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Poor oral health may increase risk of severe COVID-19 for cardiac patients

Researchers from Cairo University have found that poor oral health correlated with increased C-reactive protein levels and delayed recovery from COVID-19 especially in patients with cardiac disease. (Image: Treecha/Shutterstock)

CAIRO, Egypt: Previous studies have linked poor oral hygiene with hyper-inflammation and cardiovascular disease. Similarly, the severity of COVID-19 has been associated with hyper-inflammatory responses. Thus, researchers at Cairo University in Egypt have investigated whether there is a correlation between poor oral health and greater COVID-19 severity in patients with cardiovascular disease. They found that oral health status is an additional risk factor for such patients.

Using a questionnaire, the researchers evaluated oral health status, severity of COVID-19 symptoms, duration of recovery and C-reactive protein (CRP) levels in 308 SARS-CoV-2-positive Egyptian patients and an additional 86 such patients with cardiovascular disease. The latter were the subject of a subgroup analysis. The impact of oral health on COVID-19 severity was assessed using an oral health score, and the effects of oral health on CRP levels and recovery time were assessed as secondary end points.

According to the researchers, the correlation between oral health and COVID-19 severity showed a significant inverse relationship, as did the correlation between oral health and recovery time and CRP levels. Poor oral health correlated with increased CRP levels and delayed recovery, especially in patients with cardiac disease.

Dr Ahmed Mustafa Basuoni, cardiology consultant at the university and co-author of the study, commented in a press release: “Oral tissues could act as a reservoir for SARS-CoV-2, developing a high viral load in the oral cavity. Therefore, we recommended maintenance of oral health and improving oral hygiene measures, especially during COVID-19 infection. Simple measures like practising proper oral hygiene, raising awareness of oral health importance either in relation to COVID-19 infection or systemic diseases by using media and community medicine, regular dental visits, especially in patients with [cardiovascular disease], and using [antimicrobial] mouthwashes [could help in] preventing or decreasing the severity of COVID-19 disease.”

He added: “Oral health should be a part of routine history taking and examination in cardiac patients. Lifestyle measures should be instructed to all cardiac patients regarding good oral hygiene with regular dental visits.”


Editorial note:

The subgroup analysis findings were presented in Cairo at ACC Middle East 2021, a meeting held in collaboration with the American College of Cardiology, Egyptian Society of Cardiology and ACC Egypt Chapter last autumn. The abstract, titled “The impact of oral health status on COVID-19 severity, recovery period and C-reactive protein values in cardiac patients (subgroup analysis)”, can be requested from the American College of Cardiology.

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