The clinical association between Periodontitis and COVID-19

Shipra Gupta, Ritin Mohindra, Mohita Singla, Sagar Khera, Vaibhav Sahni, Poonam Kanta, Roop Kishor Soni, Amit Kumar, Krishan Gauba, Kapil Goyal, Mini P Singh, Arnab Ghosh, Kamal Kajal, Varun Mahajan, Ashish Bhalla, Timo Sorsa, Ismo Räisänen, Shipra Gupta, Ritin Mohindra, Mohita Singla, Sagar Khera, Vaibhav Sahni, Poonam Kanta, Roop Kishor Soni, Amit Kumar, Krishan Gauba, Kapil Goyal, Mini P Singh, Arnab Ghosh, Kamal Kajal, Varun Mahajan, Ashish Bhalla, Timo Sorsa, Ismo Räisänen

Abstract

Objectives: The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes.

Material and methods: Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed.

Results: Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests.

Conclusions: Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner.

Clinical relevance: The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care.

Keywords: COVID-19; Comorbidities; Dental; Diagnostics; Matrix metalloproteinases; Oral health; Oral hygiene; Periodontal; Periodontics; Periodontitis; Prevention; SARS-CoV-2; Ventilation.

Conflict of interest statement

T. Sorsa is the inventor of US-patents 5652223, 5736341, 5866432, 6143476, 2017/0023571A1 (granted 6.6.2019), WO2018/060553A1 (granted 31.5.2018), 10488415B2, and a Japanese patent 2016-554676.

The authors declare that they have no conflict of interest.

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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