Months into the pandemic, new theories are emerging about the nature of this disease. Many of the symptoms of COVID-19 are traced to an impairment in blood circulation. Given 40% of deaths from Covid-19 are related to cardiovascular complications, this disease may be a vascular infection as well as a respiratory one.

A new report shows that the SARS-CoV-2 virus can infect the endothelial cells that line the inside of blood vessels. Endothelial cells protect the cardiovascular system, and influence blood clotting and immune response. The report found damage to endothelial cells in the lungs, heart, kidneys, liver, and intestines in people with Covid-19.

The virus damaging blood vessels might explain why people with chronic disorders like high blood pressure, high cholesterol, diabetes, and heart disease are at a higher risk for severe complications from COVID-19. All of those diseases cause endothelial cell dysfunction, and the additional damage and inflammation in the blood vessels caused by the infection could push them over the edge and cause serious problems.

Gum disease (chronic oral inflammation) also causes endothelial dysfunction and systemic inflammation. Refer to the following chart, published in 2003 — the more severe the oral inflammation, the higher the metric of overall inflammation (hsCRP).

This might offer another explanation to the observed relationship between poor oral health and COVID-19. The endothelium of adults with a chronic oral inflammatory load is already upset before the virus is contracted.

Systemic inflammation (hsCRP) grows with severity of periodontal disease. Source: https://www.pharmaden.net/wp-content/uploads/2013/11/27.pdf

A recent article in the British Dental Journal about the links between poor oral health and severity of COVID-19 has generated a lot of attention and discussion. Now is the time to stop discussion and to deliver more affordable and convenient management of chronic oral inflammation in those venues where the high risk COVID patients are found — the physicians’ practice and retirement residences.