Department of Dentistry and Oral Health Institute, Hamad Medical Corporation, Doha, Qatar.
College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
Clin Oral Investig. 2022 Nov;26(11):6721-6732. doi: 10.1007/s00784-022-04631-6. Epub 2022 Jul 29.
In previous studies, COVID-19 complications were reported to be associated with periodontitis. Accordingly, this study was designed to test the hypothesis that a history of periodontal therapy could be associated with lower risk of COVID-19 complications.
A case-control study was performed using the medical health records of COVID-19 patients in the State of Qatar between March 2020 and February 2021 and dental records between January 2017 and December 2021. Cases were defined as COVID-19 patients who suffered complications (death, ICU admissions and/or mechanical ventilation); controls were COVID-19 patients who recovered without major complications. Associations between a history of periodontal therapy and COVID-19 complications were analysed using logistic regression models adjusted for demographic and medical factors. Blood parameters were compared using Kruskal-Wallis test.
In total, 1,325 patients were included. Adjusted odds ratio (AOR) analysis revealed that non-treated periodontitis was associated with significant risk of need for mechanical ventilation (AOR = 3.91, 95% CI 1.21-12.57, p = 0.022) compared to periodontally healthy patients, while treated periodontitis was not (AOR = 1.28, 95% CI 0.25-6.58, p = 0.768). Blood analyses revealed that periodontitis patients with a history of periodontal therapy had significantly lower levels of D-dimer and Ferritin than non-treated periodontitis patients.
Among COVID-19 patients with periodontal bone loss, only those that have not received periodontal therapy had higher risk of need for assisted ventilation. COVID-19 patients with a history of periodontal therapy were associated with significantly lower D-dimer levels than those without recent records of periodontal therapy.
The fact that patients with treated periodontitis were less likely to suffer COVID-19 complications than non-treated ones further strengthen the hypothesis linking periodontitis to COVID-19 complications and suggests that managing periodontitis could help reduce the risk for COVID-19 complications, although future research is needed to verify this.
在之前的研究中，COVID-19 的并发症被报道与牙周炎有关。因此，本研究旨在检验这样一个假设，即牙周治疗史与 COVID-19 并发症的风险较低有关。
本研究使用了 2020 年 3 月至 2021 年 2 月期间卡塔尔 COVID-19 患者的医疗健康记录和 2017 年 1 月至 2021 年 12 月期间的牙科记录进行了病例对照研究。病例定义为患有并发症（死亡、入住 ICU 和/或机械通气）的 COVID-19 患者；对照组为无重大并发症康复的 COVID-19 患者。使用逻辑回归模型，在调整人口统计学和医疗因素后，分析牙周治疗史与 COVID-19 并发症之间的关联。使用 Kruskal-Wallis 检验比较血液参数。
共纳入 1325 例患者。调整后的优势比（AOR）分析显示，与牙周健康的患者相比，未经治疗的牙周炎与需要机械通气的显著风险相关（AOR=3.91，95%CI 1.21-12.57，p=0.022），而经治疗的牙周炎则没有（AOR=1.28，95%CI 0.25-6.58，p=0.768）。血液分析显示，有牙周治疗史的牙周炎患者的 D-二聚体和铁蛋白水平明显低于未经治疗的牙周炎患者。
在患有牙周骨丧失的 COVID-19 患者中，只有未接受牙周治疗的患者有更高的辅助通气需求风险。有牙周治疗史的 COVID-19 患者的 D-二聚体水平明显低于近期无牙周治疗记录的患者。
有治疗史的牙周炎患者发生 COVID-19 并发症的可能性低于未经治疗的患者，这进一步加强了牙周炎与 COVID-19 并发症之间的关联假设，并表明管理牙周炎有助于降低 COVID-19 并发症的风险，但需要进一步研究来验证这一点。
