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      The Role of the Dental Surgeon in Controlling the Dissemination of COVID-19: A Literature Review

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          Abstract

          As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

            Fei Zhou, Ting Yu, Ronghui Du … (2020)
            Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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              A Novel Coronavirus from Patients with Pneumonia in China, 2019

              Na Zhu, Dingyu Zhang, Wenling Wang … (2020)
              Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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                Author and article information

                Contributors
                Kaline Romeiro:
                ORCID: https://orcid.org/0000-0002-6482-0628
                Journal
                Journal ID (nlm-ta): ScientificWorldJournal
                Journal ID (publisher-id): TSWJ
                Title: The Scientific World Journal
                Publisher: Hindawi
                ISSN (Print): 2356-6140
                ISSN (Electronic): 1537-744X
                Publication date Collection: 2020
                Publication date (Electronic): 1 October 2020
                Volume: 2020
                Electronic Location Identifier: 7945309
                Affiliations
                1Dental School, Centro Universitário Facol (UNIFACOL), 85, 55612-650 Vitória de Santo Antão, PE, Brazil
                2Department of Dentistry, Dental College of Pernambuco, Universidade de Pernambuco (UPE), 1650, 54753-901 Tabatinga, PE, Brazil
                3Department of Restorative Dentistry, Universidade Federal da Paraíba (UFPB), s/n, Cidade Universitária, 58051-900 João Pessoa, PB, Brazil
                4Department of Oral Medicine, Real Hospital Português de Beneficência em Pernambuco, 4760-Paissandu, 52010-075 Recife, PE, Brazil
                Author notes

                Academic Editor: Dariusz Chlubek

                Author information
                https://orcid.org/0000-0003-3912-2534
                https://orcid.org/0000-0002-8759-802X
                https://orcid.org/0000-0003-0537-9761
                https://orcid.org/0000-0002-7881-0316
                https://orcid.org/0000-0002-9336-7797
                https://orcid.org/0000-0002-7897-2489
                https://orcid.org/0000-0002-6482-0628
                Article
                DOI: 10.1155/2020/7945309
                PMC ID: 7532361
                SO-VID: 6eab9b50-17f9-46d4-afbd-a0897f9b2589
                Copyright © Copyright © 2020 Régida C. S. Batista et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 4 May 2020
                Date revision received : 11 August 2020
                Date accepted : 18 September 2020
                Categories
                Subject: Review Article

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