1
|
Shaka H, Ilelaboye A, Shaka A, Krishnaraju E, Khoshbin K, Doraiswamy M, Baskaran N, Mba B. Pandemic effect on national hospitalizations for acute hyperglycemic complications. Proc AMIA Symp 2024; 37:576-582. [PMID: 38910828 PMCID: PMC11188789 DOI: 10.1080/08998280.2024.2346391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/07/2024] [Indexed: 06/25/2024] Open
Abstract
Objective This study aimed to describe the effect of the pandemic on epidemiologic trends and disparities in outcomes for patients hospitalized with acute hyperglycemic complications (AHC). Methods This was a retrospective study of the National Inpatient Sample (NIS) database from 2016 to 2020. The population included adults hospitalized with AHCs as a principal diagnosis using the Clinical Classifications Software Refined code. Results There was a decrease in the AHC hospitalization rate per 100,000 admissions for type 1 diabetes (T1D) during the pandemic (577 vs 600). However, there was an increase for type 2 diabetes (T2D) (117 vs 125). The mean age during the pandemic versus prepandemic was 34.8 ± 14.1 vs 34.7 ± 14.2 (P = 0.41) and 59.1 ± 14.4 vs 58.8 ± 14.7 (P = 0.51) for T1D and T2D, respectively. No statistically significant difference was observed in mortality in T1D (0.20 vs 0.23; P = 0.42) or T2D (1.1 vs 0.8; P = 0.09). There was no difference in mortality after stratifying results by gender, race, median household income, or hospital region. During the pandemic, COVID-19 was the principal diagnosis in 5.5% of those with AHC in T1D and 9.1% in those with AHC in T2D. Conclusion The pandemic had a significant impact on the hospitalization rate for both T1D and T2D.
Collapse
Affiliation(s)
- Hafeez Shaka
- Department of Medicine, John H. Storger Jr. Hospital of Cook County, Chicago, Illinois, USA
| | - Ayodeji Ilelaboye
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Abdultawab Shaka
- Department of Medicine, Windsor University School of Medicine, Saint Kitts and Nevis
| | - Ellil Krishnaraju
- Department of Medicine, John H. Storger Jr. Hospital of Cook County, Chicago, Illinois, USA
| | - Katayoun Khoshbin
- Department of Medicine, John H. Storger Jr. Hospital of Cook County, Chicago, Illinois, USA
| | | | - Naveen Baskaran
- Department of Hospital Medicine, University of Florida, Gainesville, Florida, USA
| | - Benjamin Mba
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
2
|
Ismaiel A, Birkhahn L, Leucuta DC, Al Srouji N, Popa SL, Dumitrascu DL. Are adipokines related to COVID-19 and its severity? A systematic review and meta-analysis. Med Pharm Rep 2024; 97:120-131. [PMID: 38746027 PMCID: PMC11090279 DOI: 10.15386/mpr-2624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/01/2023] [Accepted: 06/15/2023] [Indexed: 05/16/2024] Open
Abstract
Introduction The relationship between several adipokines and COVID-19 severity has lately been evaluated, results being inconclusive. Therefore, we aimed to assess the association between adipokines in COVID-19 and its severity. Methods A search was performed in PubMed, Scopus, and Embase using predefined keywords. The Newcastle of Ottawa Scale (NOS) was used for the quality assessment of included studies. The main summary outcome was the mean difference (MD) in adipokine levels. Results A total of 8 studies involving 473 individuals were included. A significant MD in serum adiponectin levels was demonstrated in mild vs. severe COVID-19 patients (-5.734 [95% CI -11.215 - -0.252]), with no significant MD in mild vs. moderate (-7.117 [95% CI -19.546 - 5.313]), or moderate vs. severe COVID-19 (-1.846 [95% CI -4.516 - 0.824]). Moreover, no significant MD was found in adiponectin and leptin levels when comparing COVID-19 patients vs. controls (-12.675 [95% CI -36.159 - 10.808]) and (8.034 [95% CI -10.403 - 26.471]), respectively. Conclusion Adiponectin levels were significantly increased in patients with severe compared to mild COVID-19. However, no significant MD was found in adiponectin levels in mild vs. moderate and moderate vs. severe COVID-19 patients, nor in adiponectin and leptin levels in COVID-19 patients vs. controls.
Collapse
Affiliation(s)
- Abdulrahman Ismaiel
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Louis Birkhahn
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Nahlah Al Srouji
- Leon Daniello Clinical Hospital of Pneumology, Cluj-Napoca, Romania
| | - Stefan-Lucian Popa
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan L. Dumitrascu
- 2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
3
|
Yuan S, He W, Liu B, Liu Z. Research Progress on the Weak Immune Response to the COVID-19 Vaccine in Patients with Type 2 Diabetes. Viral Immunol 2024; 37:79-88. [PMID: 38498797 DOI: 10.1089/vim.2023.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is generally susceptible to the population, highly infectious, rapidly transmitted, and highly fatal. There is a lack of specific drugs against the virus at present and vaccination is the most effective strategy to prevent infection. However, studies have found that some groups, particularly patients with diabetes, show varying degrees of weak immune reactivity to various COVID-19 vaccines, resulting in poor preventive efficacy against the novel coronavirus in patients with diabetes. Therefore, in this study, patients with type 2 diabetes mellitus (T2DM) who had weak immune response to the COVID-19 vaccine in recent years were analyzed. This article reviews the phenomenon, preliminary mechanism, and related factors affecting weak vaccine response in patients with T2DM, which is expected to help in the development of new vaccines for high-risk groups for COVID-19.
Collapse
Affiliation(s)
- Shiqi Yuan
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Wenwen He
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Bin Liu
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Zhuoran Liu
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| |
Collapse
|
4
|
Khan Z, Mlawa G, Islam S, Elshowaya S, Saleem M. A Retrospective Study on the Outcome of Coronavirus Disease 2019 (COVID-19) Patients Admitted to a District General Hospital and Predictors of High Mortality. Cureus 2024; 16:e53432. [PMID: 38435221 PMCID: PMC10908435 DOI: 10.7759/cureus.53432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The clinical features and severity of coronavirus disease 2019 (COVID-19) vary between patients and countries. Patients with certain conditions are predisposed to poor outcomes compared with those without medical conditions, such as diabetes, dementia, and hypertension (HTN). METHODS The aim of this retrospective study was to assess factors associated with higher mortality in patients with COVID-19 infections and to identify the reason for hospital admission in these patients. The study was performed on patients admitted between 1 and 31 March 2020. Data collection was done retrospectively from electronic medical records. RESULTS There were 269 patient admissions during this period, of which 147 were included in this audit. The mean age of COVID-19-positive patients was 62.8 years and 65.9 years for COVID-19-negative patients during this period. Forty-seven patients requiring hospital admission were COVID-19 positive and 93 were COVID-19 negative. There were no COVID-19 swabs in the seven patients included in the audit. Approximately 50% of the COVID-19-positive patients presented with fever and shortness of breath (sob), followed by dyspnea and cough (seven patients). The most common comorbidity was HTN, followed by type 2 diabetes mellitus (T2DM) and ischemic heart disease (IHD). The survival rate was 72.3% in COVID-19-positive patients and 80% in COVID-19-negative patients. The average length of stay was 14.4 days for COVID-19-positive survivors compared to 7.8 days for COVID-19-negative survivors. Most patients who tested positive for COVID-19 infection received oseltamivir vaccination and antibiotics. The presence of HTN, diabetes mellitus (DM), age, and organ failure was associated with a high mortality risk. CONCLUSION Our study supports the findings of previous studies that diabetes, HTN, coronary artery disease, old age, and organ failure were associated with high mortality in patients admitted to hospitals with COVID-19 infections.
