Manifestações orais em pacientes com covid-19: uma revisão sistemática / Oral manifestations in patients with covid-19: a systematic review
DOI:
https://doi.org/10.34119/bjhrv4n6-055Keywords:
Infecção por Coronavírus. Disgeusia. Xerostomia.Abstract
Introdução: Evidências empíricas, biológicas e clínicas apoiam que a mucosa oral é um local inicial de entrada para SARS-CoV-2 e que sintomas orais, incluindo perda de paladar / olfato e xerostomia, podem ser sintomas precoces da COVID-19 antes mesmo da febre, tosse seca, fadiga, falta de ar e outros sintomas típicos, sendo assim um sinal de alerta. Objetivo: Revisar sistematicamente os estudos acerca das manifestações orais em pacientes com COVID-19. Metodologia: Trata-se de uma revisão sistemática, a qual foi orientada de acordo com os itens do Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement e a partir da publicação de um protocolo na base de dados PROSPERO. A formulação desta revisão sistemática buscou responder a seguinte pergunta: Qual associação das manifestações orais, apresentações clínicas e tratamentos, com a COVID-19? Para tal, foi realizada uma busca nas principais bases de dados (MEDLINE, EMBASE, ScienceDirect, Scopus), e bases regionais (LILACS, SciELO). Além disso, as seguintes bases de dados de literatura cinzenta foram pesquisadas: OpenGrey.eu e DissOnline.de. Foram considerados como critérios de inclusão: (1) estudos observacionais de indivíduos com diagnóstico de infecção por COVID-19; (2) registro das manifestações orais da COVID-19. Foram considerados como critérios de exclusão: (1) estudos sobre coronavírus não-humano; (2) artigos de revisão; (3) estudos experimentais (em animais ou in vitro); (4) relato clínico de distúrbio olfatório e/ou gustativo com início prévio ao quadro de infecção por SARS-COV-2; (5) estudos de manifestações orais em pacientes com outros vírus que não seja SARS-COV-2. Foi realizada uma extração de dados, previamente definido em um formulário eletrônico com os seguintes tópicos, por exemplo: Informações básicas do estudo, Elegibilidade, Métodos, Participantes, Intervenções, Resultados, entre outros. O risco de viés foi avaliado de acordo com as recomendações do manual e da escala de Newcastle-Ottawa. Resultados: Foram encontrados 1167 artigos após a busca realizada nas bases de dados. Após a remoção das duplicatas, restaram 809 estudos para análise. Por conseguinte, com base nos critérios de inclusão, foram excluídos 624 pelo título e 150 pelo resumo, resultando em 35 artigos para leitura na íntegra e 12 artigos incluídos no estudo. O tempo médio para o surgimento da manifestação oral foi de três a quatro dias, com duração de aproximadamente 11 dias. Os pacientes do sexo feminino apresentaram mais disfunções quimiossensoriais. A ferramenta diagnóstica variou de questionários subjetivos a testes psicofísicos. As comorbidades mais associadas à manifestação oral foram as doenças cardiovasculares. De maneira geral, não houve associação da manifestação oral com a gravidade clínica da COVID-19 e instituição de tratamento. Conclusão: A manifestação oral mais prevalente foi a disgeusia. Porém, de maneira geral, não houve correlação com a gravidade clínica da COVID-19, tampouco com tratamento.
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