Manifestações orais como indicadores clínicos da COVID-19: uma revisão de literatura

Abstract

A series of viral epidemics have emerged over the last century, the most recent being SARS-CoV-2, responsible for the COVID-19 pandemic in 2020. Transmission occurs through salivary droplets, aerosols, or contact with contaminated surfaces, which spread rapidly from the moment of infection. The virus binds to the angiotensin-converting enzyme 2 (ACE-2) receptor to enter the host cell. Initially, COVID-19 presents symptoms similar to those of other viral infections, which can progress to serious conditions, with respiratory failure, septic shock or even multiple organ failure and death. Along with these general symptoms, the literature reports signs of chemosensory disturbances in the oral cavity as a possible clinical presentation of COVID-19. This literature review aims to provide a comprehensive and updated view of the oral manifestations of COVID-19, investigate the prevalence, analyze the relationship with the severity of the disease and understand the pathophysiological mechanisms, thus contributing to the advancement of scientific knowledge and to improve healthcare related to COVID-19. Three databases (PubMed, LILACS and SciELO) were evaluated using the descriptors "oral manifestations and covid-19", and 575 articles were found. After a careful selection process, 27 studies were included in the review. The main pathophysiological mechanisms of the virus in the presentation of oral manifestations were the hyperinflammatory state and direct infection by the virus. The most common oral manifestations were ulcers and ulcerations, followed by xerostomia and alteration/loss of taste. Commonly found on the tongue, jugal mucosa, labial mucosa, palate and gums. The development of oral manifestations may vary according to age and the severity of the disease. It is concluded that oral changes can complement the known symptoms of COVID-19 and that the presence of oral symptoms not only highlights the diversity of clinical presentations of COVID-19, but also the importance of an integrated approach to obtain more evidence clinics on the pathophysiology of oral manifestations associated with COVID-19.