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López-Burgos CP, Cruz-Domínguez MDP, López-Zamora B, Medina-García G, Montiel-Cervantes LA, Colorado-Cruz MF, Vera-Lastra O, Montes-Cortés DH, Morales-Montalvo SI, Ordoñez-González I. [Impact of hyperglycemia on the prognosis of patients hospitalized for severe pneumonia in COVID-19]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:335-341. [PMID: 37216668 PMCID: PMC10437238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/30/2022] [Indexed: 05/24/2023]
Abstract
Background Adequate glycemic control improves the prognosis of patients hospitalized for pneumonia associated with severe COVID-19. Objective To evaluate the impact of hyperglycemia (HG) on the prognosis of patients hospitalized for severe pneumonia associated with COVID-19 in unvaccinated patients. Material and methods Prospective cohort study. We included patients hospitalized from August 2020 to February 2021, with severe COVID-19 pneumonia, not vaccinated against SARS-CoV-2. Data was collected from admission to discharge. We used descriptive and analytical statistics according to the data distribution. ROC curves were used to determine the cut-off points with the highest predictive performance for HG and mortality, with the IBM SPSS program, version 25. Results We included 103 patients, 32% women, 68% men, age 57 ± 13 years; 58% were admitted with HG (191, IQR 152-300 mg/dL) and 42% with normoglycemia (NG < 126 mg/dL). Mortality was higher in HG at admission 34 (56.7%) than in NG 13 (30.2%) (p = 0.008). HG was associated with diabetes mellitus 2 and neutrophilia (p < 0.05). The risk of death increases 1.558 times (95% CI 1.118-2.172) if HG is at admission and 1.43 times (95% CI 1.14-1.79) during hospitalization. Maintaining NG throughout the hospitalization contributed independently to survival (RR = 0.083 [95% CI 0.012-0.571], p = 0.011). Conclusion HG significantly impacts prognosis by increasing mortality more than 50% during hospitalization for COVID-19.
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Affiliation(s)
- Cinthya Paola López-Burgos
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco. Comalcalco, Tabasco, MéxicoUniversidad Juárez Autónoma de TabascoMéxico
| | - María del Pilar Cruz-Domínguez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", División de Investigación en Salud. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Berenice López-Zamora
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Campus Casco de Santo Tomás, Sección de Estudios de Posgrado de Investigación. Ciudad de México, MéxicoInstituto Politécnico NacionalMéxico
| | - Gabriela Medina-García
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Unidad de Investigación en Medicina Traslacional en Enfermedades Hemato-oncológicas. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Laura Arcelia Montiel-Cervantes
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Unidad de Investigación en Medicina Traslacional en Enfermedades Hemato-oncológicas. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - María Fernanda Colorado-Cruz
- Universidad Veracruzana, Campus Veracruz, Facultad de Medicina. Veracruz, MéxicoUniversidad Veracruzana, Campus VeracruzMéxico
| | - Olga Vera-Lastra
- Instituto Mexicano del Seguro Social, Hospital de Especialidades “Dr. Antonio Fraga Mouret” Centro Médico Nacional La Raza, Departamento de Medicina Interna. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Daniel Hector Montes-Cortés
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital General “Dr. Gaudencio González Garza”, Servicio de Urgencias. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Susana Isabel Morales-Montalvo
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Campus Casco de Santo Tomás, Sección de Estudios de Posgrado de Investigación. Ciudad de México, MéxicoInstituto Politécnico NacionalMéxico
| | - Irvin Ordoñez-González
- Universidad Veracruzana, Campus Veracruz, Facultad de Medicina. Veracruz, MéxicoUniversidad Veracruzana, Campus VeracruzMéxico
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Rodriguez-Miguelez P, Heefner A, Carbone S. Recognizing risk factors associated with poor outcomes among patients with COVID-19. Prog Cardiovasc Dis 2023; 76:3-11. [PMID: 36693489 PMCID: PMC9862711 DOI: 10.1016/j.pcad.2023.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected >610 million people globally, exerting major social, economic, and health impacts. Despite the large number of global casualities and severe symptomatology associated with COVID-19, a large number of individuals remain at elevated risk of infection and severe outcomes related to poor lifestyle behaviors and/or associated comorbidities. Beyond the well-known social distance and masking policies, maintaining an active lifestyle, minimizing the consumption of tobacco products, and maintaining an adequate nutrition status are some of the key factors that, in an affordable and accessible way, have the potential to improve health and minimize COVID-19 impact. In addition, bringing awareness of the higher risks and poor prognosis of COVID-19 when other conditions are present seems to be essential to protect those individuals with the highest risks.
