RESUMO
INTRODUCTION: To date various oral manifestations in patients with coronavirus disease 2019 (COVID-19) have been reported. OBJECTIVES: In the present study, we investigated the relationship between Polymerase Chain Reaction (PCR) positivity and oral signs in patients with suspected COVID-19. METHODS: A total of 383 patients who presented to the emergency department for the first time with any symptoms associated with COVID-19 were included in the study. Oral examinations were performed and the findings, PCR status, and thorax computerized tomography (CT) reports were recorded. RESULTS: Oral mucosa was involved in 246 (64.2%) patients. 175 (78,4%) of patients with COVID-19 confirmed the diagnosis with PCR test or CT results had oral manifestation. Dry mouth, microvesicles on the tonsils or pharynx, and petechiae in the oropharynx were significantly higher in patients with positive PCR tests (P = 0.001, P < 0.001, P < 0.001, respectively). The ratio of intact oral mucosa was statistically significantly higher in patients with negative PCR tests compared to those with positive PCR tests (P < 0.001). Microvesicles on the tonsils or pharynx were most associated with PCR positivity in patients without lung involvement (P < 0.001). Dry mouth, erythema of the tonsils and pharynx, petechiae in the oropharynx, and primary/secondary herpes infection are more related to PCR positivity in patients without lung involvement (P < 0.05). Lung involvement in patients with PCR positivity is related to only cheilitis (P = 0.034). CONCLUSIONS: Our study revealed that especially microvesicles, petechiae, erythema on the tonsils or pharynx, and some other oral lesions such as dry mouth, oral aphthae, and primary/secondary herpes infection are associated with PCR positivity.
RESUMO
BACKGROUND: We detected yellow-green fluorescence in the face, hair and lunulae of patients using favipiravir. AIM: We evaluated the frequency and intensity of favipiravir-associated fluorescence. PATIENTS/METHODS: The participants comprised patients who had taken at least a single dose of favipiravir and been examined no later than 30 days after the last dose. The gender, age, body mass index (BMI), Fitzpatrick's skin-type, hair color, N-acetylcysteine use, presence and the intensity of fluorescent reflection under Wood's light in the lunulae of the fingernails, hair, and the face were recorded. RESULTS: There were 275 patients, 144 (52.4%) of whom were women. 165 (57.9%) had used treatment for a maximum of 5 days, 99 (34.7%) for 6-10 days, and 21 (7.4%) for more than ten days. Using more than 22 tablets of favipiravir increased the probability of detecting fluorescence in the lunulae by 6.72 (2.61-17.23) times. Using more than 28 tablets increased the risk of fluorescence in hair and the T-zone by 5.92 (2.43-14.71) and 2.88 (1.11-7.47) times, respectively. No relationship was found between the fluorescence intensity in any localization and the total dose. However, we determined a negative correlation between the elapsed time after the last dose and the fluorescence intensity in the lunulae and the T-zone (p=0.036; p=0.031; respectively). It was noted that BMI negatively correlated with the fluorescence intensity in the lunulae (p=0.001). Skin type was related to intensity for all localizations (p<0.001). Fluorescence was found in the lunulae with significantly less frequency in patients using N-acetylcysteine (p=0.040). CONCLUSIONS: We must be aware of favipiravir-induced phototoxicity.