Collapse
Affiliation(s)
- Zahid Khan
- Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR
- Cardiology, Barts Heart Centre, London, GBR
- Cardiology and General Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
- Cardiology, Royal Free Hospital, London, GBR
| | - Gideon Mlawa
- Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| | - Saiful Islam
- General Medicine and Gastroenterology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| | - Suhier Elshowaya
- Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| | - Mohammad Saleem
- Internal Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| |
Collapse
|
5
|
Goldstein DS. Linking the Extended Autonomic System with the Homeostat Theory: New Perspectives about Dysautonomias. J Pers Med 2024; 14:123. [PMID: 38276245 PMCID: PMC10817591 DOI: 10.3390/jpm14010123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/14/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024] Open
Abstract
Dysautonomias are conditions in which altered functions of one or more components of the autonomic nervous system (ANS) adversely affect health. This essay is about how elucidating mechanisms of dysautonomias may rationalize personalized treatments. Emphasized here are two relatively new ideas-the "extended" autonomic system (EAS) and the "homeostat" theory as applied to the pathophysiology and potential treatments of dysautonomias. The recently promulgated concept of the EAS updates Langley's ANS to include neuroendocrine, immune/inflammatory, and central components. The homeostat theory builds on Cannon's theory of homeostasis by proposing the existence of comparators (e.g., a thermostat, glucostat, carbistat, barostat) that receive information about regulated variables (e.g., core temperature, blood glucose, blood gases, delivery of blood to the brain). Homeostats sense discrepancies between the information and response algorithms. The presentation links the EAS with the homeostat theory to understand pathophysiological mechanisms of dysautonomias. Feed-forward anticipatory processes shift input-output curves and maintain plateau levels of regulated variables within different bounds of values-"allostasis". Sustained allostatic processes increase long-term wear-and-tear on effectors and organs-allostatic load. They decreaseing thresholds for destabilizing and potentially fatal positive feedback loops. The homeostat theory enables mathematical models that define stress, allostasis, and allostatic load. The present discussion applies the EAS and homeostat concepts to specific examples of pediatric, adolescent/adult, and geriatric dysautonomias-familial dysautonomia, chronic orthostatic intolerance, and Lewy body diseases. Computer modeling has the potential to take into account the complexity and dynamics of allostatic processes and may yield testable predictions about individualized treatments and outcomes.
Collapse
Affiliation(s)
- David S Goldstein
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| |
Collapse
|
6
|
Zimmermann P, Sourij H, Aberer F, Rilstone S, Schierbauer J, Moser O. SGLT2 Inhibitors in Long COVID Syndrome: Is There a Potential Role? J Cardiovasc Dev Dis 2023; 10:478. [PMID: 38132646 PMCID: PMC10744331 DOI: 10.3390/jcdd10120478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
The coronavirus disease (COVID)-19 has turned into a pandemic causing a global public health crisis. While acute COVID-19 mainly affects the respiratory system and can cause acute respiratory distress syndrome, an association with persistent inflammatory stress affecting different organ systems has been elucidated in long COVID syndrome (LCS). Increased severity and mortality rates have been reported due to cardiophysiological and metabolic systemic disorders as well as multiorgan failure in COVID-19, additionally accompanied by chronic dyspnea and fatigue in LCS. Hence, novel therapies have been tested to improve the outcomes of LCS of which one potential candidate might be sodium-glucose cotransporter 2 (SGLT2) inhibitors. The aim of this narrative review was to discuss rationales for investigating SGLT2 inhibitor therapy in people suffering from LCS. In this regard, we discuss their potential positive effects-next to the well described "cardio-renal-metabolic" conditions-with a focus on potential anti-inflammatory and beneficial systemic effects in LCS. However, potential beneficial as well as potential disadvantageous effects of SGLT2 inhibitors on the prevalence and long-term outcomes of COVID-19 will need to be established in ongoing research.
Collapse
Affiliation(s)
- Paul Zimmermann
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (P.Z.); (S.R.); (J.S.)
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- Department of Cardiology, Klinikum Bamberg, 96049 Bamberg, Germany
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Research Group, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (H.S.); (F.A.)
| | - Felix Aberer
- Interdisciplinary Metabolic Medicine Research Group, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (H.S.); (F.A.)
| | - Sian Rilstone
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (P.Z.); (S.R.); (J.S.)
- Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, UK
| | - Janis Schierbauer
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (P.Z.); (S.R.); (J.S.)
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (P.Z.); (S.R.); (J.S.)
- Interdisciplinary Metabolic Medicine Research Group, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (H.S.); (F.A.)
| |
Collapse
|
7
|
Dai R, Gao H, Su R. Computer-aided drug design for virtual-screening and active-predicting of main protease (M pro) inhibitors against SARS-CoV-2. Front Pharmacol 2023; 14:1288363. [PMID: 38026989 PMCID: PMC10661973 DOI: 10.3389/fphar.2023.1288363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction: SARS-CoV-2 is a novel coronavirus with highly contagious and has posed a significant threat to global public health. The main protease (Mpro) is a promising target for antiviral drugs against SARS-CoV-2. Methods: In this study, we have used pharmacophore-based drug design technology to identify potential compounds from drug databases as Mpro inhibitors. Results: The procedure involves pharmacophore modeling, validation, and pharmacophore-based virtual screening, which identifies 257 compounds with promising inhibitory activity. Discussion: Molecular docking and non-bonding interactions between the targeted protein Mpro and compounds showed that ENA482732 was the best compound. These results provided a theoretical foundation for future studies of Mpro inhibitors against SARS-CoV-2.
Collapse
Affiliation(s)
| | - Hongwei Gao
- School of Life Science, Ludong University, Yantai, Shandong, China
| | | |
Collapse
|
8
|
Ozcan M, Zhu X, Zhang H, Javaheri A. Editorial: Lipids, lipoproteins and COVID-19. Front Cardiovasc Med 2023; 10:1293249. [PMID: 38028441 PMCID: PMC10646584 DOI: 10.3389/fcvm.2023.1293249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Mualla Ozcan
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Xuewei Zhu
- Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Hanrui Zhang
- Cardiometabolic Genomics Program, Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Ali Javaheri
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Department of Medicine, John J. Cochran Veterans Affairs Medical Center, St. Louis, MO, United States
| |
Collapse
|
9
|
Piarulli F, Carollo M, Ragazzi E, Benacchio L, Piovanello F, Simoncello I, Lapolla A. Association of COVID-19 outcomes with diabetes in the Veneto region (north-east italy): Epidemiological insights for the endemic phase? Nutr Metab Cardiovasc Dis 2023; 33:2141-2150. [PMID: 37543520 PMCID: PMC10290544 DOI: 10.1016/j.numecd.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND AND AIMS Diabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase. METHODS AND RESULTS A retrospective cohort study was conducted from February 2020 to February 2021 to examine the clinical and metabolic profiles of unvaccinated diabetic patients affected by COVID-19. Data were collected from claim databases, hospital discharge records, and clinical records within a healthcare district located in northeastern Italy with a population of 936,000. Potential prognostic indicators including sex, age, Body Mass Index (BMI), duration and type of diabetes, metabolic control, and the use of antidiabetic, antihypertensive, lipid-lowering, and antiplatelet therapies were investigated. For hospitalized patients, additional variables were recorded, such as length of hospital stay, blood pressure at admission, comorbidities, D-dimer levels, blood glucose (BG), in-hospital insulin and corticosteroid therapies, requirement for mechanical ventilation (i.e., orotracheal or tracheostomy), admission to the Intensive Care Unit (ICU), and mortality. Diabetic patients hospitalized for COVID-19 with a poorer prognosis were characterized by advanced age, longer diabetes duration, hypertension, higher usage of sulfonylureas, and lower usage of dietotherapy alone, metformin, Glucagon-Like Peptide-1 Receptor agonists (GLP1-Ra), and Renin-Angiotensin-Aldosterone System inhibitors (RAAS-i). CONCLUSION Considering the potential for COVID-19 to become endemic, special care should be taken in managing older diabetic patients' treatments.
