口腔健康在SARS-CoV-2感染及严重程度中的作用：一项回顾性病历审查

The Role of Oral Health in the Acquisition and Severity of SARS-CoV-2: A Retrospective Chart Review.

作者信息

Wadhwa S, Dave S, Daily M L, Nardone A, Li R, Rosario J, Cantos A, Shah J, Lu H H, McMahon D J, Yin M T

机构信息

Division of Growth and Development, Columbia University College of Dental Medicine, New York, NY, USA.

Department of Medicine Infectious Disease, Columbia University Irving Medical Center, New York, NY, USA.

出版信息

Saudi Dent J. 2022 Nov;34(7):596-603. doi: 10.1016/j.sdentj.2022.08.001. Epub 2022 Aug 12.

DOI:10.1016/j.sdentj.2022.08.001

PMID:35974970

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9371763/

Abstract

OBJECTIVE

Studies have shown that gingival crevices may be a significant route for entry. However, the role of oral health in the acquisition and severity of COVID-19 is not known.

DESIGN

A retrospective analysis was performed using electronic health record data from a large urban academic medical center between 12/1/2019 and 8/24/2020. A total of 387 COVID-19 positive cases were identified and matched 1:1 by age, sex, and race to 387 controls without COVID-19 diagnoses. Demographics, number of missing teeth and alveolar crestal height were determined from radiographs and medical/dental charts. In a subgroup of 107 cases and controls, we also examined the rate of change in alveolar crestal height. A conditional logistic regression model was utilized to assess association between alveolar crestal height and missing teeth with COVID-19 status and with hospitalization status among COVID-19 cases.

RESULTS

Increased alveolar bone loss, OR = 4.302 (2.510 - 7.376), fewer missing teeth, OR = 0.897 (0.835-0.965) and lack of smoking history distinguished COVID-19 cases from controls. After adjusting for time between examinations, cases with COVID-19 had greater alveolar bone loss compared to controls (0.641 ± 0.613 mm vs 0.260 ± 0.631 mm, p < 0.01.) Among cases with COVID-19, increased number of missing teeth OR = 2.1871 (1.146- 4.174) was significantly associated with hospitalization.

CONCLUSIONS

Alveolar bone loss and missing teeth are positively associated with the acquisition and severity of COVID-19 disease, respectively.

摘要

目的

研究表明牙龈沟可能是一个重要的病毒侵入途径。然而，口腔健康在新冠病毒感染及其严重程度方面所起的作用尚不清楚。

设计

利用一家大型城市学术医疗中心在2019年12月1日至2020年8月24日期间的电子健康记录数据进行回顾性分析。共识别出387例新冠病毒阳性病例，并按年龄、性别和种族与387例未确诊新冠病毒的对照进行1:1匹配。从X光片和医疗/牙科图表中确定人口统计学信息、缺牙数量和牙槽嵴高度。在107例病例和对照的亚组中，我们还检查了牙槽嵴高度的变化率。采用条件逻辑回归模型评估牙槽嵴高度和缺牙情况与新冠病毒感染状态以及新冠病毒感染病例住院状态之间的关联。

结果

牙槽骨吸收增加（比值比=4.302，95%置信区间2.510 - 7.376）、缺牙较少（比值比=0.897，95%置信区间0.835 - 0.965）以及无吸烟史可将新冠病毒感染病例与对照区分开来。在调整检查间隔时间后，新冠病毒感染病例的牙槽骨吸收比对照更严重（0.641±0.613毫米对0.260±0.631毫米，p<0.01）。在新冠病毒感染病例中，缺牙数量增加（比值比=2.1871，95%置信区间1.146 - 4.174）与住院显著相关。