ABSTRACT
Risk factors for severe COVID-19 are also associated with periodontitis. They are smoking, older age, obesity, diabetes mellitus, hypertension and cardiovascular diseases. The aim of the study was to select and analyze publications that consider a possible relationship between inflammatory periodontal diseases and the severity of COVID-19. Material and methods. The search for publications by the key words was conducted using the electronic databases: Cochrane Library;MEDLINE, eLIBRARY for systematic review. We selected 94 publications, the systematic review included 10 scientific articles presenting the results of randomized trials. Results. The results of the analysis showed the connection between COVID-19 severity and inflammatory periodontal diseases presence. In the patients with severe COVID-19 on the background of periodontitis it was established a high risk for artificial lung ventilation prescription. The course of COVID-19 is possibly depending on high expression of ACE2 receptors in oral mucosal cells and aspiration of pathogenic bacteria from periodontal tissues with saliva on the background of SARS-CoV-2 viral infection. The bacterial etiology of periodontitis plays important role of an immunological trigger that causes hyperreaction of humoral and cellular immunity, NETosis activation and NLRP3 inflammation. Conclusion. The presence of periodontitis in patients with overweight and obesity, DM or hypertension may be associated with severe COVID-19 course, possible development of complications and pneumonia.Copyright © Eco-Vector, 2023. All rights reserved.
ABSTRACT
Risk factors for severe COVID-19 are also associated with periodontitis. They are smoking, older age, obesity, diabetes mellitus, hypertension and cardiovascular diseases. The aim of the study was to select and analyze publications that consider a possible relationship between inflammatory periodontal diseases and the severity of COVID-19. Material and methods. The search for publications by the key words was conducted using the electronic databases: Cochrane Library;MEDLINE, eLIBRARY for systematic review. We selected 94 publications, the systematic review included 10 scientific articles presenting the results of randomized trials. Results. The results of the analysis showed the connection between COVID-19 severity and inflammatory periodontal diseases presence. In the patients with severe COVID-19 on the background of periodontitis it was established a high risk for artificial lung ventilation prescription. The course of COVID-19 is possibly depending on high expression of ACE2 receptors in oral mucosal cells and aspiration of pathogenic bacteria from periodontal tissues with saliva on the background of SARS-CoV-2 viral infection. The bacterial etiology of periodontitis plays important role of an immunological trigger that causes hyperreaction of humoral and cellular immunity, NETosis activation and NLRP3 inflammation. Conclusion. The presence of periodontitis in patients with overweight and obesity, DM or hypertension may be associated with severe COVID-19 course, possible development of complications and pneumonia.Copyright © Eco-Vector, 2023. All rights reserved.
ABSTRACT
Celiac disease (CD) is a common immune-mediated disease of the gastrointestinal tract that results in small bowel damage from ingesting gluten in genetically susceptible patients. The SARS-CoV-2 (COVID-19) pandemic resulted in a nationwide healthcare lockdown, with the halting of elective medical procedures and tests. The potential consequence of the COVID-19 pandemic on the long-term risk of systemic and autoimmune disorders like CD is not yet clear. There is growing evidence that COVID-19 can cause a "cytokine storm" affecting epithelial cells like intestinal mucosal cells, which may increase the risk of celiac autoimmunity;defined as positive celiac serology like anti-tissue transglutaminase immunoglobulin A (TTG IgA). Many providers report observing an increased number of newly diagnosed autoimmune disorders such as the CD post-COVID-19 pandemic. It is not clear if this is a true increase in CD autoimmunity or due to overcompensation of diagnostic numbers after the lockdown. This study aims to evaluate the effect of the COVID-19 pandemic on the frequency of CD screening tests and the rate of celiac autoimmunity reflected by positive TTG IgA titers. Method(s): This retrospective cohort study used the Rochester Epidemiology Project (REP) electronic health records between January 2018 and December 2021. All subjects who underwent celiac serology screening testing (TTG IgA) during the study period were included. The REP 7-county core region includes Olmsted County and the following 6 counties: Wabasha, Waseca, Steele, Dodge, Freeborn, and Mower. We documented the total number of celiac serology screening (TTG IgA) tests ordered during the study period and compared the frequency of tests performed and the rate of positivity before and after COVID-19. We used January 2020 as a marker of the start of the COVID- 19 pandemic in the USA;referring to the first reported case by the CDC. All patients had active research authorization at the onset of the study before being included in the analysis. All data were stored and managed in compliance with the REP and Mayo Clinic IRB regulations. Result(s): A total of 15,443 (Mean=321.7, SD= 6.7, CI= 13.4) TTG IgA screening tests for CD were ordered from January 2018 till December 2021. As expected, the frequency of celiac screening tests ordered decreased sharply during the lockdown in early 2020 (March-May) (Mean= 202.7, SD=39.8, CI= 171.4)), but it picked rapidly by June 2020 with a 2.5% increase to the pre-pandemic testing frequency rate (Figure1). Despite this sharp decrease in celiac screening testing during the lockdown, the rate of celiac autoimmunity (positive TTG IgA) was higher during similar periods in pre and post-lock down years Figure1. Comparing the rate of positivity of celiac tests done during the months of March to May of the lockdown in 2020 (44/608;7.24%) to the same period during years 2018, 2019, and 2021, we found a statistical difference in the rate of positivity (p= 0.04, df= 3) figure2. There was no significant difference in the number of tests administered between pre-and post-COVID years (7625 vs. 7818, p = 0.09). Over the study period, the total number of positive screening tests was 655/15443 (4%). Using January 2020 as our cut-off, we compared the rate of screening test positivity pre and post COVID-19 to the total number of tests as demonstrated in figure1. Conclusion(s): Celiac screening and autoimmunity were stable over the study period, however, during the lockdown, the rate of celiac autoimmunity was significantly higher as compared to similar periods before and after the pandemic year. It is not clear if this is due to false-positive TTG IgA post-COVID, or true autoimmunity. We expect that follow-up studies with a longer follow-up period during and after the COVID-19 pandemic are needed to understand the true effect of COVID-19 on celiac autoimmunity. (Figure Presented).