Collapse
Affiliation(s)
| | - Massimo Carollo
- Department of Medicine, University of Padova, 35128, Padova, Italy.
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences (DSF), University of Padova School of Medicine and Surgery, 35131, Padova, Italy.
| | | | | | - Ivana Simoncello
- Public Health Department, Padua Local Health Unit, Padua, Italy.
| | | |
Collapse
|
10
|
Park S, Jeong J, Woo Y, Choi YJ, Shin S. Incident infection risks depending on oral antidiabetic exposure in insulin-treated type 2 diabetes patients. Sci Rep 2023; 13:18462. [PMID: 37891260 PMCID: PMC10611756 DOI: 10.1038/s41598-023-45793-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023] Open
Abstract
Dipeptidyl peptidase-4 inhibitors (DPP4is) and sodium glucose cotransporter-2 inhibitors (SGLT2is) have been speculated to have a potential to increase infection risks in type 2 diabetes mellitus (T2DM) patients. We performed a cohort study using the Korean health insurance data to investigate infection risks with each drug class relative to metformin in insulin-treated T2DM patients. After propensity score matching, we included 1,498 and 749 patients in DPP4i + insulin vs metformin + insulin and 300 and 549 patients in SGLT2i + insulin vs metformin + insulin, respectively. In stratified analyses per patient factor, none of the odds ratios (ORs) were associated with a statistical significance across respiratory, genital, and urinary tract infections (UTIs), except that of the male stratum for respiratory infections (OR 0.77, p = 0.04). With regard to SGLT2is, a higher risk of genital infections was analyzed with their use than with metformin therapy (OR 1.76, p = 0.03). In stratified analyses, the OR for genital infections remained significant in the baseline cardiovascular disease stratum (OR 2.29, p = 0.01). No increased UTI risk was detected with SGLT2is compared against metformin. In this study on insulin-receiving T2DM patients, DPP4is were not associated with increased infection risks, whereas SGLT2is led to a higher risk for genital infections, but not for UTIs, relative to metformin.
Collapse
Affiliation(s)
- Sanghwa Park
- College of Pharmacy, Ajou University, Suwon, Republic of Korea
| | - Jiseon Jeong
- College of Pharmacy, Ajou University, Suwon, Republic of Korea
| | - Yunna Woo
- College of Pharmacy, Ajou University, Suwon, Republic of Korea
| | - Yeo Jin Choi
- Department of Pharmacy, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea.
| | - Sooyoung Shin
- College of Pharmacy, Ajou University, Suwon, Republic of Korea.
- Research Institute of Pharmaceutical Science and Technology (RIPST), Ajou University, Suwon, Republic of Korea.
| |
Collapse
|
11
|
Anand M, Danumjaya P, Rao PRS. A nonlinear mathematical model on the Covid-19 transmission pattern among diabetic and non-diabetic population. MATHEMATICS AND COMPUTERS IN SIMULATION 2023; 210:346-369. [PMID: 36994146 PMCID: PMC10027672 DOI: 10.1016/j.matcom.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/14/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
In this paper, a three tier mathematical model describing the interactions between susceptible population, Covid-19 infected, diabetic population and Covid-19 infected, non diabetic population is proposed. Basic properties of such a dynamic model, namely, non negativity, boundedness of solutions, existence of disease-free and disease equilibria are studied and sufficient conditions are obtained. Basic reproduction number for the system is derived. Sufficient conditions on functionals and parameters of the system are obtained for the local as well as global stability of equilibria, thus, establishing the conditions for eventual prevalence of disease free or disease environment, as the case may be. The stability aspects are discussed in the context of basic reproduction number and vice versa. An important contribution of this article is that a novel technique is presented to estimate some key, influencing parameters of the system so that a pre-specified, assumed equilibrium state is approached eventually. This enables the society to prepare itself with the help of these key, influencing parameters so estimated. Several examples are provided to illustrate the results established and simulations are provided to visualize the examples.
Collapse
Affiliation(s)
- Monalisa Anand
- Department of Mathematics, BITS-Pilani KK Birla Goa Campus, Goa 403726, India
| | - P Danumjaya
- Department of Mathematics, BITS-Pilani KK Birla Goa Campus, Goa 403726, India
| | | |
Collapse
|
12
|
Kuliczkowska-Płaksej J, Jawiarczyk-Przybyłowska A, Zembska A, Kolačkov K, Syrycka J, Kałużny M, Polowczyk-Kawałko B, Kubicka E, Bolanowski M. Ghrelin and Leptin Concentrations in Patients after SARS-CoV2 Infection. J Clin Med 2023; 12:jcm12103551. [PMID: 37240656 DOI: 10.3390/jcm12103551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
SARS-CoV2 infection can lead to severe cytokine storm especially in obese patients. Ghrelin acts not only as an appetite regulator but can also play a key role in the immune reaction. Leptin, secreted mainly by the white adipose tissue, can act as a pro-inflammatory cytokine. The crucial question is whether or not the cytokine storm in COVID-19 patients with obesity is linked to adipokine dysregulation. The aim of this study was to assess ghrelin and leptin concentrations in patients 6 months after SARS-CoV2 infection in comparison to a control group considering the influence of sex. The study group included 53 patients with a history of COVID-19 and 87 healthy subjects in the control group. Leptin and ghrelin concentrations as well as hormonal and biochemical parameters were measured. A significantly higher ghrelin concentration was observed in the COVID-19 group in comparison to the control group, with a statistically significant impact of sex on the relationship between COVID-19 and ghrelin concentration, which was lower in the males. No statistically significant differences in leptin concentration were observed between the groups. A significant negative correlation was observed between ghrelin and testosterone and morning cortisol levels in the COVID-19 group. The current study showed that ghrelin levels were significantly higher in patients 6 months after a mild course of SARS-CoV2 infection. To confirm the hypothetical protective role of ghrelin in the inflammatory process, it would be necessary to compare serum ghrelin levels between patients after mild and severe courses of COVID-19. Due to the small sample size and the lack of patients with a severe course of COVID-19, these observations need further investigation. There were no differences in leptin concentrations between the COVID-19 patients and the control group.
