<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0138-6557</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina Militar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cub Med Mil]]></abbrev-journal-title>
<issn>0138-6557</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0138-65572021000400034</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Enfermedad periodontal como factor agravante de los pacientes con la COVID-19]]></article-title>
<article-title xml:lang="en"><![CDATA[Periodontal disease as an aggravating factor in patients with COVID-19]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerra Duarte]]></surname>
<given-names><![CDATA[Yaday]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Estrada Castillo]]></surname>
<given-names><![CDATA[Mirkey]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Doncel Pérez]]></surname>
<given-names><![CDATA[Clara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Militar Central &#8220;Dr. Luís Díaz Soto&#8221;  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>50</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0138-65572021000400034&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0138-65572021000400034&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0138-65572021000400034&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN A finales de diciembre del 2019, fue reportado en Wuhan, China, un nuevo virus causante de una neumonía atípica, denominado SARS-CoV-2, cuya enfermedad se nombró COVID-19. Posteriormente se demostró que los pacientes con comorbilidades asociadas (enfermedades cardiovasculares, cerebrovasculares, vasculares periféricas y diabetes mellitus) evolucionaban de forma tórpida e incluso a la muerte. Se ha demostrado que la periodontitis es un proceso infeccioso local con afectación sistémica y comparte mecanismos fisiopatológicos con dichas enfermedades. Su posible relación se establece mediante la presencia de microorganismos patógenos en las bolsas periodontales, que producen reacciones inmunoinflamatorias sistémicas, mediadas por numerosas citocinas. Las bacteriemias de bajo grado y endotoxemias transitorias, causadas por las bacterias periodontales, son el resultado de las neumonías aspirativas y las complicaciones de enfermedades preexistentes. Estudios recientes de numerosos autores alertan sobre dicho vínculo, motivo por el cual surge la necesidad de investigar sobre el tema y la publicación del artículo de opinión sobre la enfermedad periodontal como factor agravante de los pacientes con la COVID-19. Los autores consideran relevante relacionar la infección por la microflora subgingival y sus efectos sobre diferentes órganos distantes, con los daños provocados por la COVID-19 en el mismo individuo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT At the end of December 2019, a new virus that causes atypical pneumonia called SARS-CoV-2 was reported in Wuhan, China, whose disease was named COVID-19. Later it was shown that patients with associated comorbidities (cardiovascular, cerebrovascular, peripheral vascular diseases and diabetes mellitus) evolved torpidly and even death. Periodontitis has been shown to be a local infectious process with systemic involvement and shares pathophysiological mechanisms with these pathologies. Its possible relationship is established by the presence of pathogenic microorganisms in the periodontal pockets, which produce systemic immunoinflammatory reactions mediated by numerous cytokines. Low-grade bacteremia and transient endotoxemia caused by periodontal bacteria are the result of aspiration pneumonia and complications from pre-existing diseases. Recent studies by numerous authors warn of this link, which is why the idea of &#8203;&#8203;research on the subject arose and the publication of this opinion article on periodontal disease as an aggravating factor in patients with COVID-19. Although the possible relationship between periodontitis and severe forms of COVID-19 has not been proven, there is sufficient evidence that allows it to be related to different conditions such as diabetes mellitus, high blood pressure, chronic kidney disease and cardiovascular disease. In turn, all of them are related to periodontitis, so it can be assumed that there is a relationship between periodontal disease and COVID-19.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[periodontitis]]></kwd>
<kwd lng="es"><![CDATA[enfermedad periodontal]]></kwd>
<kwd lng="es"><![CDATA[tormenta de citoquinas]]></kwd>
<kwd lng="es"><![CDATA[citoquinas]]></kwd>
<kwd lng="es"><![CDATA[bacterias periodontales]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[periodontitis]]></kwd>
<kwd lng="en"><![CDATA[periodontal disease]]></kwd>
<kwd lng="en"><![CDATA[cytokine storm]]></kwd>
<kwd lng="en"><![CDATA[cytokines]]></kwd>
<kwd lng="en"><![CDATA[periodontal bacteria]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González Díaz]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Toledo Pimentel]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
<name>
<surname><![CDATA[Corrales Álvarez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Veitía Cabarroca]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnóstico, pronóstico y tratamiento de la enfermedad periodontal inmunoinflamatoria crónica]]></article-title>
<source><![CDATA[Colectivo de Autores. Compendio de Periodoncia]]></source>
<year>2017</year>
<edition>2da</edition>
<publisher-loc><![CDATA[La Habana ]]></publisher-loc>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Páez González]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Tamayo Ortiz]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Batista Bonillo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[García Rodríguez]]></surname>
<given-names><![CDATA[YC]]></given-names>
</name>
<name>
<surname><![CDATA[Guerrero Ricardo]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores de riesgo de periodontopatías en pacientes adultos]]></article-title>
<source><![CDATA[CCM]]></source>
<year>2015</year>
<volume>19</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González Díaz]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández Álvarez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández Arce]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Morales Aguiar]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estado periodontal de pacientes con factores de riesgo aterotrombóticos y algunas enfermedades consecuentes]]></article-title>
<source><![CDATA[Rev. Méd. Electrón]]></source>
<year>2017</year>
<volume>39</volume>
<numero>(</numero>
<issue>(</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Laplace Pérez]]></surname>
<given-names><![CDATA[BN]]></given-names>
</name>
<name>
<surname><![CDATA[Legrá Matos]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández Laplace]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Quiñones Márquez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Piña Suárez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Castellanos Almestoy]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedades bucales en el adulto mayor]]></article-title>
<source><![CDATA[CCM]]></source>
<year>2013</year>
<volume>17</volume>
<numero>(</numero>
<issue>(</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cárdenas Perdomo]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Macías]]></surname>
