Periodontitis as a Risk of Hospitalization and Death by SARS-CoV-2.

Dear Editors,

We concur with the observations of Mauer et al. [1] addressing the comparative analysis of risks of hospitalization, clinical outcomes and death due to SARS-CoV-2 in patients hospitalized in Lombardy. Affordable precision/personalized medicine which combines the patients clinical data with lab-on-a-chip biomarkers, imaging and point-of-care diagnostics is the way forward if we want to dispense quality care to patients. Among real time monitoring of COVID-19 related risk diseases, it is pertinent to monitor oral and periodontal health, when we take into perspective the probability of poor gum health contributing to the COVID-19 related hospitalization and other adverse outcomes [2-4].

Sufficient evidence in literature underscores the importance of oral health, with emphasis on the prevention and treatment of periodontitis, linking it with many systemic diseases, and now with COVID-19 [3-5]. The same is suggested by the sample of 78 COVID-19 positive (delta variant) patients from India among whom patients with periodontitis were significantly more likely to need hospital admission, assisted ventilation or have COVID-19 related pneumonia than the periodontally healthy patients (p < 0.05; Table 1) [3]. Further studies are warranted to address the effect of oral and periodontal health on hospitalization and death due to other COVID-19 variants.

TABLE 1

Association between Periodontal disease status (Healthy, Gingivitis, Periodontitis) and Hospital admission, COVID-19 related pneumonia and assisted ventilation among 78 Indian COVID-19 positive patients (India, 2021).

	Healthy	Gingivitis	Periodontitis	p-value a
Home isolation	16a	12a	0b	<0.001
Hospital admission (Ward + ICU)	11a	9a	30b
COVID-19 related pneumonia: Yes	3a	4a,b	14b	0.007
COVID-19 related pneumonia: No	24a	17a,b	16b
Assisted ventilation required	3a	5a	21b	<0.001
Assisted ventilation not required	24a	16a	9b

Pearson Chi-Square (Exact Sig. 2-sided).

Each superscript letter denotes a subset of periodontal disease status groups whose column proportions do not differ significantly from each other measured by pairwise Z-tests (Bonferroni corrected) at the 0.05 level.