{Reference Type}: Journal Article
{Title}: Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study.
{Author}: Bemquerer LM;Oliveira SR;de Arruda JAA;Costa FPD;Miguita L;Bemquerer ALM;de Sena ACVP;de Souza AF;Mendes DF;Schneider AH;Azevedo MCS;Travassos DV;Garlet GP;Cunha FQ;de Aguiar RS;de Souza RP;Gomez RS;Spahr A;Obregon-Miano F;Abreu LG;Costa FO;Silva TA;
{Journal}: Odontology
{Volume}: 112
{Issue}: 1
{Year}: Jan 2024 14
{Factor}: 2.885
{DOI}: 10.1007/s10266-023-00811-2
{Abstract}: <B>OBJECTIVE: </B>Periodontitis and coronavirus disease (COVID-19) share risk factors and activate similar immunopathological pathways, intensifying systemic inflammation. This study investigated the clinical, immunological and microbiological parameters in individuals with COVID-19 and controls, exploring whether periodontitis-driven inflammation contributes to worsening COVID-19 endpoints.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.