Objectives
The oral cavity is a potential reservoir for respiratory pathogens which can predispose patients to bacterial super-infection. Several trials have correlated poor oral hygiene with hyper-inflammation. Similarly, COVID-19 severity has been linked to hyper-inflammatory responses. Hence, in this study, we assumed that increased COVID-19 severity may be linked to poor oral health status. This was achieved through assessing oral health status, severity of COVID-19 symptoms, C-reactive protein (CRP) levels and duration of recovery.
Methods
Cross-sectional study based on a questionnaire; 308 Egyptian patients with confirmed positive polymerase chain reaction (PCR) tests were included in the study after exclusion criteria. The questionnaire was designed with two sections: the first section for oral health evaluation and the second section for COVID-19 severity evaluation. Assessment of the effect of oral health on COVID-19 severity was performed using an oral health score. The effect of oral health on CRP and recovery period were evaluated as secondary endpoints. Data of CRP levels and COVID-19 PCR tests were collected via the questionnaire and confirmed by reviewing medical records.
Results
The correlation between oral health and COVID-19 severity showed a significant inverse correlation (p <0.001, r = -0.512). Moreover, the correlation between oral health with recovery period and CRP values also revealed a significant inverse correlation (p <0.001, -0.449 and p <0.001, -0.190, respectively), showing that poor oral health was correlated to increased values of CRP and delayed recovery period.
Conclusions
Our study provided some evidence that oral health could have a potential impact on the severity of COVID-19. However, the correlation is limited by the study design. A more substantial research project is required to address this relation.
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Background
Myocardial recovery following primary percutaneous coronary intervention is often suboptimal despite of restoration of thrombolysis in myocardial infarction (TIMI) 3 flow, in part due to thrombus embolization which results in impairing microvascular reperfusion besides increasing infarct size. The purpose of the present study was to estimate the effect of aspiration thrombectomy followed by intracoronary delivery of tirofiban on decreasing the infarct size utilizing cardiac MRI (cMR) in large anterior ST-segment elevation myocardial infarction (STEMI) patients.
Patients
A prospective randomized controlled study of 100 patients with large anterior STEMI were randomized to (Study group) using intracoronary tirofiban (intracoronary) and (control group) without intocoronary tirofiban. A 6 F thrombus aspiration catheter was used in all patients. Tirofiban was injected locally at the place of the highly thrombus burden through the aspiration device after flushing the aspiration device well.
Results
Patients of intracoronary tirofiban group compared with control group had a significant difference in decreasing the infarct size at 30 days [median, 15.451 g – interquartile range (IQR), 17.404 gm – n = 50] vs (median, 43.828 g – IQR, 49.599 g – n = 50) P value = 0.002.
Conclusion
In patients early presented with large anterior STEMI, infarct size at 30 days was significantly decreased by intracoronary tirofiban delivered to the infarct lesion site followed aspiration thrombectomy.
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