20 September 2021

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Oral health status and Covid-19 disease severity: is there a correlation?

Lara Figini

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Recently, WHO and the Centers for Disease Control and Prevention (CDC) have recognized several risk factors for COVID-19 infection, including older age, diabetes, hypertension, states of immunosuppression and cardiovascular diseases. These comorbidities are associated with the increased severity of COVID-19 disease; However, there are various other risk factors that could influence the outcomes of this disease. The oral cavity is well known as a potential reservoir for respiratory pathogens, as it hosts more than 700 bacterial species or philotypes. Viral respiratory infections predispose patients to bacterial superinfections. Severe cases of COVID-19 were found to be significantly associated with secondary bacterial infections. Additionally, several studies have linked the severity of COVID-19 disease to the high viral load of SARSCoV-2 in the nasal and oral cavity.

Materials and methods
In a cross-sectional study, published in the British Dental Journal in February 2021, the authors hypothesized that the increased severity of COVID-19 disease could be linked to poor oral health. Oral health status, COVID-19 symptoms, C-reactive protein (CRP) levels, and duration of recovery were assessed.

308 Egyptian patients with Covid-19, with confirmed positive polymerase, were included in the study after the exclusion criteria and submitted to a questionnaire. The questionnaire consisted of two sections: the first section aimed at assessing the oral health status and the second section aimed at assessing the severity of the COVID-19 disease.

Evaluation of the effect of oral health on COVID-19 disease severity was performed using an oral health score. The effect of oral health on CRP and recovery period were evaluated as secondary endpoints. COVID-19 CRP and PCR level data and tests were collected via questionnaire and confirmed by reviewing medical records.

Results
From the data of this study, it was possible to find a significant inverse correlation between oral health and severity of COVID-19 disease, as well as a significant inverse correlation between oral health and recovery period and CRP values. This shows what poor oral health is correlated with increased CRP values and a delayed recovery period. 

Conclusions
From the data from this study, which must be confirmed in other similar studies, it can be concluded that oral status may have a potential impact on the severity of COVID-19 disease.

For additional information: The impact of oral health status on COVID-19 severity, recovery period and C-reactive protein values