ORAL LESIONS AND NEUROSTOMATOLOGICAL DISORDERS ASSOCIATED WITH COVID-19: A REVIEW OF CURRENT RESEARCH
Abstract
Resume. The coronavirus disease 2019 (COVID-19) pandemic, caused by SARS-CoV-2, has been recognized as a multisystemic disease extending beyond its primary respiratory effects. This systematized literature review aims to synthesize and analyze the current evidence from Scopus-indexed and other major databases on the spectrum of oral cavity alterations and associated neurostomatological syndromes in patients with COVID-19. A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for articles published from December 2019 to October 2025, following PRISMA guidelines. The search strategy utilized keywords related to COVID-19, oral manifestations, and neurological symptoms. Included studies comprised systematic reviews, observational studies, and case series detailing oral and neurostomatological findings in confirmed COVID-19 patients. Data on prevalence, clinical characteristics, and proposed pathophysiology were extracted and narratively synthesized. The review identified a wide range of oral manifestations, with the tongue (38%), labial mucosa (26%), and palate (22%) being the most affected sites. Common lesions included ulcers, erosions, vesicles, depapillated tongue, and macules. Neurostomatological symptoms, particularly dysgeusia (taste disturbance) and anosmia (smell disturbance), were frequently reported as early and sometimes sole indicators of infection. The underlying pathophysiology is multifactorial, involving direct viral invasion via angiotensin-converting enzyme 2 (ACE2) receptors highly expressed in oral tissues, systemic inflammation (cytokine storm), vasculitis, coagulopathy, and opportunistic infections secondary to immunosuppression. Oral and neurostomatological manifestations are significant and diverse features of COVID-19. Dysgeusia and various mucosal lesions can serve as early diagnostic clues. A thorough oral examination is crucial for early detection, management of local symptoms, and understanding the systemic impact of the disease. These findings underscore the importance of integrating dental and oral medicine into the comprehensive care of COVID-19 patients. Keywords: COVID-19; SARS-CoV-2; Oral Manifestations; Neurostomatology; Dysgeusia; Anosmia; Literature Review; ACE2.