Are Oral Mucosal Changes a Sign of COVID-19? A Cross-Sectional Study at a Field Hospital

A Nuño González; K Magaletskyy; P Martín Carrillo; B Lozano Masdemont; A Mayor Ibarguren; M Feito Rodríguez; P Herranz Pinto

doi:10.1016/j.ad.2021.02.007

Are Oral Mucosal Changes a Sign of COVID-19? A Cross-Sectional Study at a Field Hospital

Actas Dermosifiliogr (Engl Ed). 2021 Feb 27;112(7):640-644. doi: 10.1016/j.ad.2021.02.007. Online ahead of print.

[Article in English, Spanish]

Authors

A Nuño González¹, K Magaletskyy², P Martín Carrillo³, B Lozano Masdemont⁴, A Mayor Ibarguren², M Feito Rodríguez², P Herranz Pinto²

Affiliations

¹ Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España. Electronic address: dra.almudenanunogonzalez@gmail.com.
² Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España.
³ SERMAS, Centro de Salud de Colmenarejo, Colmenarejo, Madrid, España.
⁴ Servicio de Dermatología, Hospital Universitario de Móstoles , Móstoles, Madrid, España.

Abstract

Background: Coronavirus disease 19 (COVID-19) has many manifestations, including respiratory, thrombotic, neurologic, digestive, and cutaneous ones. Cutaneous manifestations have been classified into 5 clinical patterns: acro-ischemic (pseudo-chilblain), vesicular, urticarial, maculopapular, and livedoid. Oral manifestations have also been reported, but much less frequently.

Patients and methods: We performed a cross-sectional study in which we examined the oral mucosa of 666 patients with COVID-19 at the IFEMA field hospital in Madrid in April 2020.

Results: Seventy-eight patients (11.7%) had changes involving the oral mucosa. The most common were transient anterior U-shaped lingual papillitis (11.5%) accompanied or not by tongue swelling (6.6%), aphthous stomatitis (6.9%), a burning sensation in the mouth (5.3%), mucositis (3.9%), glossitis with patchy depapillation (3.9%), white tongue (1.6%), and enanthema (0.5%). Most of the patients also reported taste disturbances.

Conclusion: COVID-19 also manifests in the oral cavity. The most common manifestations are transient U-shaped lingual papillitis, glossitis with patchy depapillation, and burning mouth syndrome. Mucositis with or without aphthous ulcers or enanthema may also be observed. Any these findings may be key clues to a diagnosis of COVID-19.

Keywords: Aftas; Alteraciones orales; Anterior lingual papillitis; Aphthae; COVID-19; Coronavirus; Disgeusia; Dysgeusia; Edema lingual; Enantema; Enanthema; Macroglosia; Macroglossia; Manifestaciones orales; Mucositis; Oral changes; Oral manifestations; Papilitis; Papilitis lingual anterior; Papillitis; Swollen tongue.