Public health implication of periodontal disease chronic inflammatory biomarkers C-reactive protein, D-dimers, serum ferritin and lactate dehydrogenase enzyme association with the severity of COVID-19 infection

BACKGROUND: This study investigated periodontal disease as a potential risk factor for severity of COVID-19 Infection. OBJECTIVES: This study explored the associations of periodontal disease with severity of COVID-19 infection along with chronic inflammatory biomarkers routinely collected during COVID-19 as the diagnostic and prognostic factor for treatment and severity of the COVID-19 infection. METHODS: Periodontal Disease condition status was assessed as per world health organization (WHO) oral health assessment for adults defined criteria from survivor of COVID-19 infection, with data collected from the COVID-19 infection treatment dedicated tertiary care hospital in Bahawalpur Division, Southern Punjab, Pakistan. RESULTS: Among 383 patients, 42 (11.0%) had mild, 77 (20.1%) had moderate, and 186 (48.6%) had severe COVID-19. A total of 78 patients (20.4%) were diagnosed with advanced periodontitis. Multivariate analysis revealed a significant association between periodontal disease and COVID-19 severity, with an adjusted odds ratio (AOR) of 9.567 (95% confidence interval [CI]: 1.982-46.186; p < 0.001). Furthermore, patients with both periodontal disease and diabetes mellitus had a markedly increased risk (AOR = 36.739; 95% CI: 1.924-701.666; p < 0.017). Key biomarkers, such as lactate dehydrogenase (AOR = 0.100; 95% CI: 0.017-0.575; p < 0.010) and C-reactive protein (AOR = 0.028; 95% CI: 0.0020.362; p < 0.006), also showed significant associations. CONCLUSION: These findings underscore the public health relevance of periodontal disease as a contributing factor for the severity of COVID-19 and highlight the diagnostic value of routine collected inflammatory biomarkers in managing chronic and infectious conditions like COVID-19 Infection.