Association between Periodontitis and COVID-19 Based on Severity Scores of HRCT Chest Scans

Abstract

Background: A relationship between periodontitis and COVID-19 may exist, as highlighted by several hypothetical models. However, the evidence is limited. Hence, the present study was conducted to determine whether an association exists between periodontitis and COVID-19. Methods: A cross-sectional study was carried out with patients diagnosed with COVID-19 who were divided into three groups—mild, moderate, and severe COVID-19—based on the COVID-19 severity score of high-resolution computed tomography (HRCT) chest scans. Periodontal parameters—including the plaque index (PI), ratio of sites with gingival bleeding (BOP), pocket depth (PD), gingival recession (REC), clinical attachment loss (CAL), and mean numbers of mobile and missing teeth due to periodontitis—were recorded for all three groups. Statistical analyses were applied to the data. Results: Of 294 patients with COVID-19, approximately 50.68% (n = 149) had periodontitis, and the highest percentage (87.5%) was reported in the severe COVID-19 group. Additionally, severe and advanced stages of periodontitis (stage III–IV) were found to be significantly more frequent in subjects with severe COVID-19 than in the other two groups. The HRCT severity score (CT-SS) was moderately correlated with increased levels of periodontal parameters. Conclusions: Results of logistic regression analyses showed that the probability of developing severe COVID-19 was 2.81 times higher in patients with periodontitis. An association exists between periodontitis and severe COVID-19.

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis

“…A total of 22 studies, involving 92,535 patients were included in the present systematic review; [ 22 – 25 , 27 – 29 , 33 – 47 ] of these, 12 studies were included in the meta-analysis [ 23 , 25 , 27 , 28 , 33 , 35 , 36 , 40 , 41 , 43 , 44 , 46 , 47 ]. Twelve of these studies were case–control studies, [ 22 – 25 , 29 , 34 , 35 , 37 , 38 , 42 , 44 , 46 ] three cohort studies, [ 27 , 28 , 39 ] and seven cross-sectional studies [ 33 , 36 , 40 , 41 , 43 , 45 , 47 ].…”

Epidemiological pattern of COVID-19 and its association with periodontal health in an urban Indian cohort

“…Other studies focusing on COVID-19 severity or complications such as assisted ventilation, intensive care admission and deaths report 3 to 36 times higher odds of any COVID-19 complication among periodontally compromised individuals ( 14 – 16 , 18 , 19 , 38 ) compared to those with healthy periodontium. Despite reporting statistically significant results, the wide confidence intervals indicate low precision due to small sample size.…”

“…Cross-sectional ( 12 , 14 , 16 – 19 ) and prospective ( 13 , 15 ) observational studies report, over three-fold increase in severity of COVID-19 infection (and death) among persons with poor oral health or PD. However, they are limited by either sample size, lack of community level prospective data, or clinically ascertained oral health status.…”

Periodontal disease and COVID-19: a systematic review and meta-analysis of observational studies

“…These included six case-control studies 11,12,22−25 , three cohort studies 26-28 and two crosssectional studies. 5,29 The NOS scores of the Seven studies were ≧ 5, and the scores of the 11 checklist recommend by AHRQ were ≧ 8, which suggested moderate or high quality for the included studies. The basic characteristics of the included literature are shown in Table 1.…”