Abstract
In less than four months, an unprecedented pandemic changed the world scenario, closing institutions and commerce, paralyzing sports championships, blocking frontiers, and putting almost all populations in a house quarantine regimen. Immunocompromised patients are within the high-risk group to severe outcomes from COVID-19. However, there is no clear evidence of the association between impaired immune host status and complications from SARS-CoV-2 infection so far. The virus is transmitted by inhalation or direct contact with infected secretions, and therefore the dental office is a highly susceptible environment for such transmission. Here, we review the literature and discuss immunological COVID-19 related issues. We also make suggestions for immunocompromised patients' support in this new emerging context of clinical dental practice. Until comprehensive findings are published, individuals with impaired immunity should be considered as high-risk. Cross infection control procedures for the clinical care of immunocompromised patients should follow the same guidelines that are being proposed for immunocompetent ones. However, during the active outbreak, people under immunosuppressive conditions should not receive elective procedures, even if they do not have symptoms or exposure history to COVID-19, and in case of emergence, care must be done in a separate airborne room. In the pos-pandemic phase, the dental care general recommendations should be the same for all subjects. Changes in the current guidelines have been proposed to SARS-CoV-2 infection control in order to provide the best and safe dental practice. However, they still need to be validated by future studies.
Highlights
On 12 December 2019, a patient was hospitalized with severe pneumonia of unknown etiology, in Wuhan, Hubei province, China
Clusters of similar cases were spreading within the province, and, in early January 2020, the unidentified pneumonia was discovered to be caused by a novel viral subtype of the Coronaviridae family, designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1,2,3]
Hypertension, chronic respiratory system diseases, diabetes and cardiopathies were highlighted as potential risk factors to severe outcomes from COVID-19.5 These findings are supported by the current epidemiological evidence that recently added obesity into the high-risk group.[6]
Summary
On 12 December 2019, a patient was hospitalized with severe pneumonia of unknown etiology, in Wuhan, Hubei province, China. Clusters of similar cases were spreading within the province, and, in early January 2020, the unidentified pneumonia was discovered to be caused by a novel viral subtype of the Coronaviridae family, designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1,2,3] By the end of January 2020, WHO. Declared SARS-CoV-2 infection as a Public Health Emergency of International Concern and a few days after, officially named the disease as “coronavirus disease 2019” (COVID-19). Immunosupressed patients were added within higher risk group for severe illness from COVID-19
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