Association between periodontitis and severity of COVID‐19 infection: A case–control study

Abstract

Aim COVID‐19 is associated with an exacerbated inflammatory response that can result in fatal outcomes. Systemic inflammation is also a main characteristic of periodontitis. Therefore, we investigated the association of periodontitis with COVID‐19 complications. Materials and Methods A case–control study was performed using the national electronic health records of the State of Qatar between February and July 2020. Cases were defined as patients who suffered COVID‐19 complications (death, ICU admissions or assisted ventilation), and controls were COVID‐19 patients discharged without major complications. Periodontal conditions were assessed using dental radiographs from the same database. Associations between periodontitis and COVID 19 complications were analysed using logistic regression models adjusted for demographic, medical and behaviour factors. Results In total, 568 patients were included. After adjusting for potential confounders, periodontitis was associated with COVID‐19 complication including death (OR = 8.81, 95% CI 1.00–77.7), ICU admission (OR = 3.54, 95% CI 1.39–9.05) and need for assisted ventilation (OR = 4.57, 95% CI 1.19–17.4). Similarly, blood levels of white blood cells, D‐dimer and C Reactive Protein were significantly higher in COVID‐19 patients with periodontitis. Conclusion Periodontitis was associated with higher risk of ICU admission, need for assisted ventilation and death of COVID‐19 patients, and with increased blood levels of biomarkers linked to worse disease outcomes.

Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis

“…Five review articles [29][30][31][32][33], two hypothesis articles [34,35], one perspective article [36], one special issue [37], one commentary [38], one case-control study [39], and one case report [40] were included. Sampson et al mentioned that the four major comorbidities linked to an increased risk of COVID-19 complications and death are also linked to altered oral biofilms and periodontal disease; oral infections are normal in patients with a serious case of COVID-19, with bacterial superinfections responsible for more than half of all deaths [29].…”

Making a complex dental care tailored to the person: Population health in focus of predictive, preventive and personalised (3P) medical approach

“…Clear association between diagnosed periodontitis and high risk of admission to intensive care units (ICU), need for assisted ventilation and increased COVID-19 related death has been demonstrated [42]. In consensus, the study performed in UK has reported over 50% of deaths in COVID-19 infected patients exhibiting bacterial superinfections and severe disease course [41].…”

“…Still, this is considered to be a health condition, but not a disease. Contextually, speci c measures of oral hygiene and dental prevention should be appropriately adapted to the needs of this age group preventing oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function, and deterioration of swallowing function which collectively lead to the oral hypo-function with advanced ageing [41][42][43].…”

Teleodontología para prevenir la enfermedad periodontal en pacientes geriátricos durante la pandemia de COVID-19

“…Cuando los pacientes llegan a una edad avanzada suelen presentar una mayor prevalencia de las enfermedades periodontales, por lo que el tratamiento odontológico que se les brinde va a ser un factor fundamental para poder mantener su salud bucal (1,2) ; más aún, estos cuidados toman mayor relevancia debido a que estudios recientes señalan que pacientes con periodontitis se asocian con un mayor riesgo de ingreso en la UCI, necesidad de ventilación asistida y la muerte de los pacientes con COVID-19 (3) .…”