COVID-19 and periodontitis: reflecting on a possible association

• Main Authors: Giuseppina Campisi, Maria Eleonora Bizzoca, Lorenzo Lo Muzio
• Format: Article
• Language: English
• Published: BMC 2021-05-01
• Series: Head & Face Medicine
• Subjects: Periodontitis; COVID-19; Coronavirus; SARS-CoV-2; IL-6; IL-17
• Online Access: https://doi.org/10.1186/s13005-021-00267-1

Abstract Recent studies have demonstrated a relationship between the severe clinical course of COVID-19 and other chronic diseases such as: cardiovascular disease, hypertension, diabetes mellitus, obesity and chronic renal disease. It may be possible to extend this association to a common and chronic oral disease in adults: periodontitis. Alternatively, the latter could be simply related to the systemic chronic diseases cited above, as already observed in the non-COVID-19 literature. In order to provide an overview and their opinion, the authors in this perspective article will report and discuss the most recent references of interest relating to COVID-19 and periodontitis pathophysiology. Within such a narrative review, the authors will hypothesize that the association between chronic periodontitis and COVID-19 could exist via two pathways: a direct link, through the ACEII and CD147 receptors used by the virus to infect the cells, which would occur in greater numbers in cases of periodontitis (thereby favoring a SARS-CoV-2 infection); and/or an indirect pathway involving the overexpression of inflammatory molecules, especially IL-6 and IL-17. An expression of the latter has been found to play a role in periodontitis, in addition to severe cases of COVID-19, although it is still unclear if it plays a direct role in the worsening of the clinical course.