ABSTRACT
Background: A larger proportion of people with severe cases of Coronavirus Disease 2019 (COVID-19) appears to have comorbidities compared to the general population. However, evidence regarding the roles of periodontal disease(PD), in context of Coronavirus Disease 2019(COVID-19), is limited. Thus, to explore the association between PD and COVID-19, this systematic review and meta analysis was conducted. Methods: 7 online databases were searched by January 31, 2023. Heterogeneity was tested by I2 index. OR and 95% CI were pooled through either random-effect or fixed-effect models. Subgroup analyses, sensitivity analyses, and publication bias assessments were also conducted. Results: Of the 823 articles identified and reviewed, 11 articles with 16,708 subjects met inclusion criteria and were included. PD was found to be associated with a statistically significant increase in risk of progression to severe diseases for COVID-19 patients(OR=2.20, 95% CI=1.38-3.49). Further analysis suggested that PD was associated with assisted ventilation(OR=5.01, 95% CI:2.61-9.63), ICU admission(OR=1.61, 95% CI:1.24-2.09), pneumonia(OR=5.19, 95% CI:1.17-23.00), and death(OR=2.25, 95% CI:1.55-3.28) for COVID-19 cases. Conclusions: Our results show that individuals with PD have an increased risk for ICU admission, assisted mechanical ventilation therapy, and a significantly increased risk of pneumonia and death. This suggests, to some extent, that the oral cavity is the gateway to COVID-19 infection; in other words, periodontitis is a risk factor for COVID-19 severity.
Subject(s)
Periodontitis , Pneumonia , Periodontal Diseases , Parkinson Disease , Death , COVID-19ABSTRACT
Background Hyperinflammation and coagulopathy are hallmarks of COVID-19 and synergistically contribute to illness progression. Antiplatelet agents have been proposed as candidate drugs for COVID-19 treatment on the basis of their antithrombotic and anti-inflammatory properties. A systematic review and meta-analysis that included early observational studies and recent randomized controlled trials (RCTs) was performed to summarize and compare evidence on this issue. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify studies published up to Nov 7, 2021, and the results of registered clinical trials were followed up to Mar 30, 2022. We included RCTs and observational studies assessing the effect of antiplatelet therapy in adult patients with COVID-19. Data on baseline patient characteristics, interventions, controls, and outcomes were extracted by two independent reviewers. The primary outcome was mortality. Data were pooled using a random-effects model. Results Twenty-seven studies were included, of which 23 observational studies were pooled in a meta-analysis, and the remaining four RCTs (ACTIV-4B, RECOVERY, ACTIV-4a, and REMAP-CAP) were narratively synthesized. Based on 23 observational studies of 87,824 COVID-19 patients, antiplatelet treatment favors a lower risk of mortality [odds ratio (OR) 0.72, 95% confidence interval (CI) 0.61–0.85;I2 = 87.0%, P < 0.01]. The narrative synthesis of RCTs showed conflicting evidence, which did not support adding antiplatelet therapy to the standard care, regardless of the baseline illness severity and concomitant anticoagulation intensity. Conclusion While the rationale for using antiplatelet treatment in COVID-19 patients is compelling and was supported by the combined result of early observational studies, evidence from RCTs did not confirm this approach. Several factors that could explain this inconsistency were highlighted alongside perspectives on future research directions.
ABSTRACT
Objective: To determine the serum IgM and IgG antibody levels post-COVID-19 vaccination, and provide scientific evidence for COVID-19 antibody response after vaccination.