Infectious and Immunological Links Between Periodontitis and COVID-19: A Review

Hassan Alkharaan

doi:10.12659/MSM.948069

26 May 2025 : Review article

Infectious and Immunological Links Between Periodontitis and COVID-19: A Review

Hassan Alkharaan

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DOI: 10.12659/MSM.948069

Med Sci Monit 2025; 31:e948069

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Introduction Periodontitis and Respiratory Diseases Oral Microbiome and SARS-CoV-2 Infection Expression Profile of SARS-CoV-2 Entry Factors in the Oral Cavity Immuno-Inflammatory Mechanisms Underlying Periodontitis and COVID-19 Future Directions Conclusions References

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Table 1 Features of oral bacterial species detected in patients with COVID-19.

Virulence	Significance	References
Produces endotoxin with a high potency		[,]¹³⁵
Expresses Dipeptidyl peptidase-4 endopeptidase that hydrolyzes the penultimate proline or alanine dipeptides from the N-terminal polypeptide chains		[,–]³⁸
Secretes trypsin-like protease which is an endo-peptidase capable of degrading proteins and large peptidesAlso secretes aminopeptidase involvement in bradykinin formation	Associated with periodonttitis, bone infections and oral squamous cell carcinoma development	[–]¹⁴¹
Catalase-positiveAble to eliminate HO, which rescues the growth of these anaerobic periodontopathogens produces heme, which is the preferred iron source of the periodontopathogenic		[,]¹⁴⁴

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Infectious and Immunological Links Between Periodontitis and COVID-19: A Review

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