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

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.