<given-names><![CDATA[NV]]></given-names>
</name>
<name>
<surname><![CDATA[Solorzano Intriago]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La enfermedad periodontal como riesgo de la enfermedad sistémica]]></article-title>
<source><![CDATA[SALUD Y VIDA]]></source>
<year>2019</year>
<volume>3</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>495-529</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Huertos Ochoa]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Raffo Peña]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Sihuay Torres]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La enfermedad periodontal podría ser una comorbilidad para la COVID-19]]></article-title>
<source><![CDATA[Revista Cubana de Investigaciones Biomédicas]]></source>
<year>2021</year>
<volume>40</volume>
<numero>(</numero>
<issue>(</issue>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aquino Martínez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández Vigueras]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe COVID-19 Lung Infection in Older People and Periodontitis]]></article-title>
<source><![CDATA[J. Clin. Med]]></source>
<year>2021</year>
<volume>10</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>79</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Escobar Arregocés]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[COVID-19 su patogenia y relación con enfermedades sistémicas como la enfermedad cardiovascular y la diabetes: ¿Podría la enfermedad periodontal aportar en esta relación?]]></article-title>
<source><![CDATA[JPAPO]]></source>
<year>2020</year>
<volume>4</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gutiérrez Flores]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zambrano Rodríguez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Implicaciones bucales por COVID-19. Revisión de tema]]></article-title>
<source><![CDATA[Odontol. Sanmarquina]]></source>
<year>2020</year>
<volume>23</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>419-23</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bertolini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pita]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Koo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Cárdenas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Meethil]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Periodontal disease in the COVID-19 era: potential reservoir and increased risk for SARS-CoV-2]]></article-title>
<source><![CDATA[PesquiBras. Odontopediatria. Clín. Integr]]></source>
<year>2020</year>
<volume>20</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Badran]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Gaudin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Struillou]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Amador]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Soueidan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Periodontal pockets: A potential reservoir for SARS-CoV-2?]]></article-title>
<source><![CDATA[Med. Hypotheses]]></source>
<year>2020</year>
<volume>143</volume>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cuello Carballo]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz Alfonso]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Cruz Quesada]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Carbó Rodríquez]]></surname>
<given-names><![CDATA[HL]]></given-names>
</name>
<name>
<surname><![CDATA[Dopico Ravelo]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Caracterización clínico-epidemiológica de los pacientes confirmados con la COVID-19 en Pinar del Río]]></article-title>
<source><![CDATA[Rev Cienc Med Pinar del Río]]></source>
<year>2020</year>
<volume>24</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Escobar]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bernaola]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Alfaro]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Taype]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Marcos]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Description of patients with severe COVID-19 treated in a national referral hospital in Peru]]></article-title>
<source><![CDATA[Rev. Perú. Med. Exp. Salud publica]]></source>
<year>2020</year>
<volume>37</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>253-8</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez Abreu]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez Tejeda]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Dieguez Guach]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Características clínico-epidemiológicas de la COVID-19]]></article-title>
<source><![CDATA[Rev. Haban. Cienc. Méd]]></source>
<year>2020</year>
<volume>19</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vaibhav]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Shipra]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[COVID-19 &amp; Periodontitis: The cytokine connection]]></article-title>
<source><![CDATA[Elsevier. Medical Hypotheses]]></source>
<year>2020</year>
<volume>144</volume>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cankat]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Kubra C¸ Figen]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ceren]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Nihal]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Is periodontal disease a risk factor for developing severe Covid-19 infection? The potential role of Galectin-3 Experimental]]></article-title>
<source><![CDATA[Biology and Medicine]]></source>
<year>2020</year>
<volume>245</volume>
<numero>16</numero>
<issue>16</issue>
<page-range>1425-7</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campos Fabri]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Potential link between COVID-19 and Periodonitis: Citokine Storm, Inmunosuppression and Dysbiosis]]></article-title>
<source><![CDATA[OHDM]]></source>
<year>2020</year>
<volume>19</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>1-5</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campos Fabri]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Potential link between COVID-19 and Periodonitis: Citokine Storm, Inmunosuppression and Dysbiosis]]></article-title>
<source><![CDATA[OHDM]]></source>
<year>2020</year>
<volume>19</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>1-5</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pineda Bombino]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Toledo Pimentel]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Veitia Cabarrocas]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad periodontal inflamatoria crónica y enfermedades cardiovasculares]]></article-title>
<source><![CDATA[Medicentro Electrónica]]></source>
<year>2020</year>
<volume>24</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tamayo Ortiz]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez Torres]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Cabalé Bolaños]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Relación entre las enfermedades periodontales y sistémicas]]></article-title>
<source><![CDATA[Correo Científico Médico]]></source>
<year>2019</year>
<volume>23</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>1-10</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
