National Institute for Medical Research Development (NIMAD), Tehran, Iran.
Evid Based Dent. 2021 Jan;22(2):66-68. doi: 10.1038/s41432-021-0179-x.
Data sources The national electronic health records of the Hamad Medical Corporation (HMC) in the State of Qatar.Data extraction and synthesis This case-control study included 568 patients from the HMC electronic database for data eliciting from 27 February 2020 to 31 July 2020. Patients with coronavirus disease 2019 (COVID-19) complications were considered as cases. Controls were defined as COVID-19 patients without major complications (discharged). Multivariate logistic regression was performed to assess the association between the exposures (periodontitis, demographics and medical conditions) and outcomes (COVID-19 complications). The association was adjusted for possible confounding factors. Additionally, sensitivity analyses were performed to account for stronger risk factors of the determined complications. The results were reported using the odds ratio (OR) and 95% confidence intervals (CIs). Laboratory data (blood parameters concerning the course of COVID-19) were also compared between the case and control groups.Results The patients were divided into 40 cases and 528 controls. Among the patients with periodontitis, 12.8% (33/258) went through COVID-19 complications, whereas 2.2% (7/310) of those without periodontitis experienced complications. The adjusted OR of patients with periodontitis was 3.67 (95% CI 1.46-9.27) for all COVID-19 complications, 8.81 (95% CI 1.00-77.7) for death, 3.54 (95% CI 1.39-9.05) for intensive care unit admission and 4.57 (95% CI 1.19-17.4) for the need of assisted ventilation. After conducting subgroup analyses for age, diabetes and smoking, periodontitis was still significantly associated with all the outcomes. Laboratory biomarkers (haemoglobin A1c, white blood cells and C-reactive protein) had higher levels in COVID-19 patients with periodontitis than those without periodontal disease.Conclusions This study concluded that periodontitis was significantly associated with higher risks of COVID-19 complications and higher blood marker levels. These results, however, are not of high quality and further research in this regard is required.
数据来源：卡塔尔哈马德医疗公司（HMC）的国家电子健康记录。
数据提取与综合：本病例对照研究纳入了 HMC 电子数据库中的 568 名患者，数据采集时间为 2020 年 2 月 27 日至 2020 年 7 月 31 日。患有 2019 年冠状病毒病（COVID-19）并发症的患者被视为病例。对照组定义为无重大并发症（出院）的 COVID-19 患者。采用多变量逻辑回归评估暴露（牙周炎、人口统计学和医疗状况）与结局（COVID-19 并发症）之间的关联。对可能的混杂因素进行了调整。此外，还进行了敏感性分析，以考虑到确定并发症的更强风险因素。结果以比值比（OR）和 95%置信区间（CI）表示。还比较了病例组和对照组之间的实验室数据（与 COVID-19 病程相关的血液参数）。
结果：患者分为 40 例病例和 528 例对照。牙周炎患者中，12.8%（33/258）发生 COVID-19 并发症，而无牙周炎患者中，2.2%（7/310）发生并发症。患有牙周炎的患者发生所有 COVID-19 并发症的调整 OR 为 3.67（95%CI 1.46-9.27），死亡的 OR 为 8.81（95%CI 1.00-77.7），重症监护病房收治的 OR 为 3.54（95%CI 1.39-9.05），需要辅助通气的 OR 为 4.57（95%CI 1.19-17.4）。对年龄、糖尿病和吸烟进行亚组分析后，牙周炎仍与所有结局显著相关。COVID-19 患者的实验室生物标志物（糖化血红蛋白 A1c、白细胞和 C 反应蛋白）水平高于无牙周疾病的患者。
结论：本研究表明，牙周炎与 COVID-19 并发症风险增加和血液标志物水平升高显著相关。然而，这些结果质量不高，需要对此进行进一步研究。
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