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Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study

El Tantawi M 1 , Sabbagh HJ 2 , Alkhateeb NA 3 , Quritum M 1 , Abourdan J 4 , Qureshi N 5 Show all authors , Qureshi S 6 , Hamoud A 7 , Mahmoud N 8 , Odeh R 9 , Al-Khanati NM 10 , Jaber R 11 , Balkhoyor AL 12 , Shabi M 13 , Folayan MO 14 , Gomaa N 15 , Al Nahdi R 16 , Mahmoud N 17 , El Wazziki H 18 , Alnaas M 19 , Samodien B 20 , Mahmoud R 21 , Abu Assab N 22 , Saad S 23 , Al-Hachim S 24 , Alshaikh A 25 , Abdelaziz W 1

Affiliations 

  • 1 Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
  • 2 Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
  • 3 Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  • 4 Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
  • 5 City Quay Dental Practice and Implant Centre, Dundee, Scotland, United Kingdom
  • 6 Department of Education, University of Kashmir, Srinagar, Kashmir, India
  • 7 Faculty of Dentistry, Alexandria University, Alexandria, Egypt
  • 8 Faculty of Dentistry, National Ribat University, Khartoum, Sudan
  • 9 College of Dentistry, Ajman University, Ajman, United Arab Emirates
  • 10 Department of Oral and Maxillofacial Surgery/Faculty of Dentistry, Syrian Private University, Damascus, Syria
  • 11 General Courses, King Abdulaziz University, Jeddah, Saudi Arabia
  • 12 Faculty of Engineering, King Abdulaziz University, Jeddah, Saudi Arabia
  • 13 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  • 14 Obafemi Awolowo University, Ile-ife, Osun State, Nigeria
  • 15 Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
  • 16 Department of Dental Surgery, Oman Dental College, Muscat, Oman
  • 17 UCSI University, Kuala Lumpur, Malaysia
  • 18 Department of Cereal Plant Pathology, National Institute of Aricultural Research, Settat, Morocco
  • 19 Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
  • 20 Western Cape Education Department, Western Cape, South Africa
  • 21 International Medical Center, Jeddah, Saudi Arabia
  • 22 Schools of Awqaf, Directorate of Education, Jerusalem, Palestine
  • 23 Gothenburg University, Gothenburg, Sweden
  • 24 Health Education Services, Ingham County, Lansing, Michigan, United States of America
  • 25 Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
PeerJ, 2022;10:e13555.
PMID: 35860046 DOI: 10.7717/peerj.13555

Abstract

BACKGROUND: Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered.

OBJECTIVES: The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers.

METHODS: This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations.

RESULTS: Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19- infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86).

CONCLUSION: Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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