Oral Complications of ICU Patients with COVID-19: Case-Series and Review of Two Hundred Ten Cases.

COVID-19 candidiasis critical care macroglossia oral manifestations pressure ulcer prone position

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
04 Feb 2021
Historique:
received: 14 01 2021
revised: 31 01 2021
accepted: 01 02 2021
entrez: 9 2 2021
pubmed: 10 2 2021
medline: 10 2 2021
Statut: epublish

Résumé

The critically ill patients suffering from coronavirus disease (COVID-19) and admitted to the intensive care units (ICUs) are susceptible to a wide array of complications that can be life-threatening or impose them to long-term complications. The COVID-19 oral mucocutaneous complications require multidisciplinary management and research for their pathophysiological course and epidemiological significance; therefore, the objective of this study was to evaluate the prevalence and characteristics of the critically ill COVID-19 patients with oral complications. We described the clinical and microbiological characteristics of the critically ill COVID-19 patients in our ICU department (Banska Bystrica, Slovakia). In addition, we reviewed the current body of evidence in Ovid MEDLINE Three out of nine critically ill patients (33.3%) in our ICU department presented with oral complications including haemorrhagic ulcers and necrotic ulcers affecting the lips and tongue. The microbiological assessment revealed the presence of opportunistic pathogens, confirming the possibility of co-infection. On reviewing the current literature, two hundred ten critically ill patients were reported to have oral complications due to their stay in the ICU setting. Perioral pressure ulcers were the most common complication, followed by oral candidiasis, herpetic and haemorrhagic ulcers, and acute onset macroglossia. The prolonged prone positioning and mechanical ventilation devices were the primary risk factors for those oral complications, in addition to the immunosuppressive drugs. The multidisciplinary approach is strongly advocated for monitoring and management of COVID-19 patients, thus implying that dermatology and oral healthcare specialists and nurses should be integrated within the ICU teams.

Sections du résumé

BACKGROUND BACKGROUND
The critically ill patients suffering from coronavirus disease (COVID-19) and admitted to the intensive care units (ICUs) are susceptible to a wide array of complications that can be life-threatening or impose them to long-term complications. The COVID-19 oral mucocutaneous complications require multidisciplinary management and research for their pathophysiological course and epidemiological significance; therefore, the objective of this study was to evaluate the prevalence and characteristics of the critically ill COVID-19 patients with oral complications.
METHODS METHODS
We described the clinical and microbiological characteristics of the critically ill COVID-19 patients in our ICU department (Banska Bystrica, Slovakia). In addition, we reviewed the current body of evidence in Ovid MEDLINE
RESULTS RESULTS
Three out of nine critically ill patients (33.3%) in our ICU department presented with oral complications including haemorrhagic ulcers and necrotic ulcers affecting the lips and tongue. The microbiological assessment revealed the presence of opportunistic pathogens, confirming the possibility of co-infection. On reviewing the current literature, two hundred ten critically ill patients were reported to have oral complications due to their stay in the ICU setting. Perioral pressure ulcers were the most common complication, followed by oral candidiasis, herpetic and haemorrhagic ulcers, and acute onset macroglossia. The prolonged prone positioning and mechanical ventilation devices were the primary risk factors for those oral complications, in addition to the immunosuppressive drugs.
CONCLUSIONS CONCLUSIONS
The multidisciplinary approach is strongly advocated for monitoring and management of COVID-19 patients, thus implying that dermatology and oral healthcare specialists and nurses should be integrated within the ICU teams.

Identifiants

pubmed: 33557130
pii: jcm10040581
doi: 10.3390/jcm10040581
pmc: PMC7913822
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Subventions

Organisme : Masarykova Univerzita
ID : MUNI/IGA/1543/2020
Organisme : Masarykova Univerzita
ID : MUNI/A/1608/2020
Organisme : Ministerstvo Školství, Mládeže a Tělovýchovy
ID : LTC20031

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Auteurs

Barbora Hocková (B)

Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia.
Department of Prosthetic Dentistry, Faculty of Medicine and Dentistry, Palacky University, 775 15 Olomouc, Czech Republic.

Abanoub Riad (A)

Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.
Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.

Jozef Valky (J)

Department of Anaesthesiology, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia.

Zuzana Šulajová (Z)

Department of Anaesthesiology, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia.

Adam Stebel (A)

Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia.

Rastislav Slávik (R)

Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia.

Zuzana Bečková (Z)

Department of Clinical Microbiology, F. D. Roosevelt University Hospital, 975 17 Banska Bystrica, Slovakia.
St. Elizabeth University of Health and Social Work, 812 50 Bratislava, Slovakia.

Andrea Pokorná (A)

Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.
Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.

Jitka Klugarová (J)

Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.
Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.

Miloslav Klugar (M)

Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.
Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.

Classifications MeSH