Oral clinical manifestation and risk factors of COVID-19 infected patients

Objective To investigate the characteristics of oral clinical manifestation and risk factors of patients infected with novel corona virus （COVID-19）. Methods A total of 649 COVID-19 patients admitted to Beijing Friendship Hospital Affiliated to Capital Medical University from December 2022 to June 2023 were enrolled. All patients were divided into the young （18-40 years）， middle-aged （41-65 years） and elderly groups （&gt; 65 years） according to age. The changes in oral clinical manifestation and related risk factors during COVID-19 infection were investigated and analyzed. Results Among 649 infected patients， 231 were male and 418 were female， with an average age of （42.69&#x00B1;12.55） years. Except loose teeth， the differences were statistically significant in the incidence of other oral clinical manifestation during the positive and negative periods （all <i>P &lt; </i>0.05）. After age grouping， there were significant differences in the incidence of taste disorder （young group <i>vs.</i> elderly group， middle-aged group <i>vs.</i> elderly group）， pulpitis/apical periodontitis （young group <i>vs.</i> middle-aged group）， gingival swelling and pain （middle-aged group <i>vs.</i> elderly group）， gingival itching and swelling （middle-aged group <i>vs.</i> elderly group）， dry mouth （middle-aged group <i>vs.</i> elderly group， young group <i>vs.</i> elderly group）， and oral ulcers （middle-aged group <i>vs.</i> elderly group， young group <i>vs.</i> elderly group） during the positive period （all <i>P &lt; </i>0.017）. During the period of negative conversion， there were significant differences in the incidence of gingival swelling and pain （young group <i>vs.</i> middle-aged group， young group <i>vs.</i> elderly group）， dry mouth （middle-aged group <i>vs.</i> elderly group， young group <i>vs.</i> elderly group）， and oral ulcers （middle-aged group <i>vs.</i> elderly group） （all <i>P &lt; </i>0.017）. After gender grouping， in the positive period， the incidence of taste disorder and dry mouth in the female patients was significantly higher than that of male counterparts （both <i>P &lt; </i>0.05）， whereas the incidence of tongue discomfort in male patients was significantly higher compared with that of female patients （<i>P &lt; </i>0.05）. During the negative conversion period， there was a significant difference in the incidence of taste disorder between two genders （<i>P &lt; </i>0.05）， and the incidence of other oral manifestation did not significantly differ between two genders （all <i>P &gt; </i>0.05）. Univariate and multivariate Logistic regression analyses showed that both female gender and hypertension were the risk factors for the changes of oral clinical manifestation in COVID-19 patients （both <i>P &lt; </i>0.05）. The drugs taken by patients during COVID-19 infection were not associated with the changes of oral clinical manifestation （all <i>P &gt; </i>0.05）. Conclusions Oral clinical manifestation probably differ during different stages of COVID-19 infection， which might be associated with gender and age， etc. Extensive attention should be paid to oral hygiene of COVID-19 patients. For patients with high risk factors （female gender and hypertension）， oral hygiene education should be strengthened and specific preventive measures and guidance should be delivered， aiming to maintain and improve their oral hygiene conditions.