Oral mucosal lesions in patients with COVID-19: a systematic review

Bhujel, Nabina; Zaheer, Khaleda; Singh, Rabindra P

COVID-19 is a new disease which mainly presents with respiratory symptoms, however can present with a multitude of signs and symptoms affecting various body systems. Several oral manifestations related to COVID-19 have also been reported. We carried out a systematic review to explore the types of oral mucosal lesions that have been reported in COVID-19 related literature up to the date of 25th of March 2021. A structured electronic databases search using Medline, Embase and CINAHL as well as gray literature search using Google Scholar revealed a total of 322 studies. After removal of duplicates and the primary and secondary filtering process, 12 studies were included for final appraisal. We have identified several different types of oral mucosal lesions in patients with COVID-19 infection, present at various locations within the oral cavity. Most of the studies appraised in this review were of high risk of bias according to the Joanna Briggs Institute checklist. The current published literature does not allow differentiation as to whether the oral lesions are caused by the viral infection itself or instead related to oral manifestations secondary to existing patient comorbidities or treatment instigated to combat the disease. It is important for healthcare professionals to be aware of the possible link between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.