Dear Editors,
We concur with the observations of Mauer et al. [1] addressing the comparative analysis of risks of hospitalization, clinical outcomes and death due to SARS-CoV-2 in patients hospitalized in Lombardy. Affordable precision/personalized medicine which combines the patients clinical data with lab-on-a-chip biomarkers, imaging and point-of-care diagnostics is the way forward if we want to dispense quality care to patients. Among real time monitoring of COVID-19 related risk diseases, it is pertinent to monitor oral and periodontal health, when we take into perspective the probability of poor gum health contributing to the COVID-19 related hospitalization and other adverse outcomes [2–4].
Sufficient evidence in literature underscores the importance of oral health, with emphasis on the prevention and treatment of periodontitis, linking it with many systemic diseases, and now with COVID-19 [3–5]. The same is suggested by the sample of 78 COVID-19 positive (delta variant) patients from India among whom patients with periodontitis were significantly more likely to need hospital admission, assisted ventilation or have COVID-19 related pneumonia than the periodontally healthy patients (p < 0.05; Table 1) [3]. Further studies are warranted to address the effect of oral and periodontal health on hospitalization and death due to other COVID-19 variants.
TABLE 1
| Healthy | Gingivitis | Periodontitis | p-valuea | |
|---|---|---|---|---|
| Home isolation | 16a | 12a | 0b | <0.001 |
| Hospital admission (Ward + ICU) | 11a | 9a | 30b | |
| COVID-19 related pneumonia: Yes | 3a | 4a,b | 14b | 0.007 |
| COVID-19 related pneumonia: No | 24a | 17a,b | 16b | |
| Assisted ventilation required | 3a | 5a | 21b | <0.001 |
| Assisted ventilation not required | 24a | 16a | 9b |
Association between Periodontal disease status (Healthy, Gingivitis, Periodontitis) and Hospital admission, COVID-19 related pneumonia and assisted ventilation among 78 Indian COVID-19 positive patients (India, 2021).
Pearson Chi-Square (Exact Sig. 2-sided).
Each superscript letter denotes a subset of periodontal disease status groups whose column proportions do not differ significantly from each other measured by pairwise Z-tests (Bonferroni corrected) at the 0.05 level.
Statements
Ethics Statement
The studies involving human participants were reviewed and approved by the Postgraduate Institute of Medical Education and Research, Chandigarh, India Institutional Ethics Committee (INT/IEC/2021/SPL-636). The patients/participants provided their written informed consent to participate in this study.
Author Contributions
SG contributed to conceptualization, data curation, analysis and writing-original draft. Analysis and writing-review and editing was done by IR and TS. SG has directly accessed and verified the data reported in the manuscript.
Funding
This work was carried out as a part of routine COVID-19 diagnostic activity of the Regional Virus Diagnostic Laboratory under ICMR New Delhi, by the Department of Virology, PGIMER, Chandigarh.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
1
Mauer N Chiecca G Carioli G Gianfredi V Iacoviello L Bertagnolio S et al The First 110, 593 COVID-19 Patients Hospitalised in Lombardy: A Regionwide Analysis of Case Characteristics, Risk Factors and Clinical Outcomes. Int J Public Health (2022) 67:1604427. 10.3389/ijph.2022.1604427
2
Sorsa T Sahni V Buduneli N Gupta S Räisänen IT Golub LM et al Active Matrix Metalloproteinase-8 (aMMP-8) point-of-care Test (POCT) in the COVID-19 Pandemic. Expert Rev Proteomics (2021) 18(8):707–17. Epub 2021 Sep 11. PMID: 34468272; PMCID: PMC8442753. 10.1080/14789450.2021.1976151
3
Gupta S Mohindra R Singla M Khera S Sahni V Kanta P et al The Clinical Association between Periodontitis and COVID-19. Clin Oral Investig (2022) 26(2):1361–74. 10.1007/s00784-021-04111-3
4
Gupta S Saarikko M Pfützner A Räisänen IT Sorsa T . Compromised Periodontal Status Could Increase Mortality for Patients with COVID-19. Lancet Infect Dis (2022) 22(3):314. 10.1016/S1473-3099(22)00065-2
5
Genco RJ Sanz M . Clinical and Public Health Implications of Periodontal and Systemic Diseases: An Overview. Periodontol 2000 (2020) 83(1):7–13. 10.1111/prd.12344
Summary
Keywords
COVID-19, oral health, death, prevention, ventilation
Citation
Gupta S, Räisänen IT and Sorsa T (2022) Periodontitis as a Risk of Hospitalization and Death by SARS-CoV-2. Int J Public Health 67:1605156. doi: 10.3389/ijph.2022.1605156
Received
22 June 2022
Accepted
22 July 2022
Published
31 August 2022
Volume
67 - 2022
Edited by
Olaf Von Dem Knesebeck, University Medical Center Hamburg-Eppendorf, Germany
Updates
Copyright
© 2022 Gupta, Räisänen and Sorsa.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Timo Sorsa, timo.sorsa@helsinki.fi
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