Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study

Maha El Tantawi, Heba Jafar Sabbagh, Nada Abubakor Alkhateeb, Maryam Quritum, Joud Abourdan, Nafeesa Qureshi, Shabnum Qureshi, Ahmed Hamoud, Nada Mahmoud, Ruba Odeh, Nuraldeen Maher Al-Khanati, Rawiah Jaber, Abdulrahman Loaie Balkhoyor, Mohammed Shabi, Morenike O. Folayan, Noha Gomaa, Raqiya Al Nahdi, Nawal Mahmoud, Hanane El Wazziki, Manal AlnaasBahia Samodien, Rawa Mahmoud, Nour Abu Assab, Sherin Saad, Sondos Al-Hachim, Ali Alshaikh, Wafaa Abdelaziz

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
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Background: Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered. Objectives: The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers. Methods: This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations. Results: Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (11.1% vs 7.5%, p = 0.009) and change in taste (11.5% vs 2.7%, p < 0.001) were greater in COVID-19 infected than non-infected persons. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86). Conclusion: Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.

Original languageEnglish
Article numbere13555
Number of pages13
Publication statusPublished - 15 Jul 2022


  • COVID-19
  • Dry mouth
  • Oral lesions
  • Smoking

ASJC Scopus subject areas

  • General Neuroscience
  • General Biochemistry,Genetics and Molecular Biology
  • General Agricultural and Biological Sciences


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