Interactive Effects of COVID-19 Infection and Psychological Factors on Oral Health-Related Quality of Life in Myanmar.

BACKGROUND

The complex association between COVID-19 and psychological factors may significantly impact oral health, including oral health-related quality of life (OHRQoL). Despite their interconnected nature, literature regarding their collective impact on OHRQoL is limited.

OBJECTIVE

This study aims to assess the independent and interactive effects of COVID-19 infection and psychological factors on OHRQoL.

MATERIALS AND

METHODS

The cross-sectional study included 158 participants from a health centre in Yangon city. Participants were categorised into three groups based on their COVID-19 infection history, hospitalisation and oxygen supply: 'not experienced', 'experienced, non-hospitalised' and 'experienced, hospitalised'. Validated instruments, including Depression, Anxiety and Stress Scale-21 (DASS-21) to measure emotional states and the Oral Health Impact Profile-14 (OHIP-14) to assess OHRQoL, were employed. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, linear regressions and interaction analysis were computed.

RESULTS

The median OHIP-14 score was 7.2. Among 85 confirmed COVID-19 cases, 38.8% (n = 33) received hospitalisation and oxygen supply. Multivariable regression analysis identified 'experienced, hospitalised' (95% CI: 6.36, 11.76), difficulty falling asleep (95% CI: 2.65, 7.18), depressive symptoms (95% CI: 7.38, 12.44), anxiety symptoms (95% CI: 2.93, 7.52) and stress symptoms (95% CI: 4.55, 11.11) as predictors of OHIP-14. Interaction analysis revealed their associations varied by hospitalisation history. In non-hospitalised individuals, depressive symptoms were positively interacted with OHRQoL (95% CI: 1.34, 9.02). Significant associations were observed between 'experienced, hospitalised' × 'depressive, anxiety and stress symptoms' and OHRQoL in both univariable and multivariable analyses.

CONCLUSION

A COVID-19 infection history and psychological distress significantly affect OHRQoL in Myanmar participants. Moreover, a strong interactive association was observed between hospitalisation during infection and symptoms of psychological distress.