Indian Journal of Dental Research

EDITORIAL
Year
: 2020  |  Volume : 31  |  Issue : 5  |  Page : 669-

Post COVID-19 fungal and microbial infections


SM Balaji 
 Executive Editor, Indian Journal of Dental Research, Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu, India

Correspondence Address:
S M Balaji
Executive Editor, Indian Journal of Dental Research, Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu
India




How to cite this article:
Balaji S M. Post COVID-19 fungal and microbial infections.Indian J Dent Res 2020;31:669-669


How to cite this URL:
Balaji S M. Post COVID-19 fungal and microbial infections. Indian J Dent Res [serial online] 2020 [cited 2021 Jan 20 ];31:669-669
Available from: https://www.ijdr.in/text.asp?2020/31/5/669/306440


Full Text



The COVID-19 pandemic has impacted oral health care delivery and affected the regular dentist's life, as we know it.[1] Besides the huge ramification on the way of healthcare delivery, more COVID-19 specific oral pathologies started to emerge.[1],[2],[3],[4] The oral post-COVID-19 complications such as abnormal taste and smell have been reported widely from several parts of the world, including India.[5],[6],[7],[8] However, the incidence of altered oral microbiome, particularly fungal infection are being increasing reported in literature.[9] In clinical practice, at least in this parts of the world, anecdotal fungal infections are getting more common, especially with jaw osteomyelitis. Though there is no structured studies being reported, post-COVID-19 patients presenting with signs and symptoms of fungal osteomyelitis has been discussed among healthcare professionals.

The cause of oral fungal infections in post-COVID-19 patients could emanate from use of corticosteroids, alteration of the oral microbial flora drastically allowing the commensals to become pathogenic, potential dry mouth because of disease/drugs could also favor the fungal elements.[10] Also, the cytokine elements could influence the oral microbial flora, suppressing common bacteria and allowing pathogenic fungal elements to flourish. Also, the various drugs given could also predispose to alteration of microbial flora. High fever, by itself, can change the oral microbial shift. In addition, the neglect of oral care during such fever episodes cannot be ignored. Together, this can lead the opportunistic fungal infection to flourish. Hence in such a situation, in any post-COVID-19 patient, any abnormalities such as rapidly progressing periodontal condition should be properly (start with radiology) to be investigated.[11] The epidemiological, clinical, microbiological, and histopathological profile of such patients needs to be investigated. This could shed in more light of this acute phenomenon and help to design better treatment protocols. Early and accurate diagnosis is essential as treatment for fungal osteomyelitis is complicated.[12] Simple documentation of fungal osteomyelitis of jaws in post-COVID-19 patients as an isolated case reports or case series would help to shed more light on the disease process.

References

1Seneviratne CJ, Lau MWJ, Goh BT. The role of dentists in COVID-19 is beyond dentistry: Voluntary medical engagements and future preparedness. Front Med (Lausanne) 2020;7:566.
2Amorim Dos Santos J, Normando AGC, Carvalho da Silva RL, De Paula RM, Cembranel AC, Santos-Silva AR, et al. Oral mucosal lesions in a COVID-19 patient: New signs or secondary manifestations? Int J Infect Dis 2020;97:326-8.
3Brandão TB, Gueiros LA, Melo TS, Prado-Ribeiro AC, Nesrallah ACFA, Prado GVB, et al. Oral lesions in patients with SARS-CoV-2 infection: Could the oral cavity be a target organ? Oral Surg Oral Med Oral Pathol Oral Radiol 2020:S2212-4403(20)31119-6. doi: 10.1016/j.oooo.2020.07.014.
4Sinadinos A, Shelswell J. Oral ulceration and blistering in patients with COVID-19. Evid Based Dent 2020;21:49.
5Abduljabbar T, Alhamdan RS, Al Deeb M, AlAali KA, Vohra F. Association of salivary content alteration and early ageusia symptoms in COVID-19 infections: A systemic review. Eur J Dent 2020. doi: 10.1055/s-0040-1716986.
6Garg R, Jain R, Sodani A, Chouksey D, Dosi R, Athale S, et al. Neurological symptoms as initial manifestation of Covid-19 - An observational study. Ann Indian Acad Neurol 2020;23:482-6.
7Ninchritz-Becerra E, Soriano-Reixach MM, Mayo-Yánez M, Calvo-Henríquez C, Martínez-Ruiz de Apodaca P, Saga-Gutiérrez C, et al. Subjective evaluation of smell and taste dysfunction in patients with mild COVID-19 in Spain. Med Clin (Barc) 2020:S0025-7753(20)30666-7. doi: 10.1016/j.medcli.2020.08.004.
8Krishnasamy N, Natarajan M, Ramachandran A, Vivian Thangaraj JW, Etherajan T, Rengarajan J, et al. Clinical outcomes among asymptomatic or mildly symptomatic COVID-19 patients in an isolation facility in Chennai, India. Am J Trop Med Hyg 2020. doi: 10.4269/ajtmh.20-1096.
9Song G, Liang G, Liu W. Fungal co-infections associated with global COVID-19 pandemic: A clinical and diagnostic perspective from China. Mycopathologia 2020;185:599-606.
10Lei Y, Song Y, Shu Y, Zhao Y, Huo X, Wang H, et al. Fungal antigenemia in patients with severe Coronavirus disease 2019 (COVID-19): The facts and challenges. J Microbiol Immunol Infect 2020;53:657-9.
11Cespedes MDS, Souza JCRP. Coronavirus: A clinical update of Covid-19. Rev Assoc Med Bras 2020;66:116-23.
12Balaji SM, Balaji P. Maxillary rehabilitation after complete destruction by fungal osteomyelitis. Indian J Dent Res 2019;30:807-9.