Oral lesions and saliva alterations of COVID-19 patients in an intensive care unit: A retrospective study

Spec Care Dentist. 2022 Sep;42(5):494-502. doi: 10.1111/scd.12705. Epub 2022 Mar 3.

Abstract

To detect the type and frequency of oral lesions and clinical conditions suggestive of saliva alterations in COVID-19 patients in an intensive care unit (ICU), as well as to describe the patient´s management in each case METHODS: Information about oral conditions and mechanical ventilation was collected from oral medicine records of COVID-19 patients in an ICU (n = 519) RESULTS: From the total collected, 472 patients (90.9%) were examined by the oral medicine staff. In 242/472 patients (51.3%), alterations in the oral cavity were noted. The most frequent changes were mechanical trauma (18.1%, derived mainly from intubation), vascular/coagulation disturbances (24.1%, petechiae, bruises, varicoses, and oral bleeding), and saliva alterations (24.4%, dry mouth, and sialorrhea). Infectious lesions were mentioned in the oral medicine records (16.9%), most associated with a viral infection (15.7%), mainly herpesvirus. Improved oral change protocols included oral hygiene, use of specific medications, and laser therapy CONCLUSION: COVID-19 patients in the ICU often showed dryness in the oral and mucosa oral lesions related to vascular/coagulation disturbances, and mechanical trauma derived from orotracheal tube. An oral medicine staff must be aligned with the ICU multidisciplinary team to manage COVID-19 patients, as well as to establish diagnoses and oral cavity treatments.

Keywords: COVID-19; intensive care unit; oral lesions; oral medicine; salivary flow changes.

MeSH terms

  • COVID-19*
  • Humans
  • Intensive Care Units
  • Mouth Diseases*
  • Respiration, Artificial / adverse effects
  • Respiration, Artificial / methods
  • Retrospective Studies
  • Saliva*