Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study

Maha El Tantawi; Heba Jafar Sabbagh; Nada Abubakor Alkhateeb; Maryam Quritum; Joud Abourdan; Nafeesa Qureshi; Shabnum Qureshi; Ahmed Hamoud; Nada Mahmoud; Ruba Odeh; Nuraldeen Maher Al-Khanati; Rawiah Jaber; Abdulrahman Loaie Balkhoyor; Mohammed Shabi; Morenike O Folayan; Noha Gomaa; Raqiya Al Nahdi; Nawal Mahmoud; Hanane El Wazziki; Manal Alnaas; Bahia Samodien; Rawa Mahmoud; Nour Abu Assab; Sherin Saad; Sondos Al-Hachim; Ali Alshaikh; Wafaa Abdelaziz

doi:10.7717/peerj.13555

Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study

PeerJ. 2022 Jul 15:10:e13555. doi: 10.7717/peerj.13555. eCollection 2022.

Authors

Maha El Tantawi¹, Heba Jafar Sabbagh², Nada Abubakor Alkhateeb³, Maryam Quritum¹, Joud Abourdan⁴, Nafeesa Qureshi⁵, Shabnum Qureshi⁶, Ahmed Hamoud⁷, Nada Mahmoud⁸, Ruba Odeh⁹, Nuraldeen Maher Al-Khanati¹⁰, Rawiah Jaber¹¹, Abdulrahman Loaie Balkhoyor¹², Mohammed Shabi¹³, Morenike O Folayan¹⁴, Noha Gomaa¹⁵, Raqiya Al Nahdi¹⁶, Nawal Mahmoud¹⁷, Hanane El Wazziki¹⁸, Manal Alnaas¹⁹, Bahia Samodien²⁰, Rawa Mahmoud²¹, Nour Abu Assab²², Sherin Saad²³, Sondos Al-Hachim²⁴, Ali Alshaikh²⁵, Wafaa Abdelaziz¹

Affiliations

¹ Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
² Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
³ Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Medical Faculty, Istanbul Medipol University, Istanbul, Turkey.
⁵ City Quay Dental Practice and Implant Centre, Dundee, Scotland, United Kingdom.
⁶ Department of Education, University of Kashmir, Srinagar, Kashmir, India.
⁷ Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
⁸ Faculty of Dentistry, National Ribat University, Khartoum, Sudan.
⁹ College of Dentistry, Ajman University, Ajman, United Arab Emirates.
¹⁰ Department of Oral and Maxillofacial Surgery/Faculty of Dentistry, Syrian Private University, Damascus, Syria.
¹¹ General Courses, King Abdulaziz University, Jeddah, Saudi Arabia.
¹² Faculty of Engineering, King Abdulaziz University, Jeddah, Saudi Arabia.
¹³ King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
¹⁴ Obafemi Awolowo University, Ile-ife, Osun State, Nigeria.
¹⁵ Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada.
¹⁶ Department of Dental Surgery, Oman Dental College, Muscat, Oman.
¹⁷ UCSI University, Kuala Lumpur, Malaysia.
¹⁸ Department of Cereal Plant Pathology, National Institute of Aricultural Research, Settat, Morocco.
¹⁹ Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom.
²⁰ Western Cape Education Department, Western Cape, South Africa.
²¹ International Medical Center, Jeddah, Saudi Arabia.
²² Schools of Awqaf, Directorate of Education, Jerusalem, Palestine.
²³ Gothenburg University, Gothenburg, Sweden.
²⁴ Health Education Services, Ingham County, Lansing, Michigan, United States of America.
²⁵ Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.

Abstract

Background: Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered.

Objectives: The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers.

Methods: This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations.

Results: Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19- infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86).

Conclusion: Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.

Keywords: COVID-19; Dry mouth; Oral lesions; Smoking.

MeSH terms

Adolescent
Adult
COVID-19* / epidemiology
Cross-Sectional Studies
Humans
Smoking / adverse effects
Tobacco Smoking
Xerostomia*
Young Adult

Grants and funding

The authors received no funding for this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.