What factors predict craniomandibular disorders in severe COVID-19 survivors after prolonged intubation? - 19/07/22

Doi : 10.1016/j.jormas.2022.07.004

Poramate Pitak-Arnnop ^a,^⁎,^{^{1
All authors contributed equally to this work.}} , Chatpong Tangmanee ^b,^{^{1
All authors contributed equally to this work.}}, Wantanee Mutirangura ^c,^{^{1
All authors contributed equally to this work.}}, Benjamas Apipan ^d,^{^{1
All authors contributed equally to this work.}}, Prim Auychai ^e,^{^{1
All authors contributed equally to this work.}}, Jean-Paul Meningaud ^f,^{^{1
All authors contributed equally to this work.}}, Andreas Neff ^a,^g,^{^{1
All authors contributed equally to this work.}}
^a Department of Oral and Craniomaxillofacial Plastic Surgery, Faculty of Medicine, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Philipps-University of Marburg, Marburg, Germany
^b Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand
^c Department of Occlusion and Accredited Training Center for Dental Occlusion and Orofacial Pain, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
^d Division of Anesthesiology, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
^e Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
^f Department of Plastic, Reconstructive, Esthetic and Maxillofacial Surgery, AP-HP, Faculty of Medicine, Henri Mondor University Hospital, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France
^g Head of the TMJ Section of the Strasbourg Osteosynthesis Research Group (S.O.R.G), Past President of the European Society of TMJ Surgeons (ESTMJS), Member of the German Association for Functional Diagnostics and Therapy of the TMJ (DGFDT) and of the German Association for Oral and Maxillofacial Surgeons (DGMKG), Germany

^⁎Corresponding author at: Department of Oral and Craniomaxillofacial Plastic Surgery, Faculty of Medicine, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Philipps-University of Marburg, Klinik für MKG-Chirurgie, Baldingerstr., Marburg 35043, Germany.Department of Oral and Craniomaxillofacial Plastic SurgeryFaculty of MedicineUniversity Hospital of Giessen and MarburgUKGM GmbHCampus MarburgPhilipps-University of MarburgKlinik für MKG-ChirurgieBaldingerstr.Marburg35043Germany

conectar o crear una cuenta

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.

Conéctese para beneficiarse!

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 19 July 2022
This article has been published in an issue click here to access

Highlights

•

If there is/are at least one of these 3 predictors: bilateral molar loss, convex face, and peak C-reactive protein during intensive medical care ≥ 40 mg/l, severe COVID-19 survivors with prolonged intubation (PI) ≥ 1 week should apt to craniomandibular disorder (CMD) screening and/or patient referral to a CMD specialist, regardless of patient's age, gender, underlying CMDs, or previous dental checkups

•

Aproximately one in every 10 severe COVID-19 survivors (or one in every two to four patient with at least one predictor) will suffer from CMDs within the first six months after PI ≥ 1 week.

El texto completo de este artículo está disponible en PDF.

Abstract

Purposes

To estimate and identify predictors of craniomandibular disorders (CMDs) in severe COVID-19 survivors after prolonged intubation ≥ 1 week (SCOVIDS-PI).

Methods

This retrospective study enrolled two cohorts of SCOVIDS-PIs with vs. without CMD during a one-year period. The predictor variables were demographic, dental, anesthetic, and laboratory parameters. The main outcome was presence of CMD until six post-PI months (yes/no). Appropriate statistics were computed with α = 95%.

Results

The sample comprised 176 subjects aged 59.2 ± 17.2 years (range, 27–89; 11.9% with CMDs; 30.1% females). CMDs were significantly associated with (1) bilateral posterior tooth loss (P = 0; number needed to screen [NNS] = 1.6), (2) dentofacial skeletal class II/convex face (P = .01; NNS = 2.2), and (3) peak CRP during intensive care ≥ 40 mg/l (P = .01; NNS = 3.5). With combined predictors, NNS became 2 to 4.3.

Conclusions

Three predictors of CMDs in SCOVIDS-PIs: bilateral molar loss, convex face, and CRP ≥ 40 mg/l, indicate CMD screening and/or referral to a CMD specialist, regardless of patients’ age, gender, underlying CMDs, or previous dental checkups. Screening ∼2 to 4 “SCOVIDS-PIs with ≥ one predictor” will identify one CMD events/patients during the first six post-PI months.

El texto completo de este artículo está disponible en PDF.

Keywords : Craniomandibular disorder, COVID-19, SARS-CoV-2, Prolonged intubation

Abbreviations : ACE2, CI, CMD, CRP, COVID-19, DGFDT, ICU, MVPs, NNS, OCEBM, OR_adj., OTI, PI, RANK, RANKL, RR, r_s, SARS-CoV-2, SCOVIDS-PI, STROBE, TMJ, Trp-Kyn