“Reconnoitering the Association of Interleukin-6 with Chronic Periodontitis and Covid-19: An Observational Study

Keywords: COVID 19, Periodontitis, IL6


Aim: The aim of the present study was to investigate comparatively the systemic levels of interleukin-6 in COVID-19 positive patients with/without chronic periodontitis and recovered COVID-19 patient with/without chronic periodontitis respectively. Methods: Total 200 consecutive confirmed cases were included and categorized equally into four groups- Group1A & Group 1B (COVID-19 positive), Group 2A & Group 2B (COVID-19 recovered),based on periodontal status along with Interleukin-6 levels. Peripheral blood samples were taken and Serum Interleukin-6 concentrations were tested using a highly sensitive (Chemiluminescence immunoassay) CLIA method on admission during hospital stay. Results: There were 50 subjects taken in all study groups. The mean age was 40.80, 38.02, 41.06, 38.98 in Group (1A,1B,2A&2B) respectively and the difference in mean age group was not significant (P>0.05). The mean interleukin-6 level was 26.0752, 1.5306, 4.1290, 0.7514 pg/ml in Group1A, 1B, 2A, 2B respectively and the difference was statistically significant (P-0.0001*). The mean difference in inter-group comparison was seen significant (P<0.05) among group1A vs(1B,2A,2B) & non-significant (P>0.05) among group1Bvs(2A,2B) & group2A vs 2B respectively. Conclusion: Chronic periodontitis must be included in diagnostic work-up to stratify SARS- CoV-2 severity.


Shimabukuro-Vornhagen A,Gödel P,Subklewe M,Stemmler HJ,Schlößer HA, et al. Cytokine release syndrome. J Immuno Therapy Cancer 2018; 6:56-2.
2. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, et al. COVID-19: Consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395:1033-1034.
3. Fabri GM.Potential Link between COVID-19 and Periodontitis: Cytokine Storm, Immunosuppression, and Dysbiosis. Oral Health and Dental Management. 2020;20(1):1-5.
4. Ascierto PA, Fox B, Urba W, et al. Insights from immuno-oncology: the Society for Immunotherapy of Cancer Statement on access to IL-6-targeting therapies for COVID-19. J Immunother Cancer. 2020;8:e000878.
5. Wang J, Li Z, Cheng X, Hu H, Liao C, Li P, Lu J, Chen Z.Epidemiologic characteristics, transmission chain, and risk factors of severe infection of COVID-19 in Tianjin, a Representative Municipality City of China. Frontiers in public health. 2020;8.1-9.
6. Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role
for monocytes and macrophages. Nature Reviews. Immunology. 2020;20(6):1-8.
Report of the WHO-China Joint Mission on Coronavirus Disease 2019(COVID-19). https://www.who.int/publications-detail/report-of-the-whochina-joint-mission-on- coronavirus-disease-2019-(covid -19)/. Accessed 2 Apr 2020.
8.Huang C, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
9.Could-gum-disease-make-coronavirus-deadly.Available on https://www.dailymail.co.uk/health/article-8600401/

10. Natalie Rahhal .Could gum disease make coronavirus more deadly? People with the dental issue have higher levels of immune proteins involved in the 'cytokine storm' seen in severe COVID-19 cases. Published: 6 August 2020.

11.Gani DK, Lakshmi D, Krishnan R, Emmadi P. Evaluation of C-reactive protein and interleukin-6 in the peripheral blood of patients with chronic periodontitis. J IS P 2009;13(2):69.
12. Guillot JL,Pollock SM, Johnson RB. Gingival interleukin‐6 concentration following phase I therapy. J Periodontol 1995;66(8):667-72.
13. Schulert GS, Grom AA. Pathogenesis of macrophage activation syndrome and potential for cytokine-directed therapies. Annual review of medicine. 2015;14(66):145-59.
14. Zeqing Feng et al. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directly decimates human spleens and lymph nodes. MedRxiv. 2020.( Medrxiv preprint doi: https://doi.org/10.1101/2020.03.27.20045427).
15. Ulhaq ZS, Soraya GV. Interleukin-6 as a potential biomarker of COVID-19 progression. Med Mal Infect. 2020;50(4):382–383.
16.Revised National Clinical Management Guidelines for COVID. Available on https://www.mohfw.gov.in
17. Chen G, et al. Clinical and immunologic features in severe and moderate Coronavirus Disease 2019. J Clin Invest. 2020b;130(5):2620–9.
18. Tao L, et al. The potential role of IL-6 in monitoring severe case of coronavirus disease 2019. https://doi.org/10.1101/2020.03.01.20029769. Posted on medRxiv 10 Mar 2020. (preprint)
19. Gong J, et al. Correlation analysis between disease severity and infammation-related parameters in patients with COVID-19 pneumonia. https:// doi.org/10.1101/2020.02.25.20025643. Posted on medRxiv 27 Feb 2020. (preprint)
20. Chen XH, et al. Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely associated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients. https ://doi.org/10.1101/2020.02.29.20029520. Posted on medRxiv 27 Feb 2020. (preprint)
21. COVID-19 Patients With Periodontitis Face Greater Risk of Dying. Available on. https://news.yahoo.com/study-gum-disease-cause-serious-070639762. Dentistry Today
22. Zhao D, et al. A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias. Clin Infect Dis. 2020;71(15):756–61.
23. Grifoni E, et al. Interleukin-6 as prognosticator in patients with COVID-19. J Infect. 2020;81(3):452–82.
24. Tobias Herold et al. Level of IL-6 predicts respiratory failure in hospitalized symptomatic COVID-19 patients. Medrxiv preprint
How to Cite
KUMARI, S. (2021). “Reconnoitering the Association of Interleukin-6 with Chronic Periodontitis and Covid-19: An Observational Study. UNIVERSITY JOURNAL OF DENTAL SCIENCES, 7(3). https://doi.org/10.21276/ujds.2021.7.3.1