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Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?
Sampson, V, Kamona, N, Sampson, A
British dental journal. 2020;228(12):971-975
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Abstract
On 30 January 2020, the World Health Organisation identified COVID-19, caused by the virus SARS-CoV-2, to be a global emergency. The risk factors already identified for developing complications from a COVID-19 infection are age, gender and comorbidities such as diabetes, hypertension, obesity and cardiovascular disease. These risk factors, however, do not account for the other 52% of deaths arising from COVID-19 in often seemingly healthy individuals. This paper investigates the potential link between SARS-CoV-2 and bacterial load, questioning whether bacteria may play a role in bacterial superinfections and complications such as pneumonia, acute respiratory distress syndrome and sepsis. The connection between COVID-19 complications and oral health and periodontal disease is also examined, as the comorbidities at highest risk of COVID-19 complications also cause imbalances in the oral microbiome and increase the risk of periodontal disease. We explore the connection between high bacterial load in the mouth and post-viral complications, and how improving oral health may reduce the risk of complications from COVID-19.
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Autoimmune and inflammatory diseases following COVID-19.
Galeotti, C, Bayry, J
Nature reviews. Rheumatology. 2020;16(8):413-414
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Targeting the Adipose Tissue in COVID-19.
Malavazos, AE, Corsi Romanelli, MM, Bandera, F, Iacobellis, G
Obesity (Silver Spring, Md.). 2020;28(7):1178-1179
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Plain language summary
A UK study showed that 72% of COVID-19 patients in critical care units had either overweight or obesity, whilst studies in Italy have shown that 99% of deaths occurred in patients who had at least one underlying chronic condition, including obesity, diabetes and hypertension. As obesity is tightly connected with diabetes and other inflammatory conditions, it is difficult to separate the effects of the obesity per se, from other chronic conditions that are commonly associated with the obesity. The authors discuss possible molecular mechanisms by which the fat tissue itself may increase the risk of more severe COVID-19 disease, such as angiotensin converting enzyme 2 (ACE2) receptors and dipeptidyl peptidase 4 (two receptors which occur in fat tissue and may be entry points of the virus into the cell) and an imbalance between the secretion of anti‐ and proinflammatory compounds from visceral fat cells. The authors conclude that the role of the adipose (fat) tissue during infectious diseases, such as COVID‐19, could be important and note that this is a modifiable risk factor.
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Obesity is Associated with Severe Forms of COVID-19.
Caussy, C, Wallet, F, Laville, M, Disse, E
Obesity (Silver Spring, Md.). 2020;28(7):1175
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Plain language summary
One of the emerging findings of the COVID-19 pandemic is a prevalence of obesity and the severity of SARS-Cov-2 suffered by patients. Findings from this French seminal study reports a higher number of invasive mechanical ventilation in patients at Lille hospital with severe obesity (28.2%) with a BMI ≥35 kg/m2 versus lean patients < 25 kg/m2. At the time of print there were still 37% of these obese patients in ICU, in need of longer treatment than lean patients. Data from a Lyon hospital showed a lower number of obesity patients admitted into ICU at 11.3%, however this correlates with geographical differences in obesity levels. There were also differences in the medical approach between hospitals with Lyon favouring high-flow oxygen therapy through a nasal cannula with only the most severe patients mechanically ventilated. The differences in therapy raises the question whether patients with severe obesity (BMI ≥35 kg/m2) would benefit from an earlier intervention using invasive mechanical ventilation to help reduce the overall time spent in ICU.
