Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence

Mainas, Giuseppe; Nibali, Luigi; Ide, Mark; Almahmeed, Wael; Al-Rasadi, Khalid; Al-Alawi, Kamila; Banach, Maciej; Banerjee, Yajnavalka; Ceriello, Antonio; Cesur, Mustafa; Cosentino, Francesco; Firenze, Alberto; Gallucci, M.; Goh, Su-Yen; Kalra, Sanjay; Kapoor, Nitin; Kempler, Péter; Lessan, Nader; Lotufo, Paulo A; Παπάνας, Νικόλαος; Rizvi, Ali A.; Sahebkar, Amirhossein; Santos, Raul D.; Stoian, Anca Pantea; Tóth, Peter P.; Viswanathan, Vijay; Rizzo, Manfredi

doi:10.3390/metabo13010040

Cited by 7 publications

(4 citation statements)

References 131 publications

(138 reference statements)

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“…It has also been proposed [ 59 ] that inflamed periodontal tissues can act as reservoirs for pro-inflammatory cytokines, including TNF-α, IL-1α, IL-1β, and IL-6, exacerbating a previously existing systemic inflammation [ 60 , 61 ]. In a recent narrative review, the authors concluded that periodontitis and COVID-19 have in common a “hyper-inflammatory” state [ 62 ]. Dysregulated immune response in periodontitis.…”

Section: Resultsmentioning

confidence: 99%

Oral and systemic health: is there a “new” link with COVID-19?

et al. 2023

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Objectives The objective of the present narrative review was to evaluate the evidence of a possible association between periodontitis and COVID-19, and its biological plausibility, using as models the potential associations with cardiovascular diseases, diabetes, and some respiratory diseases. Methods A recent systematic review was used as main reference to explore the associations of periodontitis with different respiratory diseases, including COVID-19, following two focussed questions: a PECOS question, aimed to explore epidemiological evidence, and a PICOS question, designed to explore the evidence derived from intervention studies. In addition to that evidence, other relevant scientific documents, including consensus papers, were carefully selected and appraised. Findings Convincing evidence was found to support the association of periodontitis and cardiovascular diseases, diabetes, and some respiratory diseases. The biological plausibility behind those associations is based on four factors: (1) bacteraemia of oral bacteria and periodontal pathogens, (2) increased systemic inflammation, (3) common genetic factors, and (4) common environmental risk factors. Limited initial evidence is available to support an association between periodontitis and COVID-19 complications. Among the proposed factors to explain the suggested association, a combination of the previously mentioned factors, plus additional factors related with SARS-CoV-2 characteristics and pathogenicity, has been suggested. Conclusions Initial evidence suggests that periodontitis may be associated with a more severe COVID-19 and with a higher risk of death due to COVID-19. Clinical relevance Due to the possible association between periodontitis and an increased severity for COVID-19, additional efforts should be made to improve oral and periodontal health, including the promotion of oral healthy habits, such as oral hygiene.

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Section: Resultsmentioning

confidence: 99%

Oral and systemic health: is there a “new” link with COVID-19?

et al. 2023

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“…In the aftermath of the COVID-19 pandemic, numerous studies ( 3 ) ( 54 – 56 ) have surfaced suggesting a potential connection between periodontitis and COVID-19, both of which appear to induce and exacerbate various cardiometabolic complications ( 57 ). The nexus between COVID-19 and PD is intricate and multifaceted, with evidence implying a shared inflammatory pathophysiology ( 58 ).…”

Section: Discussionmentioning

confidence: 99%

Bibliometric research on analysis of links between periodontitis and cardiovascular diseases

Tang,

Wu,

Zheng

et al. 2023

Front. Cardiovasc. Med.

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BackgroundPeriodontitis (PD) and cardiovascular diseases (CVD) rank among the most prevalent pathologies worldwide, and their correlation has been a subject of prolonged investigation. Numerous studies suggest shared etiological factors; however, a definitive causal connection remains unestablished. The objective of this study was to employ bibliometric and visual analyses in order to comprehensively examine the overarching characteristics, focal areas of research, and prospective trends pertaining to the PD-CVD relationship.MethodsWe sourced articles, reviews, and online publications on PD- and CVD- research from the Web of Science Core Collection (WoSCC) spanning from January 1, 1993, to May 15, 2023. A triad of analytical tools (R-Bibliometrix, VOSviewer 1.6.19, and CiteSpace 6.2.R3) were utilized to facilitate collaboration network analysis, co-citation analysis, co-occurrence analysis, and citation burst detection.ResultsOut of the 1,116 publications that fulfilled the eligibility criteria in the WoSCC database, the comprehensive characteristics analysis divulged a sustained growth trend in publication frequency. In the cluster analysis of reference co-citation and keyword co-occurrence, prominent themes such as “periodontitis”, “cardiovascular diseases”, “inflammation”, “Porphyromonas gingivalis”, and “atherosclerosis” consistently emerged. Contemporary topics such as “peri-implantitis,” “COVID-19”, “cardiovascular risk factors,” and “endocarditis” were pinpointed as burgeoning research hotspots.ConclusionBased on this bibliometric study, in the field of association studies between PD and CVD, the etiologic mechanisms of both diseases have been intensively studied in the last three decades. Periodontal pathogens might serve as potential initiating factors linking PD and CVD. Inflammation may constitute a significant etiological factor shared by both diseases. Several emerging topics, such as COVID-19 and peri-implantitis, exhibit promising potential. This exhaustive overview casts light on pivotal research arenas, augmenting the field's understanding and stimulating further scholarly investigations.

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“…Patients with a history of periodontitis may therefore be more vulnerable to COVID-19 exacerbations. [4][5] COVID-19 and Oral Microorganisms Michael J. Cox and colleagues 6 emphasized the significance of co-infections in COVID-19 outcomes, raising an overlooked aspect-oral bacteria's potential role in facilitating these co-infections. Poor oral hygiene, recognized as a catalyst for oral dysbiosis, increases pathogenic bacteria prevalence.…”

Section: Covid-19 and It's Impact On Periodontal Healthmentioning

confidence: 99%

The pandemic’s bite – Exploring relationship between periodontitis and COVID-19

Joshi,

Aamir,

Shukla

et al. 2024

JOHS

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The outbreak of the COVID-19 pandemic has significantly reshaped the medical management landscape, spotlighting interconnections between systemic health and oral well-being. This review article delves into the multifaceted relationship between COVID-19 and periodontal disease, exploring the intricate ways in which this viral infection has influenced the prevalence, progression, and management of gum health. We embark on an in-depth analysis of the bidirectional partnership between COVID-19 and periodontal disease, elucidating how the viral infection might exacerbate pre-existing periodontal conditions and how periodontal health might impact the severity and outcomes of COVID-19 infections. By comprehensively examining emerging research, we uncover the potential mechanisms underpinning this relationship, from inflammatory pathways to immune responses, providing insights into the biological crosstalk between COVID-19 and periodontal health. Moreover, this review navigates through the implications of the pandemic on oral healthcare delivery, discussing the challenges faced in accessing dental services, altered oral hygiene practices, and the paradigm shift in preventive and therapeutic approaches for managing periodontal disease in COVID-19 era.

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Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence

Cited by 7 publications

References 131 publications

Oral and systemic health: is there a “new” link with COVID-19?

Oral and systemic health: is there a “new” link with COVID-19?

Bibliometric research on analysis of links between periodontitis and cardiovascular diseases

The pandemic’s bite – Exploring relationship between periodontitis and COVID-19

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