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Haber R, Ghezzawi M, Puzantian H, Haber M, Saad S, Ghandour Y, El Bachour J, Yazbeck A, Hassanieh G, Mehdi C, Ismail D, Abi-Kharma E, El-Zein O, Khamis A, Chakhtoura M, Mantzoros C. Mortality risk in patients with obesity and COVID-19 infection: a systematic review and meta-analysis. Metabolism 2024; 155:155812. [PMID: 38360130 DOI: 10.1016/j.metabol.2024.155812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/13/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
Obesity is a risk factor for severe respiratory diseases, including COVID-19 infection. Meta-analyses on mortality risk were inconsistent. We systematically searched 3 databases (Medline, Embase, CINAHL) and assessed the quality of studies using the Newcastle-Ottawa tool (CRD42020220140). We included 199 studies from US and Europe, with a mean age of participants 41.8-78.2 years, and a variable prevalence of metabolic co-morbidities of 20-80 %. Exceptionally, one third of the studies had a low prevalence of obesity of <20 %. Compared to patients with normal weight, those with obesity had a 34 % relative increase in the odds of mortality (p-value 0.002), with a dose-dependent relationship. Subgroup analyses showed an interaction with the country income. There was a high heterogeneity in the results, explained by clinical and methodologic variability across studies. We identified one trial only comparing mortality rate in vaccinated compared to unvaccinated patients with obesity; there was a trend for a lower mortality in the former group. Mortality risk in COVID-19 infection increases in parallel to an increase in BMI. BMI should be included in the predictive models and stratification scores used when considering mortality as an outcome in patients with COVID-19 infections. Furthermore, patients with obesity might need to be prioritized for COVID-19 vaccination.
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Affiliation(s)
- Rachelle Haber
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Malak Ghezzawi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Houry Puzantian
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Hariri School of Nursing, American University of Beirut, Beirut, Lebanon.
| | - Marc Haber
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Sacha Saad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Yara Ghandour
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Anthony Yazbeck
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Celine Mehdi
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Dima Ismail
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Elias Abi-Kharma
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ola El-Zein
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Assem Khamis
- Hull York Medical School, University of Hull, York, United Kingdom
| | - Marlene Chakhtoura
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Christos Mantzoros
- Beth Israel Deaconess Medical Center and Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
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Xi H, Li Q, Hensher DA, Nelson JD, Ho C. Quantifying the impact of COVID-19 on travel behavior in different socio-economic segments. TRANSPORT POLICY 2023; 136:98-112. [PMID: 37008070 PMCID: PMC10033235 DOI: 10.1016/j.tranpol.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic has resulted in substantial negative impacts on social equity. To investigate transport inequities in communities with varying medical resources and COVID controlling measures during the COVID pandemic and to develop transport-related policies for the post-COVID-19 world, it is necessary to evaluate how the pandemic has affected travel behavior patterns in different socio-economic segments (SES). We first analyze the travel behavior change percentage due to COVID, e.g., increased working from home (WFH), decreased in-person shopping trips, decreased public transit trips, and canceled overnight trips of individuals with varying age, gender, education levels, and household income, based on the most recent US Household Pulse Survey census data during Aug 2020 ∼ Dec 2021. We then quantify the impact of COVID-19 on travel behavior of different socio-economic segments, using integrated mobile device location data in the USA over the period 1 Jan 2020-20 Apr 2021. Fixed-effect panel regression models are proposed to statistically estimate the impact of COVID monitoring measures and medical resources on travel behavior such as nonwork/work trips, travel miles, out-of-state trips, and the incidence of WFH for low SES and high SES. We find that as exposure to COVID increases, the number of trips, traveling miles, and overnight trips started to bounce back to pre-COVID levels, while the incidence of WFH remained relatively stable and did not tend to return to pre-COVID level. We find that the increase in new COVID cases has a significant impact on the number of work trips in the low SES but has little impact on the number of work trips in the high SES. We find that the fewer medical resources there are, the fewer mobility behavior changes that individuals in the low SES will undertake. The findings have implications for understanding the heterogeneous mobility response of individuals in different SES to various COVID waves and thus provide insights into the equitable transport governance and resiliency of the transport system in the "post-COVID" era.
