CLINICAL AND HISTOPATHOLOGIC FEATURES OF COVID-19 IN ORAL MUCOSA: A SYSTEMATIC REVIEW

OBJECTIVES: To investigate the demographic, clinical, and histologic features of patients with COVID-19 who present oral lesions. STUDY DESIGN: An electronic search was conducted by 2 reviewers in 6 databases. Absolute and relative frequencies were obtained by descriptive analysis. RESULTS: Three publications comprising 4 cases were included. Mean patient age was 54.75 (±14.7) years, and males (n = 3, 75.0%) were more often affected. All patients (100%) were White. All individuals presented comorbidities, with the most common being diabetes (n = 2, 28.6%), hypertension (n = 2, 28.6%), and coronary heart disease (n = 2, 28.6%). All lesions presented as symptomatic ulcers (n = 4, 100%). The mean evolution time was 5 days. Hard palate (n = 2, 28.6%), tongue (n = 2, 28.6%), buccal mucosa (n = 2, 28.6%), and lip (n = 1, 14.2) were the affected sites. Regarding histologic features, the most frequent were the following: koilocytes (n = 4, 100.0%), ulcer (n = 3, 75.0%), exocytosis (n = 3, 75.0%), acute inflammation (n = 3, 75.0%), chronic inflammation (n = 2, 50.0%), and thrombus (n = 1, 25.0%). Of informed immunohistochemical markers, HSV 1 /2, CD20, CD68, CD163, CD163, CD4, CD34, CD3, and CD8 showed positivity. The mean follow up was 11.7 days with total remission of 3 (75.0%) lesions. CONCLUSIONS: There is still doubt as to whether intraoral manifestations of COVID-19 patients could be a typical pattern resulting from direct viral infection or from systemic deterioration. Further investigation is needed.