Clinical Association Between Hemogram and Oral Health Status in COVID-19: A Retrospective Study on Hospitalized Patients

Abstract AIM To assess the correlation between fundamental oral health status and the COVID-19 development process and predict the evolving risk in severe cases. MATERIALS AND METHODS This prospective study included 69 hospitalized COVID-19 patients with an average age of 87 years. The DMFT, gingival index (GI), and number of missing teeth were examined to represent the oral health status. Three time-point blood parameters (admission, mid-course, and discharge) were selected to evaluate the development of COVID-19. Associations between oral health status, blood parameters, and comorbidities were calculated using a single-factor analysis, and a nomogram was built using all variables and CT image findings by lasso regression. RESULTS The number of missing teeth and DMFT results were inversely correlated with inflammatory biomarkers. Conversely, other poor oral health indicators, including caries, GI, and tooth mobility, were positively associated with COVID-19 hematologic and inflammatory biomarkers. Moreover, D-dimer was the most essential predictor in the nomogram, and the number of missing teeth and DMFT were negatively correlated with severity risk. CONCLUSION Poor oral health status may lead to severe COVID-19. In particular, the initial CRP level and diffuse type in CT and DMFT were the most meaningful factors associated with severe development.