Collapse
Affiliation(s)
- Justyna Kuliczkowska-Płaksej
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Aleksandra Jawiarczyk-Przybyłowska
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Agnieszka Zembska
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Katarzyna Kolačkov
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Joanna Syrycka
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Marcin Kałużny
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Beata Polowczyk-Kawałko
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Eliza Kubicka
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| | - Marek Bolanowski
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wrocław Medical University, Wybrzeże Pasteura 4, 50-367 Wroclaw, Poland
| |
Collapse
|
13
|
Barkhordarian M, Behbood A, Ranjbar M, Rahimian Z, Prasad A. Overview of the cardio-metabolic impact of the COVID-19 pandemic. Endocrine 2023; 80:477-490. [PMID: 37103684 PMCID: PMC10133915 DOI: 10.1007/s12020-023-03337-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/21/2023] [Indexed: 04/28/2023]
Abstract
Evidence has shown that cardiometabolic disorders (CMDs) are amongst the top contributors to COVID-19 infection morbidity and mortality. The reciprocal impact of COVID-19 infection and the most common CMDs, the risk factors for poor composite outcome among patients with one or several underlying diseases, the effect of common medical management on CMDs and their safety in the context of acute COVID-19 infection are reviewed. Later on, the changes brought by the COVID-19 pandemic quarantine on the general population's lifestyle (diet, exercise patterns) and metabolic health, acute cardiac complications of different COVID-19 vaccines and the effect of CMDs on the vaccine efficacy are discussed. Our review identified that the incidence of COVID-19 infection is higher among patients with underlying CMDs such as hypertension, diabetes, obesity and cardiovascular disease. Also, CMDs increase the risk of COVID-19 infection progression to severe disease phenotypes (e.g. hospital and/or ICU admission, use of mechanical ventilation). Lifestyle modification during COVID-19 era had a great impact on inducing and worsening of CMDs. Finally, the lower efficacy of COVID-19 vaccines was found in patients with metabolic disease.
Collapse
Affiliation(s)
- Maryam Barkhordarian
- Department of Medicine, Division of Cardiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Arezoo Behbood
- MPH department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Maryam Ranjbar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Zahra Rahimian
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Anand Prasad
- Division of Cardiology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| |
Collapse
|
14
|
Pari B, Gallucci M, Ghigo A, Brizzi MF. Insight on Infections in Diabetic Setting. Biomedicines 2023; 11:971. [PMID: 36979949 PMCID: PMC10046483 DOI: 10.3390/biomedicines11030971] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The correlation between diabetes mellitus and infectious diseases is widely recognized. DM patients are characterized by the impaired function of the immune system. This translates into the occurrence of a variety of infections, including urinary tract, skin and surgical site infections, pneumonia, tuberculosis, and, more recently, SARS-CoV-2. Hyperglycemia has been identified as a relevant factor contributing to unfavorable outcomes in hospitalized patients including SARS-CoV-2 patients. Several studies have been performed proving that to maintain the proper and stringent monitoring of glycemia, a balanced diet and physical activity is mandatory to reduce the risk of infections and their associated complications. This review is focused on the mechanisms accounting for the increased susceptibility of DM patients to infections, with particular attention to the impact of newly introduced hypoglycemic drugs in sepsis management.
Collapse
Affiliation(s)
| | | | | | - Maria Felice Brizzi
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy
| |
Collapse
|
15
|
Sanchez T, Mavragani A, Gilcrease W, Macciotta A, Saugo C, Manfredi L, Gnavi R, Strippoli E, Zengarini N, Caramello V, Costa G, Sacerdote C, Ricceri F. Multimorbidity and SARS-CoV-2-Related Outcomes: Analysis of a Cohort of Italian Patients. JMIR Public Health Surveill 2023; 9:e41404. [PMID: 36626821 PMCID: PMC9951075 DOI: 10.2196/41404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/24/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, identifying the main risk factors has been imperative to properly manage the public health challenges that the pandemic exposes, such as organizing effective vaccination campaigns. In addition to gender and age, multimorbidity seems to be 1 of the predisposing factors coming out of many studies investigating the possible causes of increased susceptibility to SARS-CoV-2 infection and adverse outcomes. However, only a few studies conducted have used large samples. OBJECTIVE The objective is to evaluate the association between multimorbidity, the probability to be tested, susceptibility, and the severity of SARS-CoV-2 infection in the Piedmont population (Northern Italy, about 4 million inhabitants). For this purpose, we considered 5 main outcomes: access to the swab, positivity to SARS-CoV-2, hospitalization, intensive care unit (ICU) admission, and death within 30 days from the first positive swab. METHODS Data were obtained from different Piedmont health administrative databases. Subjects aged from 45 to 74 years and infections diagnosed from February to May 2020 were considered. Multimorbidity was defined both with the Charlson Comorbidity Index (CCI) and by identifying patients with previous comorbidities, such as diabetes and oncological, cardiovascular, and respiratory diseases. Multivariable logistic regression models (adjusted for age and month of infection and stratified by gender) were performed for each outcome. Analyses were also conducted by separating 2 age groups (45-59 and 60-74 years). RESULTS Of 1,918,549 subjects, 85,348 (4.4%) performed at least 1 swab, of whom 12,793 (14.9%) tested positive for SARS-CoV-2. Of these 12,793 subjects, 4644 (36.3%) were hospitalized, 1508 (11.8%) were admitted to the ICU, and 749 (5.9%) died within 30 days from the first positive swab. Individuals with a higher CCI had a higher probability of being swabbed but a lower probability of testing positive. We observed the same results when analyzing subjects with previous oncological and cardiovascular diseases. Moreover, especially in the youngest group, we identified a greater risk of being hospitalized and dying. Among comorbidities considered in the study, respiratory diseases seemed to be the most likely to increase the risk of having a positive swab and worse disease outcomes. CONCLUSIONS Our study shows that patients with multimorbidity, although swabbed more frequently, are less likely to get infected with SARS-CoV-2, probably due to greater attention on protective methods. Moreover, a history of respiratory diseases is a risk factor for a worse prognosis of COVID-19. Nonetheless, whatever comorbidities affect the patients, a strong dose-response effect was observed between an increased CCI score and COVID-19 hospitalization, ICU admission, and death. These results are important in terms of public health because they help in identifying a group of subjects who are more prone to worse SARS-CoV-2 outcomes. This information is important for promoting targeted prevention and developing policies for the prioritization of public health interventions.
