Periodontal disease increases the host susceptibility to COVID-19 and its severity: a Mendelian randomization study

Abstract

Background Emerging evidence shows that periodontal disease (PD) may increase the risk of Coronavirus disease 2019 (COVID-19) complications. Here, we undertook a two-sample Mendelian randomization (MR) study, and investigated for the first time the possible causal impact of PD on host susceptibility to COVID-19 and its severity. Methods Summary statistics of COVID-19 susceptibility and severity were retrieved from the COVID-19 Host Genetics Initiative and used as outcomes. Single nucleotide polymorphisms associated with PD in Genome-wide association study were included as exposure. Inverse-variance weighted (IVW) method was employed as the main approach to analyze the causal relationships between PD and COVID-19. Three additional methods were adopted, allowing the existence of horizontal pleiotropy, including MR-Egger regression, weighted median and weighted mode methods. Comprehensive sensitivity analyses were also conducted for estimating the robustness of the identified associations. Results The MR estimates showed that PD was significantly associated with significantly higher susceptibility to COVID-19 using IVW (OR = 1.024, P = 0.017, 95% CI 1.004–1.045) and weighted median method (OR = 1.029, P = 0.024, 95% CI 1.003–1.055). Furthermore, it revealed that PD was significantly linked to COVID-19 severity based on the comparison of hospitalization versus population controls (IVW, OR = 1.025, P = 0.039, 95% CI 1.001–1.049; weighted median, OR = 1.030, P = 0.027, 95% CI 1.003–1.058). No such association was observed in the cohort of highly severe cases confirmed versus those not hospitalized due to COVID-19. Conclusions We provide evidence on the possible causality of PD accounting for the susceptibility and severity of COVID-19, highlighting the importance of oral/periodontal healthcare for general wellbeing during the pandemic and beyond.

Covid‐19 and SARS‐CoV‐2 infection in periodontology: A narrative review

“… 42 Wang et al evidenced that periodontal disease was significantly associated with higher susceptibility to Covid‐19 and the disease severity. 43 In this study, periodontal disease was characterized as periodontitis related‐Socransky phenotype, suggesting a high correlation and positive loading with pathogens, including P. gingivalis , P. intermedia , P. nigrescens , T. forsythus , T. denticola , F. nucleatum and C. rectus . 44 …”

Association between periodontitis and COVID-19 infection: a two-sample Mendelian randomization study

“…Here, we present evidence that periodontitis and GCF IL-1 β are COVID-19 risk factors. A newly published study has also explored the causal relationship between periodontitis and COVID-19 based on MR methods and reached the same conclusion that there is a causal association between periodontitis and COVID-19 ( Wang et al, 2021 ). However, in this study, we further explored the causal effects of periodontitis-related phenotypes, including PCT3, PCT5 and inflammatory indicators IL-1 β on COVID-19, and obtained the causal association of IL-1 β in gingival crevicular fluid on COVID-19.…”

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

“…A correlation between periodontitis and COVID-19 has already been stated in several studies from hypotheses to clinical studies and reviews [ 18 , 19 , 20 , 21 , 22 ]. A cytokine response has long been recognized to play a role in the pathogenesis of periodontitis [ 23 ].…”