Serum glucose, lactate dehydrogenase and hypertension are mediators of the effect of body mass index on severity of COVID-19

Associations of Inflammation with Risk of Cardiovascular and All-Cause Mortality in Adults with Hypertension: An Inflammatory Prognostic Scoring System

BACKGROUND

Inflammation is one of the major pathways in the progression of hypertension (HTN), and the related inflammatory markers have demonstrated certain predictive values. The current study aimed to integrate these markers to construct an inflammatory prognostic scoring (IPS) system and to assess the prognostic values of IPS in patients with HTN.

METHODS

A total of 9846 adult participants with HTN from NHANES 1999-2010 were enrolled and followed up. Demographic characteristics and the related laboratory results for the 12 inflammatory markers were collected. LASSO-COX regression, Kaplan-Meier, restricted cubic spline COX regression (RCS), receiver operator characteristic curve (ROC), and random survival forests (RSF) analysis were applied to explore the values of individual and IPS parameters.

RESULTS

At the census date of follow-up, 2387 (24.2%) were identified as all-cause deaths and 484 (4.9%) as cardiovascular deaths. All inflammatory markers showed certain prognostic values. Then, based on the LAASO analysis, LDH, ALP, LYM, NLR, MLR, SIRI, and RDW were included in the construction of the IPS system. The higher IPS had significantly worse long-term prognosis in Kaplan-Meier analysis (p log-rank <0.001). Also, IPS remained an independent prognosticator compared to the lowest quartile (All p for trend <0.001), and the ROC showed satisfactory values in the long-term prognosis of both cardiovascular and all-cause mortality. RCS further showed a linear association of IPS with cardiovascular mortality and all-cause mortality (p for non-linearity >0.05). Two different algorithms of RSF, variable importance and minimal depth, to evaluate the prognostic importance showed that IPS was the best in survival prediction.

CONCLUSION

Our results highlight that a higher IPS (system integrating the inflammatory markers) was associated with the increased risk of cardiovascular and all-cause mortality in patients with HTN, suggesting that IPS is a useful method for risk stratification in HTN.

Modifiable Risk Factors for SARS-CoV-2

As the COVID-19 pandemic has raged on, considerable research has been performed around the world evaluating the environmental, genetic, lifestyle, and nutritional factors that significantly impact the COVID-19 pandemic. Many studies have now shown that key risk factors for SARS-CoV-2 infection, severity, and even death are modifiable. Patients, whether partially vaccinated, fully vaccinated, or not vaccinated, are expecting their clinicians to provide them with evidence-based guidance and to help them prioritize the factors most important for them. In this editorial we review the current state of the research on modifiable risk factors for SARS-CoV-2 infection, disease severity, and death.

The Influence of Obesity on the Evolution of SARS-COV2 Infection

Aim: The issue of body weight has left a deep mark on the COVID-19 pandemic, where this category of patients has been linked to significant increases in morbidity and mortality due to infection. Conversely, due to the restrictions imposed, the pandemic has worsened the situation of overweight people. Our study conducted over a period of one year and five months aims to assess the prevalence of obesity among patients with SARS-COV2 infection in Constanta County.

Material and method: This retrospective study included a number of 177 patients hospitalized with the diagnosis of SARS-COV2 infection in the Clinical Hospital of Pneumoftiziology Constanta.

Results: 2483 of patients confirmed with SARS-COV2 infection were identified in our Department, out of which 302 had a body mass index over 30 kg/m2. We included a random sample of 95 men and 82 women in a database. The average age was 55 years. The most common comorbidities were hypertension (48%), diabetes (13%), and cardiovascular disease (12%). The most common symptoms were fever (67%), cough (58%), dyspnea (37%), and asthenia (29%). The radiological appearance showed the predominance of the moderate form (49%) and the severe form (22%). Antibiotic treatment was based on third-generation cephalosporins (53%), and the evolution was for improvement with a survival rate of 86%. Only one death was reported in our study.

Conclusion: The body mass index influences the evolution of infected cases. Old age, male gender and associated comorbidities are risk factors for a poorer prognosis and greater complications in patients with SARS-COV2.