Oral Manifestations, Dental Interventions, and Clinical Outcomes in Hospitalized COVID-19 Patients: A Two-Year Cohort Study in São Paulo, Brazil.

Abstract

Objectives: To investigate the demographic, epidemiological, and medical profiles of hospitalized COVID-19 patients who received dental care, and to identify their main oral health needs. Methods: This retrospective, descriptive cohort study analyzed medical and dental records of patients hospitalized with COVID-19 at a private tertiary hospital in São Paulo, Brazil, from January 2020 to March 2022. The data collected included demographic variables, comorbidities, length of hospitalization, need for respiratory support, clinical outcomes, dental diagnoses, and procedures performed. Results: A total of 129 medical records were reviewed. The sample included 93 males (72%) and 36 females (28%), with a mean age of 72 years. Comorbidities were present in 92% of cases, most frequently a prior COVID-19 infection (59%), diabetes (36%), and depression (31%). The mean hospital stay was 51 days, with a median of 33 days. Most patients (91%) required ICU care; among these, 87% received invasive mechanical ventilation. Dental consultations were most commonly requested for oral assessments (88%), lesions (58%), and opportunistic infections (8%). The most frequent diagnoses were trauma-related lesions from orotracheal intubation (63%), opportunistic infections (45%), and odontogenic or periodontal infections (15%). Primary treatments included oral hygiene procedures (89%), photobiomodulation therapy (67%), and tooth extractions (6%). Patients received an average of eight dental consultations. The overall mortality rate was 26%. Conclusions: Older male patients with COVID-19 frequently required intensive dental care during hospitalization. Oral trauma and opportunistic infections were common, highlighting the need for specialized dental management in critically ill populations.