Massive Macroglossia, a Rare Side Effect of COVID-19: Clinical, Histologic, and Genomic Findings in COVID-19-Positive Versus COVID-19-Negative Patients

Authors

Victoria A Mañón
David Chubb
Laura S Farach
Rachid Karam
Mary C Farach-Carson
Nadarajah Vigneswaran
Karan Saluja
Simon Young
Mark Wong
James C Melville

Publication Date

12-1-2022

Journal

Oral and Maxillofacial Surgery

Abstract

PURPOSE: The primary purpose of this study is to identify if there is an underlying genetic predisposition for COVID-related macroglossia and if this susceptibility is higher among individuals of African heritage. Secondary objectives include determining if genetic testing of COVID-infected patients who are intubated and prone could identify patients with higher susceptibility to the development of macroglossia.

METHODS: A retrospective chart review was completed for each patient, and prospectively, genetic and histopathologic analyses were completed. Whole-exome sequencing was completed on two patients; immunohistochemistry was completed on the COVID-positive tissue samples.

RESULTS: Histopathology of the COVID-positive patient revealed significant peri-lymphocytic infiltrate, which was absent in the COVID-negative patient. Immunohistochemistry confirmed the presence of immune cells. Results from the whole-exome sequencing were inconclusive.

CONCLUSION: The findings of this study are consistent with others that have observed a lymphocytic infiltrate in the organs of patients infected with SARS-CoV-2. On histology, IHC highlighted a CD45 + predominance, indicating that a robust immune response is present in the tissues. The pathobiology of this phenomenon and its role in the development and/or persistence of massive macroglossia requires further study.

Keywords

Oral pathology, COVID-19, Oral surgery, Histopathology, Immunohistochemistry

Comments

PMID: 34981214