歯周炎とCOVID-19感染の重症度との関連：症例対照研究

Association between periodontitis and severity of COVID-19 infection: a case-control study.

• Nadya Marouf
• Wenji Cai
• Khalid N Said
• Hanin Daas
• Hanan Diab
• Venkateswara Rao Chinta
• Ali Ait Hssain
• Belinda Nicolau
• Mariano Sanz
• Faleh Tamimi

抄録

背景:

COVID-19は、致命的な転帰をもたらす可能性のある炎症反応の悪化と関連している。全身性の炎症も歯周炎の主な特徴である。そこで、我々は歯周炎とCOVID-19の合併症との関連を調査した。

BACKGROUND: COVID-19 is associated with an exacerbated inflammatory response that can result in fatal outcomes. Systemic inflammation is also a main characteristic of periodontitis. Therefore, we investigated the association of periodontitis with COVID-19 complications.

方法:

2020年2月から7月までの間に、カタール州の全国電子カルテを用いて症例対照研究を実施した。症例はCOVID-19の合併症（死亡、ICU入院、人工呼吸器補助）を起こした患者と定義し、対照は大きな合併症を起こさずに退院したCOVID-19患者とした。歯周状態は、同じデータベースの歯科用X線写真を用いて評価した。歯周炎とCOVID-19の合併症との関連を、人口統計学的、医療的、行動学的因子を調整したロジスティック回帰モデルを用いて解析した。

METHODS: A case-control study was performed using the national electronic health records of the State of Qatar between February and July 2020. Cases were defined as patients who suffered COVID-19 complications (death, ICU admissions or assisted ventilation), controls were COVID-19 patients discharged without major complications. Periodontal conditions were assessed using dental radiographs from the same database. Associations between periodontitis and COVID 19 complications were analyzed using logistic regression models adjusted for demographic, medical and behaviour factors.

結果:

合計568人の患者が含まれていた。潜在的交絡因子を調整した後、歯周炎は死亡（OR=8.81、95％CI 1.00～77.7）、ICU入院（OR=3.54、95％CI 1.39～9.05）、人工呼吸の必要性（OR=4.57、95％CI 1.19～17.4）を含むCOVID-19の合併症と関連していた。同様に、白血球、Dダイマー、C反応性蛋白の血中濃度は、COVID-19の歯周炎患者で有意に高かった。

RESULTS: In total, 568 patients were included. After adjusting for potential confounders, periodontitis was associated with COVID-19 complication including death (OR=8.81,95% CI 1.00-77.7), ICU admission (OR=3.54, 95% CI 1.39-9.05), and need for assisted ventilation (OR=4.57, 95% CI 1.19-17.4). Similarly, blood levels of white blood cells, D-dimer, and C Reactive Protein, were significantly higher in COVID-19 patients with periodontitis.

結論:

歯周炎は、ICUへの入院、人工呼吸器の必要性、COVID-19患者の死亡のリスクの高さ、および疾患転帰の悪化に関連するバイオマーカーの血中濃度の上昇と関連していた。

CONCLUSION: Periodontitis was associated with higher risk of ICU admission, need for assisted ventilation and death of COVID-19 patients, and with increased blood levels of biomarkers linked to worse disease outcomes.

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