key: cord-0866046-a8aeqcim
authors: Vieira, Alexandre R.
title: Oral Manifestations in Coronavirus Disease 2019 (COVID‐19)
date: 2020-06-07
journal: Oral Dis
DOI: 10.1111/odi.13463
sha: dbd39c26e79369bfff2888f396a667ee5ac216d4
doc_id: 866046
cord_uid: a8aeqcim

Martín Carreras‐Presas et al. (2020) reported a case in May in Oral Diseases that they suggested was the first case report describing of a COVID‐19 patient with oral manifestations including oral pain, desquamative gingivitis, ulcers and blisters. Galván Casas et al. (2020) provided a description in April in the British Journal of Dermatology of the cutaneous manifestations of COVID‐19 in an impressive 375 case series, and with that, they had documented for the first time the oral manifestations of the disease. The report includes an atlas of these manifestations as a downloadable supplement that includes apparently 150 different cases and among those, two cases with intra‐oral manifestations that vary from ulcers in the palatal mucosa, to localized erythema in the palate and the margins of gingiva.

description in April in the British Journal of Dermatology of the cutaneous manifestations of COVID-19 in an impressive 375 case series, and with that, they had documented for the first time the oral manifestations of the disease. The report includes an atlas of these manifestations as a downloadable supplement that includes apparently 150 different cases and among those, two cases with intra-oral manifestations that vary from ulcers in the palatal mucosa, to localized erythema in the palate and the margins of gingiva.

It is not surprising COVID-19 has oral manifestations, since many other viral infections also have similar presentations (Nedwick-Castro and Vieira, 2012; Clarkson et al., 2017) . It will be interesting to determine in the near future how frequent those manifestations are in individuals presenting symptoms in contrast to infected asymptomatic. We evaluated a 32-year old White male

This article is protected by copyright. All rights reserved that had shortness of breath associated with coughing for one-week early March and three weeks later developed pseudo-chilblain. He keeps good oral hygiene and had no prior signs of gingival inflammation, and although reporting higher levels of stress and less rigorous oral hygiene during the episode, he did not show any signs of gingival bleeding or inflammation. Therefore, we hypothesize that mild cases of COVID-19 may not show any oral manifestations. For the severe cases, in which a persistent inflammatory status appears to act as a trigger for the coagulation cascade and is associated with increased levels of fibrinogen degradation products (e.g. D-dimer), we believe that prior underlying untreated moderate or severe periodontitis may worsen COVID-19. Conversely, periodontal therapy in individuals with initial COVID-19 symptoms may reduce the risk of the condition to become severe by reducing the amount of D-dimer in the plasma, which is what we see when patients with periodontitis are treated (Dikshit, 2015) .

García-Doval, I. (2020) Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases

Oral vesiculobullous lesions associated with SARS-CoV-2 infection

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There are no sources of funding to report. The author contributed to conception, design, data acquisition and interpretation, drafted and critically revised the manuscript.

The author has no conflict of interest to report.