The Oral-Systemic Link: A Review about the strong Correlation between Diabetes mellitus, Periodontitis and COVID-19 Outcome
Main Article Content
Abstract
The SARS-CoV-2 virus leads to symptoms ranging from mild flu symptoms to severe COVID-19 pneumonia requiring mechanical ventilation and even death. According to epidemiological observations, diabetes mellitus is a major risk factor for severe outcome, next to older age, s, hypertension, and other serious chronic illnesses. Recent studies have determined that the oral cavity mucosa is the main entry portal for the SARS-CoV-2 virus into the body. The viruses accumulate in the mouth at locations where the main viral receptor is highly expressed. The oral pathway of the virus into the body and the contributing factors are described in this review. The immune system of people with diabetes is generally impaired. Diabetes induces chronic systemic inflammation, which regularly manifests as periodontitis in the oral cavity. Furthermore, frequent hyperglycemia leads to additional weakening of the mucosal immune barrier. These findings provide plausible explanations for the more frequent severe courses of respiratory viral infections in diabetes patients. An oral examination helps to identify patients at elevated risk. Activated matrix metalloproteinase-8 (aMMP-8) is an established biomarker for measuring the degree of oral inflammation and is an indicator of the destruction of collagen and bone structures in the mouth. aMMP-8 point-of-care tests are readily available. We propose that the current recommendations for the prevention of SARS-CoV-2-associated severe COVID-19 disease should be extended to consider the aspects of measuring and sanitizing oral health, as well as to include preventive regular daily disinfection of the mouth and the pharynx.
Article Details
How to Cite
PFÜTZNER, Andreas et al.
The Oral-Systemic Link: A Review about the strong Correlation between Diabetes mellitus, Periodontitis and COVID-19 Outcome.
Medical Research Archives, [S.l.], v. 11, n. 1, jan. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3449>. Date accessed: 23 nov. 2024.
doi: https://doi.org/10.18103/mra.v11i1.3449.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, Khare S, Srivastava A. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020 Jul-Aug;14(4):535-545. doi: 10.1016/j.dsx.2020.04.044. Epub 2020 May 6. PMID: 32408118; PMCID: PMC7200339
4. Miller LE, Bhattacharyya R, Miller AL. Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis. Medicine (Baltimore). 2020 Oct 2;99(40):e22439. doi: 10.1097/MD.0000000000022439. PMID: 33019426; PMCID: PMC7535849.
5. Pfützner A, Lazzara M, Jantz J. Why Do People With Diabetes Have a High Risk for Severe COVID-19 Disease?-A Dental Hypothesis and Possible Prevention Strategy. J Diabetes Sci Technol. 2020 Jul;14(4):769-771. doi: 10.1177/1932296820930287. Epub 2020 Jun 7. PMID: 32506937; PMCID: PMC7673189.
6. Li S, Wang J, Zhang B, Li X, Liu Y. Diabetes Mellitus and Cause-Specific Mortality: A Population-Based Study. Diabetes Metab J. 2019 Jun;43(3):319-341. doi: 10.4093/dmj.2018.0060. PMID: 31210036; PMCID: PMC6581547.
7. Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol 2000. 2007;44:127–153. doi: 10.1111/j.1600-0757.2006.00193.x.
8. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012 Jan;55(1):21-31. doi: 10.1007/s00125-011-2342-y. Epub 2011 Nov 6. PMID: 22057194; PMCID: PMC3228943.
9. Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol. 2002;30:182–192. doi: 10.1034/j.1600-0528.2002.300304.x.
10. Teeuw WJ, Gerdes VEA, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care. 2010;33:421–427. doi: 10.2337/dc09-1378
11. Skamagas M, Breen TL, LeRoith D. Update on diabetes mellitus: Prevention, treatment, and association with oral diseases. Oral Dis 2008; 14:105–14.
12. Janket SJ, Jones JA, Meurman JH, Baird AE, Van Dyke TE. Oral infection, hyperglycemia, and endothelial dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105:173–9.
13. Levison ME. Pneumonia, including necrotizing pulmonary infections (lung abscess). In Harrison's Principles of Internal Medicine, 13th edn, ed. KJ Isselbacher, E Braunwald, JD Wilson et al., pp. 1197– 1206. McGraw Hill, New York, 1994
14. Sinclair DG, Evans TW. Nosocomial pneumonia in the intensive care unit. Br J Hosp Med 1994; 51:177– 180.
15. Toews GB. Nosocomial pneumonia. Am J Med Sci 1986; 291:355– 367.
16. Terpenning M, Bretz W, Lopatin D, Langmore S, Dominguez B, Loesche W. Bacterial colonization of saliva and plaque in the elderly. Clin Infect Dis 1993; 16(Suppl 4):S314– S316.
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