Is periodontitis patient more susceptible to severe forms of Covid-19?-An evidence based review
Gopika G Nair, Sharath K Shetty, Arjumand Farooqui, Santosh Martande, Anita Kulloli, D Gopalakrishnan
Periodontitis is an immuno-inflammatory disorder that can cause destruction of the teeth supporting structures. In periodontitis, the periodontal ligament cells, gingival fibroblasts and epithelial cells produce prion flammatory mediators such as interleukin-1 beta, interleukin-6, interleukin-8, prostaglandin-E2, tumor-necrosis factor alpha that can cause alteration of the innate and adaptive immune responses at the periodontal sites. They help in regulating the synthesis and secretion of matrix-metalloproteinases and receptor-activator-of-NF-kappa B-ligand which leads to soft tissue and bone loss. An outbreak of coronavirus disease (COVID-19) was observed in China on December 2019. COVID-19 has been reported to exhibit a “cytokine storm” which points a possibility for an increased level of neutrophil extracellular traps, common with the cytokine expression profile of periodontitis. Oral cavity shows an abundant expression of angiotensin- converting enzyme 2 which has also been noted in COVID-19 free patients with periodontal disease in cell types such as fibroblasts, osteoblasts and osteoclasts involved in the bone and soft tissue remodeling around teeth and implants. Gingival crevicular fluid and saliva has proven track record for evaluating the presence of the viral shedding. Several risk factors such as age, gender, smoking, diabetes, obesity, and pathogenic microbes are shared between COVID-19 and periodontal disease.Therefore, from the literature evidence the conclusion drawn is that there can be a possible link between severity of periodontitis and severity of COVID-19 manifestations.
Gopika G Nair, Sharath K Shetty, Arjumand Farooqui, Santosh Martande, Anita Kulloli, D Gopalakrishnan. Is periodontitis patient more susceptible to severe forms of Covid-19?-An evidence based review. International Journal of Multidisciplinary Research and Development, Volume 8, Issue 10, 2021, Pages 35-40