Current Perspectives On Covid-19 Complications In 2025: Focus On The Oral Cavity And Systemic Effects.

Abstract

The COVID-19 pandemic, driven by SARS-CoV-2, exhibits significant oral and systemic complications mediated by viral binding to ACE2 receptors densely expressed in oral mucosa (50× higher than lungs). Recent evidence confirms oral manifestations in 20–45% of cases, including dysgeusia (38–47%), xerostomia (17.8–46.3%), and mucosal ulcers (20.5%), often serving as early disease indicators. Pathogenic mechanisms involve direct viral cytopathy in salivary glands, cytokine storm-induced microthrombosis, and autoimmune cross-reactivity, with viral RNA persisting in oral tissues for ≤60 days. Systemically, Long COVID (10–35% of patients) manifests with fatigue (58%), neurological sequelae ("brain fog" RR 2.68), cardiovascular injury (myocarditis: 2.3% in athletes), and new-onset autoimmune disorders (e.g., GuillainBarré syndrome).