Impact of SARS-CoV-2 on periodontal tissue manifestation

Abstract

Coronavirus disease 19 (COVID-19) is a recent infectious disease that is rapidly spreading worldwide and targets human angiotensin-converting enzyme 2 receptors. A recent study found that COVID-19 induces immune responses resulting in periodontal manifestation. The purpose of this study was to investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on periodontal tissue. Periodontal bacteria are implicated in systemic inflammation, bacteremia, and pneumonia. Moreover, it has been shown that 80% of patients with severe COVID-19 had high bacterial load. It has also been reported that the severity of COVID-19 in patients associates with increased levels of inflammatory markers such as interleukin and bacterial invasion. Systemic increase in the inflammatory response reveals the similarity with cytokine storm in COVID-19 patients. These conditions revealed that elevated levels of cytokines detected in locally inflamed gingival tissue through saliva analysis could expand to the systemic circulation, resulting in systemic inflammation and vice versa. It is suggested that there is a possibility of periodontitis due to increased inflammatory responses in host as an impact of SARS-CoV-2 infection. Periodontal impact was seen in COVID-19 patients as localized erythema in margins of gingiva leading to desquamative gingivitis and oral pain. Although COVID-19 might manifest in periodontal tissues, presence of periodontal pathogen could pose a risk of superinfection, and periodontal pocket could be a favorable anatomical niche for the virus, the literature is still lacking to conclude that COVID-19 has an impact on periodontal tissues and more studies are needed.