (Covid-19) distinguished the following forms: asymptomatic infection, mild, moderate, severe and critical illness [1]. Gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of Covid-19 were clearly stated in [4] in April 2020, to the best of our knowledge, ChauxBodard et al described the first oral association with Covid-19 in a patient presenting an irregular ulcer on the dorsal side of the tongue [5]. While histopathological studies with a broad spectrum of skin dermatoses associated to Covid-19 were largely reported in the current English literature [12], histopathological analysis of oral mucous lesions is still not described

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