Direct association between periodontal disease and Covid-19-related outcomes, finds PGI Study

The study, experts said, is the first of its kind to elucidate on the basis of clinical evidence and by the usage of state-of-the-art MMP-8 based point-of-care diagnostics, the association between active gum disease and poorer Covid -19 related adverse outcomes.

The periodontics unit of Oral Health Sciences Centre, in collaboration with the Department of Internal Medicine, Department of Anaesthesia and Department of Virology, PGI, Chandigarh, has carried out a study to determine the clinical association of Periodontitis and Covid-19.

The study, experts said, is the first of its kind to elucidate on the basis of clinical evidence and by the usage of state-of-the-art MMP-8 based point-of-care diagnostics, the association between active gum disease and poorer Covid -19 related adverse outcomes.

In a cohort of 82 Covid-19 positive patients, it was found that people who had gum disease had a seven-fold increased risk of requiring assisted ventilation, 36 times more likely of being admitted to a hospital, ran a four-fold increased risk of suffering from Covid-19 pneumonia and were 14 times more likely to die, as compared to patients without gum diseases.

The study was carried out under the supervision of Professor and Head of Oral Health Sciences Centre, Krishan Gauba. Among other authors, Dr Shipra Gupta, Dr Ritin Mohindra, Dr Mohita Singla, Dr Sagar Khera, Mr Roop Kishor Soni, Dr Poonam Kanta, Dr Kapil Goyal, and Dr Mini P Singh played an important role in bringing the research to fruition.

Dr Shipra Gupta’s research group is the first in the world to have pioneered, on the basis of clinical evidence, the association between active gum disease and Covid-19 related adverse outcomes. The study, which was published in Clinical Oral Investigations Journal, is part of a continuous research process which her group has been involved in. Earlier, they were the first in the world to report the detection of the SARS CoV-2 virus, in gingival crevicular fluid, a substance emanating from around the gums. The discovery went on to be published in the Journal of Dental Research, one of the most prestigious journals in the field of dentistry and gave further credence to the theory of a link between oral health and Covid-19, as well as established another means of entry and transmission for the virus.

Periodontal disease, explained Dr Gupta, is a significant contributor to the pathophysiology of a number of systemic conditions, including respiratory illnesses. Several hypotheses have pointed towards the possibility of a link between periodontal disease and Covid-19. As convincing as it may seem, there remains a lack of actual clinical evidence to support the claims of oral health being related to the Covid disease process. The latest published report from Dr. Gupta’s ongoing research has laid such doubts to rest by confirming an association between gum disease and Covid-19 related outcomes on the basis of robust scientific evidence.

“It is established that a number of comorbidities, such as diabetes mellitus, obesity and those affecting the cardiovascular and respiratory systems, do play a significant role in determining the prognosis of Covid-19. At the same time, it is also well established in literature that periodontal disease has definitive links to these chronic disease processes and is a bonafide part of their overall pathophysiological presentation. Hence, gum diseases may eventually influence Covid-19 outcomes in both a direct and an indirect manner,” Dr Gupta said.

“Seeing that periodontal disease predominantly stems from bacterial interactions with the host, the maintenance of oral hygiene assumes greater importance in the face of this novel entity,” summed up
Dr Gupta.

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