Collapse
Affiliation(s)
| | | | - Winston Gilcrease
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,UNESCO Chair in Sustainable Development and Territory Management, University of Turin, Turin, Italy
| | - Alessandra Macciotta
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Carlo Saugo
- Klinik für Innere Medizin - Gastroenterologie, Hepatologie & Infektiologie, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Luca Manfredi
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Elena Strippoli
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Nicolás Zengarini
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Valeria Caramello
- Emergency Department and High Dependency Unit, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy
| | - Giuseppe Costa
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Fulvio Ricceri
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| |
Collapse
|
16
|
Shen MM, Rodden LN, McIntyre K, Arias A, Profeta V, Schadt K, Lynch DR. SARS-CoV-2 in patients with Friedreich ataxia. J Neurol 2023; 270:610-613. [PMID: 36219242 PMCID: PMC9552162 DOI: 10.1007/s00415-022-11419-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Megan M Shen
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Layne N Rodden
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA
| | - Kellie McIntyre
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA
| | - Adriana Arias
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA
| | - Victoria Profeta
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA
| | - Kimberly Schadt
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA
| | - David R Lynch
- Division of Neurology, The Children's Hospital of Philadelphia, 502 Abramson, Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
17
|
Krumpolec P, Kodada D, Nyáriová N, Repiská V, Minárik G. COVID-19 and Diabetes Mellitus: Mutual Interplay of Two Diseases. Curr Diabetes Rev 2023; 19:e130922208761. [PMID: 36100987 DOI: 10.2174/1573399819666220913113146] [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: 05/20/2022] [Revised: 07/16/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
Currently, when the world is fighting against the rapidly spreading pandemic of COVID-19, the silent epidemic of diabetes should not be set aside. In comparison, while COVID- 19 led to about 6 million deaths in 2021, diabetes caused 6.7 million deaths in the same year. Diabetes mellitus is a serious risk factor for worse outcomes in COVID-19 patients. Moreover, it seems that there is a bidirectional relationship between pre-existing diabetes pandemic and the rapidly spreading COVID-19 pandemic. In this article, we summarize mechanisms by which SARS-CoV-2 infects the host cell and discuss the bidirectional relationship between diabetes and COVID-19. We also focus on clinical variables in which diabetic patients differ from non-diabetic patients and which could have promising predictive value for the course and outcome of diabetic COVID-19 patients' therapy management.
Collapse
Affiliation(s)
| | - Dominik Kodada
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Nikola Nyáriová
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Vanda Repiská
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Gabriel Minárik
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
| |
Collapse
|
18
|
Barmanray RD, Gong JY, Kyi M, Kevat D, Islam MA, Galligan A, Manos GR, Nair IV, Perera N, Adams NK, Nursing A, Warren AM, Hamblin PS, MacIsaac RJ, Ekinci EI, Krishnamurthy B, Karunajeewa H, Buising K, Visvanathan K, Kay TWH, Fourlanos S. Diabetes IN hospital - Glucose and Outcomes in the COVID-19 pandemic (DINGO COVID-19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations. Intern Med J 2023; 53:27-36. [PMID: 36269315 PMCID: PMC9874487 DOI: 10.1111/imj.15937] [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: 06/13/2022] [Accepted: 09/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS A relationship between diabetes, glucose and COVID-19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID-19 during the first year of the Victorian pandemic prior to novel variants and vaccinations. DESIGN, SETTING Retrospective cohort study from March to November 2020 across five public health services in Melbourne, Australia. PARTICIPANTS All consecutive adult patients admitted to acute wards of participating institutions during the study period with a diagnosis of COVID-19, comprising a large proportion of patients from residential care facilities and following dexamethasone becoming standard-of-care. Admissions in patients without known diabetes and without inpatient glucose testing were excluded. RESULTS The DINGO COVID-19 cohort comprised 840 admissions. In 438 admissions (52%), there was no known diabetes or in-hospital hyperglycaemia, in 298 (35%) patients had known diabetes, and in 104 (12%) patients had hyperglycaemia without known diabetes. ICU admission was more common in those with diabetes (20%) and hyperglycaemia without diabetes (49%) than those with neither (11%, P < 0.001 for all comparisons). Mortality was higher in those with diabetes (24%) than those without diabetes or hyperglycaemia (16%, P = 0.02) but no difference between those with in-hospital hyperglycaemia and either of the other groups. On multivariable analysis, hyperglycaemia was associated with increased ICU admission (adjusted odds ratio (aOR) 6.7, 95% confidence interval (95% CI) 4.0-12, P < 0.001) and longer length of stay (aOR 173, 95% CI 11-2793, P < 0.001), while diabetes was associated with reduced ICU admission (aOR 0.55, 95% CI 0.33-0.94, P = 0.03). Neither diabetes nor hyperglycaemia was independently associated with in-hospital mortality. CONCLUSIONS During the first year of the COVID-19 pandemic, in-hospital hyperglycaemia and known diabetes were not associated with in-hospital mortality, contrasting with published international experiences. This likely mainly relates to hyperglycaemia indicating receipt of mortality-reducing dexamethasone therapy. These differences in published experiences underscore the importance of understanding population and clinical treatment factors affecting glycaemia and COVID-19 morbidity within both local and global contexts.
Collapse
Affiliation(s)
- Rahul D Barmanray
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia.,Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.,Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia
| | - Joanna Y Gong
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Mervyn Kyi
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.,Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Endocrinology, Northern Health, Melbourne, Victoria, Australia
| | - Dev Kevat
- Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia.,Department of Diabetes, Monash Health, Melbourne, Victoria, Australia
| | - Mohammad A Islam
- Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia.,Department of Medicine, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anna Galligan
- Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Georgina R Manos
- Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Indu V Nair
- Department of Endocrinology, Northern Health, Melbourne, Victoria, Australia
| | - Nayomi Perera
- Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia
| | - Nicholas K Adams
- Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia
| | - Ashvin Nursing
- Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia
| | - Annabelle M Warren
- Department of Endocrinology, Northern Health, Melbourne, Victoria, Australia
| | - Peter S Hamblin
- Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia.,Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Richard J MacIsaac
- Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Elif I Ekinci
- Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia.,Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia.,Department of Medicine, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Balasubramanian Krishnamurthy
- Department of Endocrinology & Diabetes, Western Health, Melbourne, Victoria, Australia.,Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Harin Karunajeewa
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia.,General Internal Medicine Unit, Western Health, Melbourne, Victoria, Australia
| | - Kirsty Buising
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kumar Visvanathan
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Thomas W H Kay
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.,St Vincent's Institute, Melbourne, Victoria, Australia
| | - Spiros Fourlanos
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.,Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
19
|
Manfra A, Chen C, Batra K, Min Tun K, Kioka MJ. Factors associated with improved outcome of inhaled corticosteroid use in COVID-19: A single institutional study. Medicine (Baltimore) 2022; 101:e32420. [PMID: 36595838 PMCID: PMC9794212 DOI: 10.1097/md.0000000000032420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Asthmatics seem less prone to adverse outcomes in coronavirus disease 2019 (COVID-19) and some data shows that inhaled corticosteroids (ICS) are protective. We gathered data on anecdotal ICS and outcomes of patients hospitalized with COVID-19, given there is literature supporting ICS may reduce risk of severe infection. In addition, we fill gaps in current literature evaluating Charlson Comorbidity Index (CCI) as a risk assessment tool for COVID-19. This was a single-center, retrospective study designed and conducted to identify factors associated intubation and inpatient mortality. A multivariate logistic regression model was fit to generate adjusted odds ratios (OR). Intubation was associated with male gender (OR, 2.815; 95% confidence interval [CI], 1.348-5.881; P = .006) and increasing body mass index (BMI) (OR, 1.053; 95% CI, 1.009-1.099; P = .019). Asthma was associated with lower odds for intubation (OR, 0.283; 95% CI, 0.108-0.74; P = .01). 80% of patients taking pre-hospital ICS were not intubated (n = 8). In-patient mortality was associated with male gender (OR, 2.44; 95% CI, 1.167-5.1; P = .018), older age (OR, 1.096; 95% CI, 1.052-1.142; P = <.001), and increasing BMI (OR, 1.079; 95% CI, 1.033-1.127; P = .001). Asthma was associated with lower in-patient mortality (OR, 0.221; 95% CI, 0.057-0.854; P = .029). CCI did not correlate with intubation (OR, 1.262; 95% CI, 0.923-1.724; P = .145) or inpatient mortality (OR, 0.896; 95% CI, 0.665-1.206; P = .468). Asthmatics hospitalized for COVID-19 had less adverse outcomes, and most patients taking pre-hospital ICS were not intubated. CCI score was not associated with intubation or inpatient mortality.
