Nature of the Interplay Between Periodontal Diseases and COVID-19

Cai, Wenji; Marouf, Nadya; Said, Khalid N.; Tamimi, Faleh

doi:10.3389/fdmed.2021.735126

Cited by 7 publications

(6 citation statements)

References 132 publications

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“…Last, the strong impact of systemic comorbidities in the association between severe COVID-19 and periodontitis may point at some background determinant of vulnerability. A common genetic predisposition to both periodontitis and severe COVID-19 has been advanced by Cai et al (2021), who identified shared genetic phenotypes mainly involving microbial recognition pattern molecules and drivers of inflammation, such as CD26, HLA, and GSTT1-M1. Beyond genes, it cannot be excluded that both severe COVID-19 and periodontitis may occur as 2 pleiotropic outcomes of a gero-vulnerable condition underpinned by high chronic inflammation and immunosenescence (Baima et al 2022).…”

Section: Biological Plausibility: Unraveling the Immune-inflammatory ...mentioning

confidence: 99%

Periodontitis and COVID-19: Biological Mechanisms and Meta-analyses of Epidemiological Evidence

et al. 2022

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Since the beginning of 2020, the entire global health care system has been severely challenged by the outbreak of coronavirus 2019 disease (COVID-19). Robust evidence has demonstrated a more severe course of COVID-19 in the presence of several comorbidities, such as cardiovascular diseases, diabetes mellitus, and obesity. Here, we critically appraise the recent research discoveries linking periodontitis to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to severe COVID-19, with a special focus on the associated biological mechanisms and the available epidemiological evidence. SARS-CoV-2 main receptors and coreceptors (ACE2, TMPRSS2, furin, CD147) are overexpressed in periodontal tissues of periodontitis patients, with inflammation, periodontal pathogens, and damage-induced pyroptosis triggering a positive feedback loop. However, meta-analyses of epidemiological studies only indicated a nonstatistically significant tendency for an increased risk of SARS-CoV-2 infection in subjects with periodontitis (odds ratio [OR] = 1.69; 95% CI, 0.91–3.13, P = 0.09). Furthermore, periodontitis may worsen clinical COVID-19 courses through multiple direct and indirect pathways, including damage to lower airways due to aspiration of periodontal pathogens, exacerbation of the cytokine storm via the low-grade chronic systemic inflammation, and SARS-CoV-2 dissemination through the ulcerated gingival epithelium with consequent induced pulmonary vessels vasculopathy. Indeed, meta-analyses of epidemiological studies indicated that periodontitis subjects are more likely to experience a more severe course of COVID-19. Specifically, periodontitis was associated with a 4-fold increased odds of hospitalization (OR = 4.72; 95% CI, 1.11–20.03, P = 0.04), 6-fold of requiring assisted ventilation (OR = 6.24; 95% CI, 2.78–14.02, P = 0.00), and more than 7-fold of death due to COVID-19 complications (OR = 7.51; 95% CI, 2.16–26.10, P = 0.00). The breakthrough analyzed here emphasizes the relevance of the mouth-systemic connection as a target to mitigate the current COVID-19 emergency and the future predicted coronavirus pandemics.

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Section: Biological Plausibility: Unraveling the Immune-inflammatory ...mentioning

confidence: 99%

Periodontitis and COVID-19: Biological Mechanisms and Meta-analyses of Epidemiological Evidence

et al. 2022

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“…The target of SARS-CoV-2 infection is cells in the respiratory tract, where Protein S in SARS-CoV-2 will bind to (angiotensin-converting enzyme 2 (ACE2) as the receptor [7]. ACE2 is found in pulmonary epithelial cells, myocardial cells, gastrointestinal system, proximal cells of renal tubules, arterial smooth muscle cells, and oral epithelial cells, where the expression of ACE2 will increase in patients with certain conditions, such as, in elderly individuals, obesity, kidney disease, and lung disease that results in individuals with the condition being more susceptible to the transmission of COVID-19 [8][9][10]. The SARS-CoV-2 virus will replicate, and the virus that has entered the body will be presented by antigens-presenting cells (APCs) and will induce T cells and B cells as humoral and cellular immune responses [11].…”

Section: Covid-19 and Periodontal Diseasementioning

confidence: 99%

Management of Periodontal Emergency during COVID-19 Pandemic

Fidyawati¹,

Wicaksono²,

Primasari³

et al. 2023

Dentistry

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The novel coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus presents with nonspecific symptoms such as fever, dry cough, shortness of breath, weakness, headache, and diarrhea. The primary mode of transmission of SARS-CoV-2 is through direct or indirect inoculation of the mucous membranes (eyes, nose, or mouth) with infectious respiratory droplets or fomites. Periodontal tissue can serve as a barrier to the SARS-CoV-2 virus in infected individuals. There are similarities between COVID-19 and periodontal disease, based on pro-inflammatory cytokines released by the body. A periodontal emergency arises when an acute condition involving the periodontium causes pain, forcing the patient to seek urgent care; therefore, most periodontal treatment can be considered as dangerous work compared to other dental procedures regarding the aspect of bioaerosol generation procedure. Transmission can occur through direct doctor-patient contact, as well as contamination from instruments or surfaces in the dentist’s practice room, and it is recommended to use PPE, to avoid aerosol splashes that occur during the work procedure, where aerosol granules and droplets can last 30 minutes after the treatment procedure is performed. The use of teledentistry is very important in periodontal care, in communication with patients regarding chief compliant, risk factor control, and oral hygiene instruction.

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“…AP is characterised by increased serum levels of immunoglobulin (Ig)A, IgG, and IgM, 17 whilst periodontitis is characterised by increased levels of ferritin and d -dimer. 28 Given the links between AP and periodontitis, in this study we also investigated possible synergies between these 2 conditions in COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Severity in Patients With Apical Periodontitis: A Case Control Study

Marouf,

Ba-Hattab,

Al-Sheeb

et al. 2024

International Dental Journal

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Nature of the Interplay Between Periodontal Diseases and COVID-19

Cited by 7 publications

References 132 publications

Periodontitis and COVID-19: Biological Mechanisms and Meta-analyses of Epidemiological Evidence

Periodontitis and COVID-19: Biological Mechanisms and Meta-analyses of Epidemiological Evidence

Management of Periodontal Emergency during COVID-19 Pandemic

COVID-19 Severity in Patients With Apical Periodontitis: A Case Control Study

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