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Affiliation(s)
- Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; Division of Pulmonary and Critical Care, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America.
| | - Allison Heefner
- Department of Kinesiology and Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; Virginia Commonwealth University School of Medicine, Richmond, VA, United States of America
| | - Salvatore Carbone
- Department of Kinesiology and Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
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3
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Electrochemical Microneedles: Innovative Instruments in Health Care. BIOSENSORS 2022; 12:bios12100801. [PMID: 36290938 PMCID: PMC9599258 DOI: 10.3390/bios12100801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022]
Abstract
As a significant part of drug therapy, the mode of drug transport has attracted worldwide attention. Efficient drug delivery methods not only markedly improve the drug absorption rate, but also reduce the risk of infection. Recently, microneedles have combined the advantages of subcutaneous injection administration and transdermal patch administration, which is not only painless, but also has high drug absorption efficiency. In addition, microneedle-based electrochemical sensors have unique capabilities for continuous health state monitoring, playing a crucial role in the real-time monitoring of various patient physiological indicators. Therefore, they are commonly applied in both laboratories and hospitals. There are a variety of reports regarding electrochemical microneedles; however, the comprehensive introduction of new electrochemical microneedles is still rare. Herein, significant work on electrochemical microneedles over the past two years is summarized, and the main challenges faced by electrochemical microneedles and future development directions are proposed.
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Leite NJC, Raimundo AMM, Mendes RDC, Marmeleira JFF. Impact of COVID-19 Pandemic on Daily Life, Physical Exercise, and General Health among Older People with Type 2 Diabetes: A Qualitative Interview Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3986. [PMID: 35409672 PMCID: PMC8998106 DOI: 10.3390/ijerph19073986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic has resulted in significant alterations to and implications for the lives of millions of people, and especially for those with pre-existing medical conditions. The aim of this study was to explore the lived experience of older people with type 2 diabetes mellitus (T2DM) throughout the first 9 months of the pandemic, with emphasis on the habits of physical exercise. We conducted a qualitative study using semi-structured interviews. The data consist of telephone interviews of seventeen older people with T2DM (10 women and 7 men, aged 62-76 years). Using thematic analysis, five themes were generated: (1) an altered social and relational life; (2) changes in routine and attitude regarding physical activity behaviour; (3) home-related activities gained relevance; (4) health and well-being impact and management; and (5) thoughts about the post-pandemic period. The increase in the number of cases and the fear of becoming infected with COVID-19 limited the social (i.e., contact with family and/or friends) and functional (i.e., daily routine, the habit of exercising) lives of these people, reverberating negatively on their health and well-being. Feelings of isolation, loneliness, anxiety were common. The findings of this study help to better understand the impact of the pandemic and determine areas of need for future interventions. A multidisciplinary approach is necessary to provide support for older people with T2DM and tackle the negative effect of the pandemic, including the reduction in physical activity.
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Affiliation(s)
- Nilton João Chantre Leite
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal; (A.M.M.R.); (J.F.F.M.)
- Comprehensive Health Research Centre (CHRC), 7000-727 Évora, Portugal
| | - Armando Manuel Mendonça Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal; (A.M.M.R.); (J.F.F.M.)
