Association Between Periodontitis and SARS-CoV-2 Infection Severity: A Cross-Sectional Study in a Turkish Population

Purpose: The aim of the present study was to evaluate the association between periodontitis and SARS-CoV-2 infection severity in a Turkish population.
Methods: Adult patients attending hospital consultation and testing positive for SARS-CoV-2 infection were consecutively enrolled in this study. Demographic variables, smoking status, COVID-19 symptoms, SpO2 levels, and markers of inflammation (D-Dimer, lymphocytes and white blood cells count, CRP) were recorded. Patients suspected of periodontal disease were evaluated using self-reported questionnaires (OHIP-14, modified CDC/AAP questionnaire). Periodontal screening score (PESS) was calculated from the questionnaire. Univariate and multivariate logistic regression analyses were performed to evaluate the association between COVID-19-associated parameters and periodontitis.
Results: The study included 134 patients diagnosed with COVID-19. Nearly half of the participants were female (n = 68, 50.7%), and the mean age of the patients was 48.7 ± 18.2 years. A statistically significant majority of individuals (69.2%) were asymptomatic, while 22.3% experienced mild symptoms, and 8.5% reported moderate or severe symptoms. Oxygen saturation was found to be higher in asymptomatic patients (96.4 ± 2.8) compared to mild (90.4 ± 5.1) and moderate/severe patients (86.6 ± 8.9) (P 0.001). There was no statistically significant difference concerning OHIP-14 score (P = 0.316), periodontitis (PESS ≥ 5) (P = 0.130), brushing habits (P = 0.901), and frequency of dental visits (P = 0.975) when considering SARS-CoV-2 infection severity. In multivariate logistic regression analysis, it was concluded that male gender (OR = 2.90, 95% CI: 1.04–8.04, P = 0.040), age 55 and above (OR = 5.94, 95% CI: 1.22–28.76, P = 0.026), and smoking (OR = 0.14, 95% CI: 0.02–0.75, P = 0.022) were statistically significant predictors of SARS-CoV-2 infection severity.
Conclusions: Even the association between SARS-CoV-2 infection severity and periodontitis, evaluated through self-reported outcome measures, were weak: male gender, age, and smoking were independent risk factors for SARS-CoV-2 infection severity in this patient cohort. Further research is warranted to explore these associations comprehensively.