Collapse
Affiliation(s)
- Andrew Manfra
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Nevada Las Vegas, Nevada, Las Vegas, USA
| | - Claire Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Nevada Las Vegas, Nevada, Las Vegas, USA
| | - Kavita Batra
- Department of Medical Education and Office of Research, University of Nevada Las Vegas, Nevada, Las Vegas, USA
| | - Kyaw Min Tun
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Nevada Las Vegas, Nevada, Las Vegas, USA
| | - Mutsumi John Kioka
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Nevada Las Vegas, Nevada, Las Vegas, USA
- * Correspondence: Mutsumi John Kioka, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Nevada, Las Vegas School of Medicine, 1701 W. Charleston Blvd., Suite 230, Las Vegas, NV 89102, USA (e-mail: )
| |
Collapse
|
20
|
Maleksabet H, Rezaee E, Tabatabai SA. Host-Cell Surface Binding Targets in SARS-CoV-2 for Drug Design. Curr Pharm Des 2022; 28:3583-3591. [PMID: 36420875 DOI: 10.2174/1381612829666221123111849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/20/2022] [Accepted: 08/31/2022] [Indexed: 11/27/2022]
Abstract
The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became a major public health threat to all countries worldwide. SARS-CoV-2 interactions with its receptor are the first step in the invasion of the host cell. The coronavirus spike protein (S) is crucial in binding to receptors on host cells. Additionally, targeting the SARS-CoV-2 viral receptors is considered a therapeutic option in this regard. In this review of literature, we summarized five potential host cell receptors, as host-cell surface bindings, including angiotensin-converting enzyme 2 (ACE2), neuropilin 1 (NRP-1), dipeptidyl peptidase 4 (DPP4), glucose regulated protein-78 (GRP78), and cluster of differentiation 147 (CD147) related to the SARS-CoV-2 infection. Among these targets, ACE2 was recognized as the main SARS-CoV-2 receptor, expressed at a low/moderate level in the human respiratory system, which is also involved in SARS-CoV-2 entrance, so the virus may utilize other secondary receptors. Besides ACE2, CD147 was discovered as a novel SARS-CoV-2 receptor, CD147 appears to be an alternate receptor for SARSCoV- 2 infection. NRP-1, as a single-transmembrane glycoprotein, has been recently found to operate as an entrance factor and enhance SARS Coronavirus 2 (SARS-CoV-2) infection under in-vitro. DPP4, which was discovered as the first gene clustered with ACE2, may serve as a potential SARS-CoV-2 spike protein binding target. GRP78 could be recognized as a secondary receptor for SARS-CoV-2 because it is widely expressed at substantially greater levels, rather than ACE2, in bronchial epithelial cells and the respiratory mucosa. This review highlights recent literature on this topic.
Collapse
Affiliation(s)
- Hanieh Maleksabet
- Department of Pharmaceutical Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Rezaee
- Department of Pharmaceutical Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayyed Abbas Tabatabai
- Department of Pharmaceutical Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
21
|
Barazzoni R, Bischoff SC, Busetto L, Cederholm T, Chourdakis M, Cuerda C, Delzenne N, Genton L, Schneider S, Singer P, Boirie Y. Nutritional management of individuals with obesity and COVID-19: ESPEN expert statements and practical guidance. Clin Nutr 2022; 41:2869-2886. [PMID: 34140163 PMCID: PMC8110326 DOI: 10.1016/j.clnu.2021.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemics has created unprecedented challenges and threats to patients and healthcare systems worldwide. Acute respiratory complications that require intensive care unit (ICU) management are a major cause of morbidity and mortality in COVID-19 patients. Among other important risk factors for severe COVID-19 outcomes, obesity has emerged along with undernutrition-malnutrition as a strong predictor of disease risk and severity. Obesity-related excessive body fat may lead to respiratory, metabolic and immune derangements potentially favoring the onset of COVID-19 complications. In addition, patients with obesity may be at risk for loss of skeletal muscle mass, reflecting a state of hidden malnutrition with a strong negative health impact in all clinical settings. Also importantly, obesity is commonly associated with micronutrient deficiencies that directly influence immune function and infection risk. Finally, the pandemic-related lockdown, deleterious lifestyle changes and other numerous psychosocial consequences may worsen eating behaviors, sedentarity, body weight regulation, ultimately leading to further increments of obesity-associated metabolic complications with loss of skeletal muscle mass and higher non-communicable disease risk. Therefore, prevention, diagnosis and treatment of malnutrition and micronutrient deficiencies should be routinely included in the management of COVID-19 patients in the presence of obesity; lockdown-induced health risks should also be specifically monitored and prevented in this population. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing clinical practice guidance for nutritional management of COVID-19 patients with obesity in various clinical settings.
Collapse
Affiliation(s)
- Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy,Azienda sanitaria universitaria Giuliano Isontina (ASUGI), Cattinara Hospital, Trieste, Italy,Corresponding author. Department of Medical, Surgical and Health Sciences and Azienda sanitaria universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, Strada di Fiume 447, Trieste, Italy
| | - Stephan C. Bischoff
- Department of Nutritional Medicine and Prevention, University of Hohenheim, Stuttgart, Germany
| | - Luca Busetto
- Department of Medicine, University of Padova, Italy
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Michael Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Schneider
- Gastroenterology and Nutrition, Nice University Hospital, Université Côte d’Azur, Nice, France
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Yves Boirie
- Department of Clinical Nutrition, CHU Clermont-Ferrand, University of Clermont Auvergne, Human Nutrition Unit, CRNH Auvergne, F-63000, Clermont-Ferrand, France
| | | |
Collapse
|
22
|
Boyuk B, Akin S, Aladag N, Isik A, Erman H, Ozgur Y, Topal M, Karademir N, Tomar Uysal B, Ozbilgehan B, Kabaca D, Kalmaz C, Arslan S, Keskin O. COVID-19 pneumonia in patients with impaired fasting glucose, newly diagnosed diabetes and pre-existing diabetes: a tertiary center experience. J Investig Med 2022; 70:1481-1487. [PMID: 35654475 PMCID: PMC9195151 DOI: 10.1136/jim-2022-002363] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 01/08/2023]
Abstract
COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence of impaired fasting glucose, pre-existing diabetes mellitus (DM) or new-onset DM. 236 patients with positive reverse transcription-PCR tests for SARS-CoV-2 were included in this single-center, retrospective observational study between March 2020 and May 2021. Laboratory results, comorbidities, medications and imaging findings were noted. Logistic regression was used to estimate associated factors for admission to the intensive care unit (ICU). 43 patients with normal glucose, 53 with impaired fasting glucose, 60 with newly diagnosed DM, and 80 with pre-existing DM were classified. Patients with pre-existing DM had higher fasting glucose and glycated hemoglobin than the other groups (p<0.001 for all). Patients with newly diagnosed DM were more likely to need dexamethasone 6 mg (p=0.001). In both newly diagnosed diabetes and impaired fasting glucose groups, 250 mg methylprednisolone was needed at higher rates (p=0.002). Newly diagnosed DM had higher rates of intubation (21.6%) and more mortality (20.0%) (p=0.045 and p=0.028, respectively). Mortality and hospitalization in the ICU were lower in the group receiving antidiabetic treatment. The risk of ICU attendance was higher in patients with impaired fasting glucose (HR=1.71, 95% CI: 0.48 to 6.08) and newly diagnosed DM (HR=1.88, 95% CI: 0.57 to 6.17), compared with pre-existing DM and non-diabetics. Newly diagnosed DM and impaired fasting glucose are associated with increased mortality and intubation in inpatients with COVID-19.
