The ID-19 mutational signature was also associated with similar factors: patients with no exposure to tobacco and alcohol (n = 10, 52.6% vs. n = 7, 19.4%; p = 0.011), presence of periodontal disease (n = 11, 57.9% vs. n = 15, 41.7%; p = 0.001), presence of KMT2C (OR = 6.4, 95% CI: 1.4–28.9; p = 0.023), MUC16 (n = 7, 36.8% vs. n = 0; p = <0.001), and NOTCH2 (n = 5, 26.3% vs. n = 0; p = 0.003) mutations, and higher tumor mutational burden (TMB) (OR = 8.9, 95% CI: 2.5–32, p < 0.001). The gene discussed is NOTCH2; the disease is neoplasm.