Poor oral health status and adverse COVID-19 outcomes: A preliminary study in hospitalized patients.

Abstract

BackgroundMost of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID‐19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID‐19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID‐19 patients and their associations with the incidence of adverse COVID‐19 outcomes.MethodsWe included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID‐19 in this prospective observational study. Dental and periodontal status was assessed using in‐hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID‐19 symptoms, and hospitalization endpoints were tested using chi‐square test and incidence rate ratio (IRR) estimation using a generalized linear model with log‐Poisson regression. The regression models used a block‐wise selection of predictors for oral health‐related variables, comorbidities, and patients’ ages.ResultsOverall, poor oral health conditions were highly prevalent and associated with critical COVID‐19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07–1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44–4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12‐3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission.ConclusionThere was a positive association between deleterious oral health‐related conditions, especially periodontitis, and severe COVID‐19 outcomes in hospitalized COVID‐19 patients.