Collapse
Affiliation(s)
- Banu Boyuk
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Seydahmet Akin
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Nazire Aladag
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Arzu Isik
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Hande Erman
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Yasemin Ozgur
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Meryem Topal
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Nevra Karademir
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Busra Tomar Uysal
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Bahar Ozbilgehan
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Dilan Kabaca
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Canan Kalmaz
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| | - Seyma Arslan
- Public Health, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Turkey
| | - Ozcan Keskin
- Internal Medicine, Istanbul Kartal Dr Lufti Kirdar City Hospital, Istanbul, Turkey
| |
Collapse
|
23
|
Farakla I, Lagousi T, Miligkos M, Nicolaides N, Vasilakis IA, Mpinou M, Dolianiti M, Katechaki E, Taliou A, Spoulou V, Kanaka-Gantenbein C. Stress hyperglycemia, Diabetes mellitus and COVID-19 infection: The impact on newly diagnosed type 1 diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:818945. [PMID: 36992762 PMCID: PMC10012074 DOI: 10.3389/fcdhc.2022.818945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 07/29/2022] [Indexed: 11/13/2022]
Abstract
Several recent studies have documented an increased incidence of newly diagnosed type 1 Diabetes (T1D) cases in children and adolescents during the COVID-19 pandemic and a more severe presentation at diabetes onset. In this descriptive study, we present the experience of the Diabetes Centre of the Division of Endocrinology, Diabetes, and Metabolism of the First Department of Pediatrics of the National and Kapodistrian University of Athens Medical School at “Aghia Sophia” Children’s Hospital in Athens, Greece, concerning new cases of T1D diagnosis during the COVID-19 pandemic (March 2020- December 2021). Patients who had already been diagnosed with T1D and needed hospitalization due to poor control during the pandemic have been excluded from this study. Eighty- three children and adolescents with a mean age of 8,5 ± 4.02 years were admitted to the hospital due to newly diagnosed T1D during this 22 months’ period in comparison to 34 new cases in the previous year. All patients admitted during the pandemic with a new diagnosis of T1D, presented in their majority with DKA (Ph: 7.2) representing an increase of new severe cases in comparison to previous years (Ph 7.2 versus 7.3, p value: 0.021, in the previous year), [p-value: 0.027]. 49 cases presented with DKA, of which 24 were characterized moderate and 14 severe DKA (28.9% and 16,9%, respectively), while 5 patients newly diagnosed, needed to be admitted to the ICU to recover from severe acidosis. Whether a previous COVID- 19 infection could have been the triggering factor is not supported by the SARS-Cov2 specific antibodies analysis in our cohort of patients. As far as HbA1c is concerned there was no statistically significant difference between the pre COVID-19 year and the years of the pandemic (11.6% versus 11.9%, p- value: 0.461). Triglycerides values were significantly higher in patients with new onset T1D during COVID-19 years compared to those before the pandemic (p value= 0.032). Additionally, there is a statistically significant correlation between Ph and Triglycerides for the whole period 2020-2021 (p-value<0.001), while this correlation is not significant for the year 2019. More large- scale studies are required to confirm these observations.
Collapse
Affiliation(s)
- Ioanna Farakla
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Theano Lagousi
- Immunobiology Research Laboratory and Infectious Diseases Department “MAKKA”, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Michael Miligkos
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Nicolas C. Nicolaides
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Ioannis-Anargyros Vasilakis
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Maria Mpinou
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Maria Dolianiti
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Elina Katechaki
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Anilia Taliou
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Vasiliki Spoulou
- Immunobiology Research Laboratory and Infectious Diseases Department “MAKKA”, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Christina Kanaka-Gantenbein
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
- *Correspondence: Christina Kanaka-Gantenbein,
| |
Collapse
|
24
|
Brooks D, Schulman-Rosenbaum R, Griff M, Lester J, Low Wang CC. Glucocorticoid-Induced Hyperglycemia Including Dexamethasone-Associated Hyperglycemia in COVID-19 Infection: A Systematic Review. Endocr Pract 2022; 28:1166-1177. [PMID: 35940469 PMCID: PMC9354392 DOI: 10.1016/j.eprac.2022.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 01/08/2023]
|
25
|
Ocampo Benavides CE, Morales M, Cañón-Muñoz M, Pallares-Gutierrez C, López KD, Fernández-Osorio A. Características clínicas, imagenológicas y de laboratorio de pacientes con COVID-19 según requerimiento de ingreso a UCI en Cali, Colombia. REVISTA DE LA FACULTAD DE MEDICINA 2022. [DOI: 10.15446/revfacmed.v71n2.98696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introducción. Actualmente, hay pocos estudios en Latinoamérica sobre las características demográficas, clínicas y de laboratorio de pacientes con COVID-19 y con requerimiento de ingreso a unidad de cuidados intensivos (UCI).
Objetivo. Comparar las características sociodemográficas, clínicas, imagenológicas y de laboratorio de pacientes diagnosticados con COVID-19 atendidos en el servicio de urgencias de una clínica en Cali, Colombia, según requerimiento de ingreso a UCI.
Materiales y métodos. Estudio retrospectivo descriptivo de cohorte única realizado en 49 adultos con COVID-19 atendidos en el servicio de urgencias de un hospital de cuarto nivel de atención en Cali, Colombia, en marzo y abril de 2020, los cuales se dividieron en dos grupos: requerimiento de UCI (n=24) y no requerimiento de UCI (n=25). Se realizaron análisis bivariados para determinar las diferencias entre ambos grupos (pruebas de chi-2, exacta de Fisher, t de Student y U de Mann-Whitney), con un nivel de significancia de p<0.05.
Resultados. La edad promedio fue 53 años (DE=13) y 29 pacientes fueron hombres. Se encontraron diferencias significativas entre ambos grupos en las siguientes variables: edad promedio (UCI x̅=58 vs. No UCI x̅=49; p=0.020), presencia de diabetes (8 vs. 1; p=0.010), presencia de dificultad respiratoria (20 vs. 11; p=0.007), presencia uni o bilateral de áreas de consolidación (12 vs. 3; p=0.005), mediana del conteo de leucocitos (Med=7570/mm3 vs. Med=5130/mm3; p=0.0013), de neutrófilos (Med=5980/mm3 vs. Med=3450/mm3; p=0,0001) y linfocitos (Med=865/mm3 vs. Med=1400/mm3; p<0,0001), mediana de proteína C reactiva (Med=141,25mg/L vs. Med=27,95mg/L; p<0,001), ferritina (Med=1038ng/L vs. Med=542,5ng/L; p=0.0073) y lactato-deshidrogenasa (Med=391U/L vs, Med=248,5U/L, p=0,0014). Finalmente, 15 pacientes requirieron ventilación mecánica invasiva, 2 presentaron extubación fallida, y en total, 5 fallecieron.
