COVID-19感染と歯周炎との相関性の評価-比較検討

Assessment of correlation of COVID-19 infection and periodontitis- A comparative study.

抄録

背景:

歯周病は，歯周組織に影響を及ぼす複数の微生物によって引き起こされる宿主の炎症性疾患群であり，全身に影響を及ぼす可能性がある．

Background: Periodontal disease constitutes a group of diseases involving inflammatory aspects of the host caused by several microbial agents that affect periodontal tissues and could have systemic implications.

研究目的:

本研究では、COVID-19 感染と歯周炎の重症度との相関を、軽症者と中等症者とで比較検討することを目的とした。

Objective: The present study was conducted to assess the correlation of COVID-19 infection and severity of periodontitis in subjects who has mild form of the disease as compared to subjects having moderate form of the disease.

材料および方法:

COVID-19に罹患している116名の被験者を、簡便なサンプリング方法に基づいて2群に均等に分けた。グループ I は入院が必要な中等症の COVID であり，グループ II は軽症の COVID であり，自宅療養を行った．歯周病のステージは両群で評価された。また，C反応性蛋白（CRP），白血球（WBC），Dダイマー，ビタミンD，リンパ球などの臨床検査値も評価した．統計解析は，カイ二乗法と多重ロジスティック回帰分析により行った．

Materials and Methods: The study included 116 subjects suffering from COVID-19 that were equally divided into two groups, each based on a convenient sampling methodology. Group I had a moderate form of COVID that required hospitalization and Group II had a mild form of COVID and were treated at home. The stage of periodontal disease was assessed in both groups. Also, laboratory parameters such as level of C-reactive protein (CRP), white blood cell (WBC), D-dimer, vitamin D, and lymphocytes were also assessed. Statistical analysis was done using Chi-square and multiple logistic regression analysis.

結果:

両群とも75％以上の被験者が非喫煙者であった。2つ以上の合併症を持つ被験者は、II群（24％）に比べ、I群（51.7％）で多かった。重度の歯周炎（ステージ2～4）は、I群では81％、II群では46.2％の被験者に認められた[図1]。重度の歯周病になる確率は、II群に比べ、I群では6.32倍であった。また，2つ以上の合併症を有する者は，合併症を有しない者に比べ，重度歯周炎になるリスクが4.43倍であった．

Results: More than 75% of subjects in both groups were non-smokers. Subjects having more than one comorbid condition were more in number in Group I (51.7%) as compared to Group II (24%). Severe periodontitis (stages 2-4) was found in 81% of subjects in Group I and 46.2% of subjects in Group II [Figure 1]. The odds of getting severe periodontal disease were 6.32 times more in subjects belonging to Group I as compared to Group II. Subjects having more than one comorbid condition were 4.43 times at risk of severe periodontitis as compared to subjects with no co-morbidity.

結論:

重度の歯周病は，中等度から重度の COVID-19 感染と関連しており，Group I に属する被験者ではリンパ球，白血球，CRP のレベルが上昇していた．

Conclusion: Severe form of periodontal disease was associated with moderate-to-severe COVID-19 infection and levels of lymphocytes, WBCs, and CRP were elevated in subjects belonging to Group I.