Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study.
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Bemquerer Larissa Marques, Oliveira Sicília Rezende, de Arruda José Alcides Almeida, Costa Fernanda Pereira Delgado, Miguita Lucyene, Bemquerer Ana Luisa Marques, de Sena Ana Carolina Velasco Pondé, de Souza Alessandra Figueiredo, Mendes Daniel Fajardo, Schneider Ayda Henriques, Azevedo Michelle de Campos Soriani, Travassos Denise Vieira, Garlet Gustavo Pompermaier, Cunha Fernando de Queiroz, de Aguiar Renato Santana, de Souza Renan Pedra, Gomez Ricardo Santiago, Spahr Axel, Obregon-Miano Fabian, Abreu Lucas Guimarães, Costa Fernando Oliveira, Silva Tarcília Aparecida
Аннотация
METHODS: Case (positive RT-PCR for SARS-CoV-2) and control (negative RT-PCR) individuals underwent clinical and periodontal assessments. Salivary levels of TNF-α, IL-6, IL-1β, IL-10, OPG, RANKL, neutrophil extracellular traps, and subgingival biofilm were analyzed at two timepoints. Data on COVID-19-related outcomes and comorbidity information were evaluated from medical records.
RESULTS: Ninety-nine cases of COVID-19 and 182 controls were included for analysis. Periodontitis was associated with more hospitalization (p = 0.009), more days in the intensive care unit (ICU) (p = 0.042), admission to the semi-ICU (p = 0.047), and greater need for oxygen therapy (p = 0.042). After adjustment for confounders, periodontitis resulted in a 1.13-fold increase in the chance of hospitalization. Salivary IL-6 levels (p = 0.010) were increased in individuals with COVID-19 and periodontitis. Periodontitis was associated with increased RANKL and IL-1β after COVID-19. No significant changes were observed in the bacterial loads of the periodontopathogens Porphyromona gingivalis, Aggregatibacter actinomycetemcomitans, Tanerella forsythia, and Treponema denticola.
CONCLUSIONS: Periodontitis was associated with worse COVID-19 outcomes, suggesting the relevance of periodontal care to reduce the burden of overall inflammation. Understanding the crosstalk between SARS-CoV-2 infection and chronic conditions such as periodontitis that can influence disease outcome is important to potentially prevent complications of COVID-19.