OBJECTION: To measure the association between gingivitis or periodontitis and Covid-19-associated hospitalization in a large sample of Medicare and commercially insured U.S. patients.

METHODS: All patients with a Covid-19 diagnosis between March 2020 and January 2021 were identified in the IBM^® MarketScan^® Medicare and Commercial Research Databases, and the IBM MarketScan Dental Database using International Classification of Diseases (ICD) diagnosis code U07.1. Demographic information was measured on the date of Covid-19 diagnosis. Covid-19-related hospitalizations were identified in the 3 months following diagnosis. Diagnosis of gingivitis or periodontitis (ICD K05) and baseline clinical characteristics were measured in the year prior to Covid-19 diagnosis. The MarketScan Commercial and Medicare Research Databases provide detailed cost, use, and outcomes data for healthcare services. The Dental Research Database contains dental coverage enrollment data, plan types, provider types, diagnoses, and tooth-specific services rendered.

RESULTS: 786,238 patients (743,987 Commercial and 42,251 Medicare) were diagnosed with Covid-19 during the study period. Forty-six percent were male, and 90% were above the age of 18, with a mean age of 40. Within 3 months of Covid-19 diagnosis, 55,685 (7%) had a Covid-19-related hospitalization. Among them, 47 (<1%) had a gingivitis and/or periodontitis diagnosis before Covid-19 diagnosis. Gingivitis/periodontitis was associated with Covid-19-related hospitalization for the sample overall, the Commercial subset, and the Medicare subset (odds ratio=1.5, 1.6, 1.2, respectively).

CONCLUSIONS: In an unadjusted case-control study of commercially insured and Medicare patients, an association between gingivitis/periodontitis and severity of Covid-19 was identified. This confirms a hypothesized association put forth early in the pandemic and similar relationships found in electronic health record data. Further research should explore mitigating economic factors and baseline respiratory-related clinical characteristics.