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Affiliation(s)
- Haoning Xi
- Institute of Transport and Logistics Studies (ITLS), The University of Sydney Business School, Sydney, NSW, 2006, Australia
| | - Qin Li
- School of Economics and Management, Beihang University, Beijing, 100191, China
| | - David A Hensher
- Institute of Transport and Logistics Studies (ITLS), The University of Sydney Business School, Sydney, NSW, 2006, Australia
| | - John D Nelson
- Institute of Transport and Logistics Studies (ITLS), The University of Sydney Business School, Sydney, NSW, 2006, Australia
| | - Chinh Ho
- Institute of Transport and Logistics Studies (ITLS), The University of Sydney Business School, Sydney, NSW, 2006, Australia
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Kislaya I, Gonçalves P, Ramalhete S, Barreto M, Torres AR, Gaio V, Gómez V, Manita C, Almeida Santos J, Soeiro S, De Sousa R, Melo A, Henriques C, Guiomar R, Rodrigues AP. SARS-CoV-2 Seroprevalence Following a Large-Scale Vaccination Campaign in Portugal: Results of the National Serological Survey, September - November 2021. ACTA MEDICA PORT 2023; 36:5-14. [PMID: 36288645 DOI: 10.20344/amp.18528] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Following a COVID-19 mass vaccination campaign, it is important to evaluate the population level of SARS-CoV-2 antibodies. The aim of this study was to estimate the seroprevalence rate of SARS-CoV-2 specific antibodies acquired due to infection or vaccination in the Portuguese population. MATERIAL AND METHODS The National Serological Survey (third wave - ISN3COVID-19) is a cross-sectional nationwide epidemiological study developed on a sample of 4545 Portuguese residents aged one year or older, between the 28th September 2021 and the 19th November 2021. The SARS-CoV-2 anti-nucleoprotein and anti-spike IgG antibody levels were determined in serum samples using Abbott Chemiluminescent Microparticle Immunoassays. Seroprevalence estimates were stratified by age group, sex, administrative region and self-reported chronic conditions. Medians and respective 95% confidence intervals were used to describe the distribution of SARS-CoV-2 specific antibodies in specific population subgroups. RESULTS The total seroprevalence rate of SARS-CoV-2 was 86.4% (95% CI: 85.2% to 87.6%). A higher seroprevalence rate was estimated for women (88.3%), 50 to 59 years-old (96.5%) and in those with two or more self-reported chronic conditions (90.8%). A higher IgG (anti-Spike) concentration was observed in individuals vaccinated with the booster dose (median = 1 2601.3 AU/mL; 95% CI: 4127.5 to 19 089.1). CONCLUSION There was a significant increase in SARS-CoV-2 seroprevalence following the mass vaccination campaign in Portugal. It is important to continue to monitor the distribution of specific SARS-COV-2 antibody at the population level to further inform public health policies.
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Affiliation(s)
- Irina Kislaya
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Paulo Gonçalves
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Sara Ramalhete
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Marta Barreto
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Ana Rita Torres
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Vânia Gaio
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Verónica Gómez
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Carla Manita
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - João Almeida Santos
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Sofia Soeiro
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Rita De Sousa
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Aryse Melo
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Camila Henriques
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal
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Exploring the Association between Negative Emotions and COVID-19 Vaccine Acceptance: A Cross-Sectional Analysis of Unvaccinated Adults in Sweden. Vaccines (Basel) 2022; 10:vaccines10101695. [PMID: 36298560 PMCID: PMC9608178 DOI: 10.3390/vaccines10101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on individuals’ mental health. This study aimed to investigate how negative emotions toward the COVID-19 pandemic, including feeling anxious, depressed, upset, and stressed, were associated with COVID-19 vaccine acceptance in Sweden. The study is a cross-sectional online survey conducted between 21–28 May 2021, using three nested hierarchical logistic regression models to assess the association. The study included 965 unvaccinated individuals, 51.2% (n = 494) of whom reported their intention to get vaccinated. We observed graded positive associations between reported negative emotions and vaccine acceptance. Individuals who experienced economic stress had lower odds of vaccine acceptance while having a positive opinion of the government’s response to COVID-19 was associated with higher odds of being vaccine-acceptant. In conclusion, unvaccinated individuals experiencing negative emotions about the pandemic were more willing to get the vaccine. On the contrary, those with a negative opinion about the government’s response, and those that had experienced economic stress were less likely to accept the immunization.
