Is There an Association Between Oral Health and Severity of COVID-19 Complications?

The new coronavirus SARS-CoV-2 was first detected in late 2019 and has quickly developed into a global pandemic [1]. Age is one of the highest risk factors for developing severe symptoms of COVID-19, the disease caused by infection with SARS-CoV-2 [2]. Thus, individuals over the age of 65 and those living in long-term care facilities are especially vulnerable to morbidity and mortality due to infection with SARS-CoV-2. However, persons with chronic lung disease, moderate to severe asthma, severe obesity, diabetes, chronic kidney disease, and liver disease are also at high risk for severe COVID-19 symptoms. A recent study lists hypertension, obesity, and diabetes as the three major underlying conditions with the most unfavorable outcomes in COVID-19 patients requiring hospitalization [3]. While COVID-19 can affect multiple organs in the body, including the kidneys and liver [4, 5], the main cause of mortality is due to the ability of SARS-CoV-2 to infect the respiratory tract, leading to severe pneumonia. Patients with COVID-19 display symptoms of fever, cough, dyspnea, and other complications associated with acute respiratory distress syndrome [6-8]. A salient feature of COVID-19 is its ability to trigger an excessive immune reaction in the host, termed a ‘cytokine storm’, which causes extensive tissue damage, particularly in the connective tissue of the lungs [9]. The lung pathology of patients who die from COVID-19 pneumonia includes edema, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells [10]