Table.
Signs and symptoms associated with long COVID, medications routinely used in the treatment of these findings, their impact on oral health care interventions, and treatment modifications recommended for patients.
| SIGNS AND SYMPTOMS | MEDICATIONS | IMPACT ON ORAL HEALTH CARE INTERVENTION | TREATMENT MODIFICATION |
|---|---|---|---|
| Fatigue | NA∗ | Decreased ability to withstand treatment | Short appointments, work with patient on timing and length of appointments |
| Shortness ofBreath | Supplementary oxygen, systemic corticosteroids, bronchodilators, β2-agonists | Decreased mobility, decreased functional capacity | Pulse oximetry monitoring, monitoring for infection, patients should be instructed to bring any supplemental oxygen and new inhaled medications |
| ChestPain | NA | If present, discontinue treatment | Symptom monitoring |
| HeartFailure | NA | Decreased functional capacity | Caution with chair positioning, confirm ability to tolerate planned procedure |
| VenousThromboembolism | Antiplatelet and anticoagulant medications | Possible prolonged or excessive bleeding | Monitor hemostasis, apply local measures as needed, provide breaks, short appointments to prevent new thrombus formation |
| Seizures | NA | May lead to weakness, paralysis, paresthesia | Monitor for signs and symptoms, adjust home care according to functional capacity |
| MuscleWeakness | NA | Changes in balance and gait may affect ingress and egress from dental operatory | Caution with ingress and egress |
| PosturalOrthostaticTachycardia | NA | May be exacerbated by changes during the positioning of the dental chair | Avoid rapid chair positioning and confirm patient tolerance of position |
| NeuropathicPain andHeadache | Triptans | Can affect the orofacial region | May require evaluation and treatment by orofacial pain specialists |
| CognitiveChanges | NA | May show reduced memory and ability to make decisions | If necessary, involve other decision makers, ensure informed consent |
| PsychiatricIllness | Antianxiety and antidepressive medications | Inability to submit to care, decreased reliability | Treatment of patient concerns, understanding, monitoring and treatment of decreased salivary flow and resultant caries and periodontal disease |
| ChronicPain | Possibly treated with habit-forming medications including opioids | Inability to tolerate prolonged procedures and certain positions | Short appointments and adjustments to patient needs, positioning and breaks as needed, avoid provision of opioid analgesics |
| KidneyImpairment | NA | Decreased metabolism of medications eliminated in the kidneys | Changes in dose and timing according to kidney function |
| HepaticImpairment | NA | Decreased metabolism of hepatically processed medications | Changes in dose and timing, avoid hepatically metabolized medications as possible |
∗
NA: Not applicable.