- Comprehensive Health Research Centre (CHRC), 7000-727 Évora, Portugal
| | - Romeu Duarte Carneiro Mendes
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Northern Region Health Administration, 4000-447 Porto, Portugal
| | - José Francisco Filipe Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal; (A.M.M.R.); (J.F.F.M.)
- Comprehensive Health Research Centre (CHRC), 7000-727 Évora, Portugal
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5
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Prattichizzo F, de Candia P, Nicolucci A, Ceriello A. Elevated HbA1c levels in pre-Covid-19 infection increases the risk of mortality: A sistematic review and meta-analysis. Diabetes Metab Res Rev 2022; 38:e3476. [PMID: 34018307 PMCID: PMC8209812 DOI: 10.1002/dmrr.3476] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 01/08/2023]
Abstract
AIMS Diabetes is emerging as a risk factor for coronavirus disease (COVID)-19 prognosis. However, contradictory findings have been reported regarding the impact of glycaemic control on COVID-19 outcome. The aim of this meta-analysis was to explore the impact of hospital pre-admission or at-admission values of HbA1c on COVID-19 mortality or worsening in patients with diabetes. MATERIALS AND METHODS We searched PubMed, Embase and Scopus up to 30th December 2020. Eligibility criteria for study selection were the following: (1)enrolling patients with any form of diabetes mellitus and hospitalized for COVID-19 and (2) reporting data regarding HbA1c values before infection or at hospital admission in relation to COVID-19 mortality or worsening. Descriptive statistics, HbA1c values, odds ratios (ORs) and hazard ratios were extracted from seven observational studies and generic inverse variance (random effects) of OR was used to estimate the effect of HbA1c on COVID-19 outcome. RESULTS HbA1c was linearly associated with an increased COVID-19 mortality or worsening when considered as a continuous variable (OR 1.01 [1.01, 1.01]; p < 0.00001). Similarly, when analysing studies providing the number of events according to the degree of glycaemic control among various strata, a significantly increased risk was observed with poor glycaemic control (OR 1.15 [1.11, 1.19]; p < 0.00001), a result corroborated by sensitivity analysis. CONCLUSIONS Notwithstanding the large heterogeneity in study design and patients' characteristics in the few available studies, data suggest that patients with diabetes and poor glycaemic control before infection might have an increased risk of COVID-19 related mortality.
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Affiliation(s)
| | | | - Antonio Nicolucci
- Centre for Outcomes Research and Clinical Epidemiology (CORESEARCH)PescaraItaly
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6
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Mahrooz A, Muscogiuri G, Buzzetti R, Maddaloni E. The complex combination of COVID-19 and diabetes: pleiotropic changes in glucose metabolism. Endocrine 2021; 72:317-325. [PMID: 33886062 PMCID: PMC8060688 DOI: 10.1007/s12020-021-02729-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/09/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE Angiotensin converting enzyme 2 (ACE2) is the door for SARS-CoV-2, expressed in critical metabolic tissues. So, it is rational that the new virus causes pleiotropic alterations in glucose metabolism, resulting in the complication of pre-existing diabetes's pathophysiology or creating new disease mechanisms. However, it seems that less attention has been paid to this issue. This review aimed to highlight the importance of long-term consequences and pleiotropic alterations in glucose metabolism following COVID-19 and emphasize the need for basic and clinical research in metabolism and endocrinology. RESULTS SARS-CoV-2 shifts cellular metabolism from oxidative phosphorylation to glycolysis, which leads to a decrease in ATP generation. Together with metabolic imbalance, the impaired immune system elevates the susceptibility of patients with diabetes to this deadly virus. SARS-CoV-2-induced metabolic alterations in immune cells can result in hyper inflammation and a cytokine storm. Metabolic dysfunction may affect therapies against SARS-CoV-2 infection. The effective control of metabolic complications could prove useful therapeutic targets for combating COVID-19. It is also necessary to understand the long-term consequences that will affect patients with diabetes who survived COVID-19. CONCLUSIONS Since the pathophysiology of COVID-19 is still mostly unknown, identifying the metabolic mechanisms contributing to its progression is essential to provide specific ways to prevent and improve this dangerous virus's detrimental effects. The findings show that the new virus may induce new-onset diabetes with uncertain metabolic and clinical features, supporting a potential role of COVID-19 in the development of diabetes.
