A new exciting hypothesis: direct correlation between periodontitis and clinical evolution of COVID-19 patients. Preprint.

The aim of the present opinion article is to hypothesize a possible correlation between clinical evolution of COVID-19 and a chronic inflammatory disease such as periodontitis. Reviews have been performed about the correlations between COVID-19 and IL-6, COVID-19 and diabetes, diabetes and periodontitis. Several studies discussed the role played by IL-6 in the pathogenetic mechanisms of COVID-19. A recent study found that COVID-19 adult patients with diabetes, without other comorbidities, were at greater risk of numerous diseases COVID related, such as severe pneumonia and excessive uncontrolled inflammatory responses. Besides, serum levels of inflammation-related biomarkers, such as IL-6, were found to be higher in diabetic patients than healthy subjects, suggesting that patients with diabetes are more susceptible to the inflammatory storm that leads to rapid health deterioration of COVID-19 patients. Our hypothesis origins from strict relationship, established, between periodontitis, as being able to induce production of IL-6, and diabetes in adult patients. Hence, by evaluating the associations previously described (COVID-19 and IL-6, COVID-19 and diabetes, IL-6 and diabetes) one wonders if, at least in diabetic patients, there could be a role for periodontitis, as a systemic risk factor, in the worst COVID-19 evolution. Periodontitis and oral health status can be very important in the evaluation of COVID-19 behavior and the clinicians must examine the oral health status in these patients. post scriptum. Authors equally contributed