Oral bacteria brews a COVID-19 storm
Dr. Scott Froum highlights the common inflammatory mediators between periodontal disease and COVID-19, suggesting that periodontal disease may be a contributing factor to and/or exacerbate the severity of COVID-19 symptoms.
Jul 8th, 2020 Scott Froum, DDS
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), leads to a life-threatening pneumonia and acute respiratory distress syndrome (ARDS). The mortality rate from COVID-19 ARDS can approach 40%–50%.1 In addition to death due to pneumonia, the virus has been found to cause a hyperinflammatory state with the release of immune modulators and mediators.2 This has been described as a “cytokine storm” that has been found to cause cardiomyopathy, disseminated blood clots, stroke via large vessel occlusion, neurologic problems, thrombosis, and multiorgan failure, including heart, kidney, and brain.3 COVID-19 illness can range from mild to severe.
Disease severity has been attributed to many patient-related medical risk factors. In one of the largest cohort studies to date on 5,700 patients who entered the New York hospital system, Richardson et al. (2020) found that the top risk factors of people with severe COVID-19 symptoms included diseases associated with inflammation, such as hypertension (56.6%), obesity (41.7%), and diabetes (33.8%).4 Because of the increase in the severity of COVID-19 symptoms associated with patients who have preexisting inflammatory conditions, anti-inflammatory medications used to treat chronic/autoimmune inflammatory diseases have also been used to treat those with COVID-19.5
Periodontal disease is an inflammatory disease in which microbial etiologic factors induce a series of host responses that mediate inflammatory events, leading to tissue destruction in susceptible individuals.6 The purpose of this article is to highlight common inflammatory mediators between periodontal disease and COVID-19, and further suggest that periodontal disease may be a contributing factor and/or exacerbate COVID-19 severity.
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