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Affiliation(s)
- Abdolkarim Mahrooz
- Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
- Diabetes Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Giovanna Muscogiuri
- Sezione di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II Napoli, Napoli, Italy
| | - Raffaella Buzzetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Ernesto Maddaloni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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7
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Mechanick JI, Carbone S, Dickerson RN, Hernandez BJD, Hurt RT, Irving SY, Li DY, McCarthy MS, Mogensen KM, Gautier JBO, Patel JJ, Prewitt TE, Rosenthal M, Warren M, Winkler MF, McKeever L. Clinical Nutrition Research and the COVID-19 Pandemic: A Scoping Review of the ASPEN COVID-19 Task Force on Nutrition Research. JPEN J Parenter Enteral Nutr 2020; 45:13-31. [PMID: 33094848 DOI: 10.1002/jpen.2036] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022]
Abstract
The purpose of this scoping review by the American Society for Parenteral and Enteral Nutrition (ASPEN) Coronavirus Disease 2019 (COVID-19) Nutrition Task Force was to examine nutrition research applicable to the COVID-19 pandemic. The rapid pace of emerging scientific information has prompted this activity to discover research/knowledge gaps. This methodology adhered with recommendations from the Joanna Briggs Institute. There were 2301 citations imported. Of these, there were 439 articles fully abstracted, with 23 main topic areas identified across 24 article types and sourced across 61 countries and 51 specialties in 8 settings and among 14 populations. Epidemiological/mechanistic relationships between nutrition and COVID-19 were reviewed and results mapped to the Population, Intervention, Comparator, Outcome, and Time (PICO-T) questions. The aggregated data were analyzed by clinical stage: pre-COVID-19, acute COVID-19, and chronic/post-COVID-19. Research gaps were discovered for all PICO-T questions. Nutrition topics meriting urgent research included food insecurity/societal infrastructure and transcultural factors (pre-COVID-19); cardiometabolic-based chronic disease, pediatrics, nutrition support, and hospital infrastructure (acute COVID-19); registered dietitian nutritionist counseling (chronic/post-COVID-19); and malnutrition and management (all stages). The paucity of randomized controlled trials (RCTs) was particularly glaring. Knowledge gaps were discovered for PICO-T questions on pediatrics, micronutrients, bariatric surgery, and transcultural factors (pre-COVID-19); enteral nutrition, protein-energy requirements, and glycemic control with nutrition (acute COVID-19); and home enteral and parenteral nutrition support (chronic/post-COVID-19). In conclusion, multiple critical areas for urgent nutrition research were identified, particularly using RCT design, to improve nutrition care for patients before, during, and after COVID-19.
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Affiliation(s)
- Jeffrey I Mechanick
- Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, and, Metabolic Support, Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Roland N Dickerson
- Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Clinical Coordinator and Clinical Pharmacy Specialist, Nutrition Support Service, Regional One Health, Memphis, Tennessee, USA
| | | | - Ryan T Hurt
- Divisions of Gastroenterology and Hepatology, and Endocrinology, Diabetes, Metabolism, Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Sharon Y Irving
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Ding-You Li
- Gastroenterology and Nutrition, University of Missouri, Kansas City School of Medicine, Kansas City, Missouri, USA
| | | | - Kris M Mogensen
- Department of Nutrition, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | | | - Jayshil J Patel
- Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - T Elaine Prewitt
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Martin Rosenthal
- Acute Care Surgery Team, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Malissa Warren
- VA Portland HealthCare System, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Marion F Winkler
- Department of Surgery and Nutritional Support Service, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island, USA
| | - Liam McKeever
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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