Impact of COVID-19 on the prevalence of oral and maxillofacial disorders: A retrospective cohort study

Abstract

Objective: The COVID-19 pandemic has impacted various health conditions. Emerging evidence suggests that COVID-19 may trigger or exacerbate oral and maxillofacial conditions, yet data from Iraq and the broader Middle East remain limited. This retrospective cohort study, conducted at the Laboratory of Oral Pathology, College of Dentistry, University of Baghdad, explores potential links between COVID-19 infection and maxillofacial disorders. Methods: This was a retrospective cohort study using data from the Laboratory of Oral Pathology, College of Dentistry, University of Baghdad. Cases were divided into pre-COVID-19 and post-COVID-19 periods. Chi-square tests assessed differences in oral pathologies incidence, while logistic regression analyzed associations with COVID-19 status and corticosteroid use. Results: Mucormycosis cases demonstrated a significant increase from 3 (pre-COVID-19) to 23 (post-COVID-19), with 65.22% of post-COVID-19 patients testing COVID-19-positive. A significant increase in mucormycosis severity was observed after COVID-19 (χ² = 14.24, p = 0.0026). Logistic regression identified age (coefficient 0.8738) as having a significant association with severe mucormycosis, while COVID-19 status (coefficient 0.1272) exerted a lesser effect. Sjögren's syndrome increased from 15 to 25 cases, with a model area under the curve of 0.8, indicating substantial ability to distinguish symptom changes pre- vs. post-COVID-19. Conclusion: The findings suggest that the pandemic has considerably impacted the incidence and severity of mucormycosis and Sjögren's syndrome. Older age and COVID-19 positivity may be key drivers of severe mucormycosis, whereas COVID-19 infection appeared to exacerbate Sjögren's syndrome symptoms. These results underscore the importance of vigilant monitoring and targeted therapeutic strategies for managing oral and maxillofacial conditions during and after viral pandemics.