Publication:

Bacterial endocarditis and dental infections in the post-COVID-19 era: a review of current concepts

The COVID-19 pandemic has profoundly impacted global healthcare, leading to shifts in the epidemiology, diagnosis, and management of various infectious diseases. Infective endocarditis (IE), a severe and life-threatening infection of the endocardial surface of the heart, has seen a resurgence in recent years, with oral streptococci remaining a predominant causative agent. This review explores the evolving relationship between dental infections, oral health, and the risk of IE in the post-COVID-19 landscape. We examine the pathophysiological mechanisms linking dental bacteremia to endocardial colonization, emphasizing the role of endothelial damage induced by SARS-CoV-2 as a potential novel risk factor. The pandemic led to significant disruptions in routine dental care, resulting in an accumulation of untreated dental disease and a cohort of patients with advanced oral infections. Concurrently, altered immune responses and the pro-thrombotic, pro-inflammatory state associated with COVID-19 may create a more susceptible environment for bacterial adhesion and vegetation formation. This article synthesizes current evidence on these interactions, discusses updates in antibiotic prophylaxis guidelines, and highlights the critical importance of restoring access to dental care and reinforcing collaborative efforts between cardiologists, infectious disease specialists, and dentists in the post-pandemic period.