Oral Dysbiosis and Depressed Mucosal Immunity Exacerbate Oral PASC in an Underserved Minority Cohort

Background: Previous reports have revealed that periodontal disease (PD) was associated with presence of CoVID-19. We note Black/Hispanics compared to other racial populations have higher prevalence rates for PD and CoVID-19 and subsequent post-acute sequelae conditions (PASC) suggesting racial disparity issues. Hypothesized was PD is pre-conditioning oral mucosa for PD as a PASC from CoVID-19. Methods: A pilot study was conducted to assess PD multivariant ANOVA significant associations (CI at 95%, p<0.001) to CoVID-19 and PASC in a Black/Hispanic patient population attending clinic at Mile Square, FQHC and College of Dentistry (COD), UIC. Using a retrospective analysis (N=576, self-report CoVID+/ 576, CoVID-) of PD charted and diagnosed using standard PD criteria, and prospective analysis of PD (N=80, 40-CoVID+/ 40-COVID-; N=10 health control (HC)(white). In addition, activated saliva (paraffin chew, 5 min) derived oral microbiome (16S rRNA), viromics (metagenonmics shotgun sequencing, NGS; PCR), and mucosal immunity (flow cytometrics, PCR-qRNA) supported alternate avenues to canonical receptor expressions (ACE2/TMPRSS). Results: (1) Elevated ACE2/TMPRSS and SARS-CoV-2 -Spike (S) protein is found in CoVID+/- vs. HC in PD+, PASC+ (p<0.001) (2) Periopathogen, Tannella forsythia, predominant in a loss of diversity. (3) Significant probability (p<0.001) CMV is present. (4) Immune cell shift to macrophage and Th17(CD3+) increasing IL-6, TNF-a, IL-17A,IL-10 suppressing factors. (p<0.0001). Conclusion: Racial diversity significant probability is for PD as an oral PASC derived from COVID-19 resulting from dysbiosis and oral mucosal immune depression increasing loss of tolerance.