Assessment of COVID-19-Related Oral Findings and Candida Species at Different Disease Severity

Background The management of coronavirus disease 2019 (COVID-19) has posed a significant challenge for healthcare providers worldwide, following the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection.The oral cavity is considered as a target site of SARS-CoV2.The two most reported oral symptoms of SARS-CoV2 infection were taste alteration and dry mouth.Individuals with COVID-19 are susceptible to opportunistic fungal infections, especially with acute respiratory distress syndrome (ARDS), prolonged hospitalization and administration of broad-spectrum antibiotics, corticosteroids, or immunosuppressants.Objectives 1-Assessment of oral findings including taste alteration (TA) and salivary flow rate (SFR) in patients with COVID-19.2-Investigate the prevalence of candida species in COVID-19 patients.Materials and Methods This case-control study involved 30 individuals who tested positive for COVID-19 via reverse transcriptase-polymerase chain reaction, ages ranging from 25 to 59 years.Additionally, 30 healthy volunteers were included, matched according to age and sex with the patients.For TA an objective test includes standardized and validated solutions.For SFR calculation, saliva was collected from each participant to evaluate hyposalivation.An oral swap was collected from each participant and cultured on Sabouraud dextrose ager, candida albicans was identified using a Germ tube and via Vitek 2 compact machine.Results This study showed a significant difference in TA, SFR and frequency of candida albicans isolate (p= 0.001, p=0.0001 and p=0.0001 respectively, at level 0.05 using Pearson Chi-square and ANOVA tests) between COVID-19 and control, according to disease severity TA was significant in patients with mild cases then moderate and severe cases (p=0.001).While SFR was significantly decreased in patients with moderate and severe cases then in mild cases (p=0.0001) and the frequency of candida albicans isolation was more significant in moderate and severe cases than in mild cases (p=0.016).Conclusions Taste alteration and dry mouth are the most common oral findings in COVID-19 patients and statistically significant with disease severity, an increased prevalence of candida albicans in COVID-19 patients; likewise, statistically significant with disease severity.