Avaliação da frequência de lesões orais, distúrbios olfativos e gustativos e xerostomia em pacientes portadores da COVID-19 e oligodontia no espectro clínico das síndromes genéticas

Abstract

This study aims to investigate the manifestations of oral lesions and sensory disorders in patients diagnosed with COVID-19. In parallel, a systematic review will be carried out to explore the presence and impact of oligodontia within the spectrum of genetic syndromes.The first study of this dissertation aimed toevaluate the manifestations of COVID-19, with emphasis on oral, olfactory and gustatory alterations, xerostomia. A cross-sectional and observational study was conducted. All patients were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) and considered to have mild symptoms, according to the latest joint protocol of the World Health Organization. Patients were evaluated at a COVID-19 Referral Service in Minas Gerais, Brazil. For each patient, a clinical analysis of the oral cavity was performed on the 2nd and 7th days. A total of 414 patients were studied, of whom 139 had at least one of the conditions studied, in which the most prevalent were oral lesions (19.1%), followed by gustatory disorders (18.1%), xerostomia and olfactory dysfunction (14.2%). Among the oral lesions, there was a hodgepodge of anatomical location and clinical presentation. The occurrence involving lips and tongue represented 49 oral lesions, with the highest prevalence, respectively, ulcerations (64.5%), candidiasis (10.1%) and erythema or red plaques (8.8%). Fifty patients died. It was observed, therefore, that the oral alterations observed were present in a significant percentage. However, it cannot be concluded that they are directly caused by SARS-CoV-2. This study represents, to date, the largest series of cases of oral lesions in Brazilian patients with COVID-19. The second study aimed to describe syndromes with oligodontia in the clinical spectrum. A search was conducted using PubMed, Scopus, Lilacs, Web of Science, Livivo and EMBASE, using key terms relevant to the research questions and complemented by a search in the gray literature on Google Schoolar and ProQuest. Thissystematic review was conducted for the PRISMA 2020 checklist guidelines. The systematic review identified different types of syndromes in 84 studies. The main related syndrome was hypohidrotic ectodermal dysplasia, which was diagnosed in 21 studies. Other syndromes were related in 4, Ellis-van Creveld syndrome, oculo-facius-cardio-dental syndrome and Axenfeld Rieger syndrome, and Witkop syndrome were related in 5 studies, respectively, Ellis-van Creveld syndrome, oculo-facius-cardio-dental syndrome and Witkop syndrome. The X-linked mode of inheritance was the most reported in 14 studies, followed by the autosomal dominant mode of inheritance reported in 11 studies. Although ectohydrotic dermal dysplasia is the most reported syndrome in the literature with clinical manifestations of oligodontia, other syndromes have been observed.