{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:30:42Z","timestamp":1761921042347,"version":"3.37.3"},"reference-count":38,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:00:00Z","timestamp":1657843200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Oral manifestations and lesions could adversely impact the quality of people\u2019s lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations. <\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19- infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, <jats:italic>p<\/jats:italic> = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, <jats:italic>p<\/jats:italic> = 0.86).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.13555","type":"journal-article","created":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T08:09:35Z","timestamp":1657872575000},"page":"e13555","source":"Crossref","is-referenced-by-count":19,"title":["Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study"],"prefix":"10.7717","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4989-6584","authenticated-orcid":true,"given":"Maha","family":"El Tantawi","sequence":"first","affiliation":[{"name":"Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heba Jafar","family":"Sabbagh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz 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