The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis

Abstract

Background A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. Materials and methods PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. Results A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). Conclusions The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

Unraveling the Link between Periodontitis and Coronavirus Disease 2019: Exploring Pathogenic Pathways and Clinical Implications

“…However, the shadows of uncertainty loom large concerning the long-term impacts, emphasizing the need for further, extensive research in this domain [47,48]. On the other hand, a systematic review and meta-analysis of 22 studies involving 92,535 patients from different regions found a significant association between periodontitis and adverse COVID-19 outcomes [49]. Patients with periodontitis are at higher risk for severe COVID-19 symptoms, ICU hospitalization, and death.…”

“…Severe periodontitis is particularly associated with worse outcomes than mild periodontitis. However, due to methodological differences between studies, further standardized studies are needed to fully understand the relationship between periodontal health and COVID-19 outcomes [49]. The human microbiota encompasses a diverse range of microbial communities residing within the host, including bacteria, viruses, fungi, and protozoans.…”

Patients’ knowledge about dental emergencies, COVID-19 transmission, and required preparations in dental settings

“…Patients face the critical task of distinguishing between urgent and non-urgent dental care needs and must make informed decisions about seeking treatment [ 6 ]. While forgoing a dentist visit during a dental emergency can jeopardize oral health, unnecessary visits for non-emergency conditions may increase the risk of COVID-19 infection and negatively impact overall health [ 7 ].…”