Potential COVID-19 complications in oral cavity and maxillofacial area

Abstract

At the moment, COVID-19 is one of the most urgent pathologies, affecting the practice of doctors of various specialties. Despite this, very little is known about all the pathogenetic mechanisms of the development of a local and systemic response, and, accordingly, about all forms of manifestation of COVID-19. This article discusses the clinical manifestation of COVID-19 complications in oral cavity and maxillofacial localisation based on data from recent publications. Oral manifestations included variable mucosal lesions consistent with diagnoses such as aphthous stomatitis, herpetiform lesions, candidiasis, vasculitis, mucositis, necrotizing periodontal disease, angular cheilitis, Melkerson-Rosenthal syndrome. One of the important trends is the growth of concomitant fungal infections caused by Mucor, Rhizomucor and Aspergillus. Most often, especially in foreign sources, there was a description of rhino-orbito-cerebral acute invasive fungal rhinosinusitis, which is a potentially life-threatening fungal infection. The development of such a complication of COVID-19 can be associated with several factors, such as the nature of the immune response when the organism is damaged by the SARS-CoV-2 and the active prescription of antibiotic therapy. In the presence of an initial lesion in the sinonasal localization, the orbit is quickly involved in the pathological process, and then invasion of the cavernous sinus becomes possible. Intracranial complications include leptomeningitis or cerebritis and intracranial abscess. The nature of the changes is similar to the manifestations in sinusitis developing in connection with red bone marrow transplantation, respectively, we can assume a similar level of immunosuppression in the defeat of COVID-19. Another important distinguishing feature of the complications of coronavirus infection is the occurrence of a generalized prothrombotic state with subsequent microvascular and macrovascular thromboembolism. The most common reports are pulmonary embolism, deep vein thrombosis, cerebral infarction, and cerebral venous sinus thrombosis. In the maxillofacial localization, manifestations are possible in the form of necrotic changes in the facial bones associated with arterial thrombosis. Thus, based on the analyzed scientific publications, COVID-19 is a multisystem disease with the development of characteristic complications in the oral cavity and maxillofacial localization.