Morphological and tissue-based molecular characterization of oral lesions in patients with COVID-19: A living systematic review

Felipe Martins Silveira; André Luiz Rodrigues Mello; Laura da Silva Fonseca; Luíse Dos Santos Ferreira; Laura Borges Kirschnick; Manoela Domingues Martins; Lauren Frenzel Schuch; José Alcides Almeida de Arruda; Ciro Dantas Soares; Alexandre de Oliveira Sales; Ronell Bologna-Molina; Alan Roger Santos-Silva; Ana Carolina Uchoa Vasconcelos

doi:10.1016/j.archoralbio.2022.105374

Morphological and tissue-based molecular characterization of oral lesions in patients with COVID-19: A living systematic review

Arch Oral Biol. 2022 Apr:136:105374. doi: 10.1016/j.archoralbio.2022.105374. Epub 2022 Feb 12.

Authors

Affiliations

¹ Molecular Pathology Department, School of Dentistry, Universidad de la República, Montevideo, Uruguay; Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
² Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
³ Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil.
⁴ Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil.
⁵ Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
⁶ Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil; Division of Anatomic Pathology, Getulio Sales Diagnósticos, Private Pathology Service, Natal, Rio Grande do Norte, Brazil.
⁷ Division of Anatomic Pathology, Getulio Sales Diagnósticos, Private Pathology Service, Natal, Rio Grande do Norte, Brazil.
⁸ Molecular Pathology Department, School of Dentistry, Universidad de la República, Montevideo, Uruguay.
⁹ Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil. Electronic address: carolinauv@gmail.com.

Abstract

Objective: This living systematic review aims to integrate the morphological and tissue-based molecular characterization of oral lesions occurring in individuals infected by COVID-19 (OLICs).

Materials and design: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Scopus, Ovid, Embase, and LILACS were searched to identify reports on OLICs with morphological and/or tissue-based molecular data.

Results: Four studies reporting five cases were included. Three patients were male, and the mean age of the individuals was 47.6 years. The most reported anatomical location was the palate (n = 4), whereas ulcers were the most frequent clinical presentation (n = 3). Histopathologically, all cases revealed cell vacuolization and exocytosis in the epithelial layer. In the mesenchymal layer, inflammatory cell infiltrate and thrombi/microvascular thrombosis were observed in three cases. Immunohistochemical reactions were performed in two cases. Both cases were negative for HHV-1, HHV-2, and CMV. One case revealed positivity for SARS-CoV-2 spike protein. No other molecular tests were found for the characterization of OLIC.

Conclusions: The pathological characteristics of OLICs are still unspecific. However, with the ongoing COVID-19 pandemic and well-documented new cases, whether OLICs are due to coinfections or has a primary origin can be determined.

Keywords: COVID-19; Molecular pathology; Oral pathology; Pandemics; SARS-CoV-2.

Publication types

Review
Systematic Review

MeSH terms

COVID-19*
Humans
Male
Middle Aged
Pandemics
SARS-CoV-2
Spike Glycoprotein, Coronavirus

Substances

Spike Glycoprotein, Coronavirus
spike protein, SARS-CoV-2