Chronic oral diseases secondary to COVID-19 infection or vaccination: clinical cases and a narrative review

Area of Science:

• Immunology
• Oral Medicine
• Infectious Diseases

Background:

• Autoimmune activation following COVID-19 infection or vaccination is a potential trigger for oral mucosal immune disorders.
• Conditions like oral lichen planus, oral pemphigoid, pemphigus vulgaris, and Sjögren disease have been linked to COVID-19.
• Chronic oral symptoms such as burning, xerostomia, and altered taste/smell are also associated with COVID-19.

Purpose of the Study:

• To review and present cases of oral mucosal and non-mucosal immune disorders potentially associated with COVID-19 infection or vaccination.
• To investigate the incidence and characteristics of these conditions post-COVID-19 exposure.

Main Methods:

• A literature review of major databases (PubMed, Web of Science, Scopus, Embase) was conducted for oral lichen planus, oral bullous pemphigoid, mucous membrane pemphigoid, and pemphigus vulgaris in relation to COVID-19.
• Cases of Sjögren disease, chronic oral burning, and xerostomia following COVID-19 infection/vaccination were aggregated from the authors' clinical practice.

Main Results:

• The literature review identified 29 cases of oral lichen planus, 10 of oral bullous pemphigoid, and 28 of pemphigus vulgaris post-COVID-19 infection/vaccination.
• The majority of mucosal cases occurred after vaccination, with both new-onset and recurrent conditions reported.
• Twelve cases of non-mucosal conditions (Sjögren disease, chronic oral burning, xerostomia) were identified from clinical practice, mostly following infection.

Conclusions:

• Chronic conditions linked to COVID-19 infection or vaccination are generally rare and self-limiting.
• Comprehensive patient history, including COVID-19 exposure, is essential for differentiating potential causes of oral disorders.