The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis

Sadeq Ali Al-Maweri; Mohammed Nasser Alhajj; Esam Halboub; Faleh Tamimi; Nosizana Mohd Salleh; Mohammed Sultan Al-Ak'hali; Saba Kassim; Saleem Abdulrab; Lamyia Anweigi; Marwan Mansoor Ali Mohammed

doi:10.1186/s12903-023-03378-0

The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis

BMC Oral Health. 2023 Sep 9;23(1):658. doi: 10.1186/s12903-023-03378-0.

Authors

Affiliations

¹ College of Dental Medicine, QU Health, Qatar University, Doha, Qatar. Sadali05@hotmail.com.
² Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia.
³ Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen.
⁴ Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
⁵ College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
⁶ Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
⁷ Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.
⁸ Al Khor Health Center, Primary Health Care Corporation, Doha, Qatar.
⁹ Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Abstract

Background: A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes.

Materials and methods: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15^th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software.

Results: A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001).

Conclusions: The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.

Keywords: Association; COVID-19 outcomes; Periodontal disease; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / complications
Europe
Hospitalization
Humans
Periodontal Diseases* / complications
Prospective Studies