The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 37689665 · doi:10.1186/s12903-023-03378-0
What was done
Authors searched PubMed, Scopus, Web of Science, and Google Scholar through April 15, 2023, for studies evaluating the association between periodontitis and COVID-19 outcomes. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 across eligible studies from the USA, Europe, Asia, the Middle East, and South America.
What was found
A total of 22 studies involving 92,535 patients were included, with 12 pooled in the meta-analysis. Periodontitis was associated with a 58% higher risk of COVID-19 infection (P = 0.00001), more severe symptoms (OR = 6.95, P = 0.0008), and ICU admissions (OR = 3.15, P = 0.0001), but not overall mortality (OR = 1.92, P = 0.21). Compared to mild periodontitis, severe periodontitis was significantly associated with severe symptoms (P = 0.02), ICU admission (P = 0.0001), and higher mortality rates (P = 0.0001).
Why it matters
This review synthesizes global evidence indicating that chronic periodontal inflammation correlates with increased COVID-19 severity and ICU utilization.
Limits
All included studies were observational, which prevents causal conclusions and leaves room for confounding by shared risk factors. Substantial methodological heterogeneity was observed across studies, confidence intervals were not reported in the abstract, and only 12 of the 22 identified studies could be pooled in quantitative meta-analysis.
Cited by
- supports Having gum disease was a risk factor for severe infection or death from COVID-19.