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Vulturar DM, Crivii CB, Orăsan OH, Palade E, Buzoianu AD, Zehan IG, Todea DA. Obesity Impact on SARS-CoV-2 Infection: Pros and Cons "Obesity Paradox"-A Systematic Review. J Clin Med 2022; 11:3844. [PMID: 35807129 PMCID: PMC9267674 DOI: 10.3390/jcm11133844] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/12/2022] [Accepted: 06/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During the last years, the COVID-19 pandemic meets the pandemic generated by obesity, raising many questions regarding the outcomes of those with severe forms of infection. METHODS The present systematic review summarises and analyses the data providing evidence for or against the "obesity-paradox" in COVID-19 patients. After applying the inclusion and exclusion criteria, 23 studies were included. We also analysed the presumably underlying basic mechanisms. RESULTS The patients with a body mass index (BMI) of 30-40 kg/m2 presented severe symptoms that led to intensive care unit (ICU) admission but not increased death rate. Those with a higher degree of obesity, with a BMI higher than 40 kg/m2, led to a rise in the death rate, particularly in young patients. Obesity was associated with a higher rate of ICU admission but was not determined as an independent predictor of increased mortality. In contrast, some studies suggest a strong association between obesity or morbid obesity and the risk of death. CONCLUSIONS The existence of "obesity-paradox" cannot be stated; our study presents obesity as a critical risk factor in the evolution of COVID-19.
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Affiliation(s)
- Damiana-Maria Vulturar
- Department of Pneumology, Iuliu Hațieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (D.A.T.)
| | - Carmen-Bianca Crivii
- Morphological Sciences Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Olga Hilda Orăsan
- 5th Department Internal Medicine, 4th Medical Clinic, Iuliu Hațieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
| | - Emanuel Palade
- Department of Cardiovascular and Thoracic Surgery, Iuliu Hațieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania;
| | - Anca-Dana Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania;
| | - Iulia Georgiana Zehan
- Department of Cardiology, Heart Institute, Iuliu Hațieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania;
| | - Doina Adina Todea
- Department of Pneumology, Iuliu Hațieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (D.A.T.)
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Štěpánek L, Janošíková M, Nakládalová M, Štěpánek L, Tihelka A, Boriková A, Večeřová R, Sauer P. Relationship between Acute-Phase Symptoms and Immunoglobulin G Seropositivity up to Eight Months after COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060708. [PMID: 35743971 PMCID: PMC9230838 DOI: 10.3390/medicina58060708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/22/2022]
Abstract
Background and Objectives: Given the limited knowledge of antibody responses to COVID-19 and their determinants, we analyzed the relationship between the occurrence of acute-phase symptoms and infection-induced immunoglobulin (Ig) G seropositivity up to 8 months post-symptom onset. Materials and Methods: In this cross-sectional study, 661 middle-aged unvaccinated healthcare workers (HCWs) were interviewed about the presence of symptoms during the acute phase of their previously confirmed COVID-19 and were tested for specific IgG, targeting the spike protein (S1 and S2). The dependence of seropositivity on the symptom occurrence was explored through multiple logistic regression, adjusted for the interval between symptom onset and serology testing, and through classification and regression trees. Results: A total of 551 (83.4%) HCWs showed seropositivity and, inversely, 110 (16.6%) HCWs were seronegative. The chance of IgG seropositivity was increased by dyspnea (odds ratio (OR) 1.48, p < 0.001) and anosmia (OR 1.52, p = 0.021). Fever in HCWs with dyspnea resulted in the highest detected seropositivity rate, and anosmia in HCWs without dyspnea significantly increased the proportion of seropositivity. Conclusion: Clinical manifestation of the acute phase of COVID-19 predisposes to the development of infection-induced antibody responses. The findings can be applied for assessing the long-term protection by IgG, and thus, for creating effective surveillance strategies.
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Affiliation(s)
- Ladislav Štěpánek
- Department of Occupational Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic; (M.J.); (M.N.); (A.T.); (A.B.)
- Correspondence: or ; Tel.: +420-608-757-316
| | - Magdaléna Janošíková
- Department of Occupational Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic; (M.J.); (M.N.); (A.T.); (A.B.)
| | - Marie Nakládalová
- Department of Occupational Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic; (M.J.); (M.N.); (A.T.); (A.B.)
| | - Lubomír Štěpánek
- Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovská 1, 120 00 Prague, Czech Republic;
| | - Antonín Tihelka
- Department of Occupational Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic; (M.J.); (M.N.); (A.T.); (A.B.)
| | - Alena Boriková
- Department of Occupational Medicine, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic; (M.J.); (M.N.); (A.T.); (A.B.)
| | - Renata Večeřová
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (R.V.); (P.S.)
| | - Pavel Sauer
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (R.V.); (P.S.)
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