Conclusiones. Se observaron diferencias significativas en los valores de varios marcadores inflamatorios, daño celular y parámetros del hemograma entre los pacientes que requirieron admisión a la UCI y los que no, por lo que estas variables podrían emplearse para desarrollar herramientas que contribuyan a establecer el pronóstico de esta enfermedad.
Collapse
|
26
|
Boddhula S, Boddhula SK, Reddy Garlapati P, Patel MJ, Ekanem S, Adapa S, Fong V, Balaji S, Murthi S, Gayam V. Diabetic Ketoacidosis and COVID-19: A Case Series From an Inner-City Community Teaching Hospital in New York. Cureus 2022; 14:e26580. [PMID: 35936183 PMCID: PMC9351819 DOI: 10.7759/cureus.26580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction: Throughout the coronavirus disease 2019 (COVID-19) pandemic, studies have repeatedly shown that COVID-19 outcomes are more severe in the elderly and those with comorbidities, with diabetes being a significant risk factor associated with more severe infection. Here, we present the clinical characteristics of 25 patients with pre-existing type 2 diabetes mellitus who presented with diabetic ketoacidosis (DKA) and COVID-19 in a community hospital in Brooklyn, New York, and identify possible predictors of mortality. Methods: This retrospective case series recruited patients from March 1st to April 9th, 2020, with lab-confirmed COVID-19 and met DKA criteria on admission (based on American Diabetes Association diagnostic criteria for DKA). Results: Of the 25 patients who met the inclusion criteria, 22 were African American and three were Hispanic. Common comorbidities in addition to diabetes were hypertension, obesity, coronary artery disease, and dyslipidemia. Fever, cough, myalgias, and shortness of breath were common presenting symptoms. Most patients had elevated inflammatory markers erythrocyte sedimentation rate, C-reactive protein, D-dimer, and ferritin, but higher values increased the odds of mortality. The overall survival was 64%, with those recovering having more extended hospital stays but requiring less time in the intensive care unit. At the same time, those who died were more likely to require mechanical ventilation, have an acute cardiac injury, and/or be obese. Despite numerous studies on COVID and diabetes, only a few studies described DKA. Conclusion: This observational retrospective study illustrated that patients with diabetes are at risk of developing DKA with COVID-19 and identified some predictors of mortality. However, further studies with larger sample sizes and a control group are necessary to understand better the effects of COVID-19 on DKA and their clinical outcomes.
Collapse
|
27
|
Barmanray RD, Cheuk N, Fourlanos S, Greenberg PB, Colman PG, Worth LJ. In-hospital hyperglycemia but not diabetes mellitus alone is associated with increased in-hospital mortality in community-acquired pneumonia (CAP): a systematic review and meta-analysis of observational studies prior to COVID-19. BMJ Open Diabetes Res Care 2022; 10:10/4/e002880. [PMID: 35790320 PMCID: PMC9257863 DOI: 10.1136/bmjdrc-2022-002880] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/08/2022] [Indexed: 01/08/2023] Open
Abstract
The objective of this review was to quantify the association between diabetes, hyperglycemia, and outcomes in patients hospitalized for community-acquired pneumonia (CAP) prior to the COVID-19 pandemic by conducting a systematic review and meta-analysis. Two investigators independently screened records identified in the PubMed (MEDLINE), EMBASE, CINAHL, and Web of Science databases. Cohort and case-control studies quantitatively evaluating associations between diabetes and in-hospital hyperglycemia with outcomes in adults admitted to hospital with CAP were included. Quality was assessed using the Newcastle-Ottawa Quality Assessment Scale, effect size using random-effects models, and heterogeneity using I2 statistics. Thirty-eight studies met the inclusion criteria. Hyperglycemia was associated with in-hospital mortality (adjusted OR 1.28, 95% CI 1.09 to 1.50) and intensive care unit (ICU) admission (crude OR 1.82, 95% CI 1.17 to 2.84). There was no association between diabetes status and in-hospital mortality (adjusted OR 1.04, 95% CI 0.72 to 1.51), 30-day mortality (adjusted OR 1.13, 95% CI 0.77 to 1.67), or ICU admission (crude OR 1.91, 95% CI 0.74 to 4.95). Diabetes was associated with increased mortality in all studies reporting >90-day postdischarge mortality and with longer length of stay only for studies reporting crude (OR 1.50, 95% CI 1.11 to 2.01) results. In adults hospitalized with CAP, in-hospital hyperglycemia but not diabetes alone is associated with increased in-hospital mortality and ICU admission. Diabetes status is associated with increased >90-day postdischarge mortality. Implications for management are that in-hospital hyperglycemia carries a greater risk for in-hospital morbidity and mortality than diabetes alone in patients admitted with non-COVID-19 CAP. Evaluation of strategies enabling timely and effective management of in-hospital hyperglycemia in CAP is warranted.
Collapse
Affiliation(s)
- Rahul D Barmanray
- Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nathan Cheuk
- Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Spiros Fourlanos
- Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter B Greenberg
- Department of General Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Peter G Colman
- Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Leon J Worth
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- National Centre for Infections in Cancer (NCIC), Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
28
|
Bae JH, Choe HJ, Holick MF, Lim S. Association of vitamin D status with COVID-19 and its severity : Vitamin D and COVID-19: a narrative review. Rev Endocr Metab Disord 2022; 23:579-599. [PMID: 34982377 PMCID: PMC8724612 DOI: 10.1007/s11154-021-09705-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 01/08/2023]
Abstract
Vitamin D is associated with biological activities of the innate and adaptive immune systems, as well as inflammation. In observational studies, an inverse relationship has been found between serum 25-hydroxyvitamin D (25(OH)D) concentrations and the risk or severity of coronavirus disease 2019 (COVID-19). Several mechanisms have been proposed for the role of vitamin D in COVID-19, including modulation of immune and inflammatory responses, regulation of the renin-angiotensin-aldosterone system, and involvement in glucose metabolism and cardiovascular system. Low 25(OH)D concentrations might predispose patients with COVID-19 to severe outcomes not only via the associated hyperinflammatory syndrome but also by worsening preexisting impaired glucose metabolism and cardiovascular diseases. Some randomized controlled trials have shown that vitamin D supplementation is beneficial for reducing severe acute respiratory syndrome coronavirus 2 RNA positivity but not for reducing intensive care unit admission or all-cause mortality in patients with moderate-to-severe COVID-19. Current evidence suggests that taking a vitamin D supplement to maintain a serum concentration of 25(OH)D of at least 30 ng/mL (preferred range 40-60 ng/mL), can help reduce the risk of COVID-19 and its severe outcomes, including mortality. Although further well designed studies are warranted, it is prudent to recommend vitamin D supplements to people with vitamin D deficiency/insufficiency during the COVID-19 pandemic according to international guidelines.
Collapse
Affiliation(s)
- Jae Hyun Bae
- grid.411134.20000 0004 0474 0479Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hun Jee Choe
- grid.412484.f0000 0001 0302 820XDepartment of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Michael F. Holick
- grid.189504.10000 0004 1936 7558Section of Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University Medical Campus, 715 Albany St #437, Boston, MA 02118 USA
| | - Soo Lim
- grid.412480.b0000 0004 0647 3378Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620 South Korea
| |
Collapse
|
29
|
Plasma glucose levels and diabetes are independent predictors for mortality in patients with COVID-19. Epidemiol Infect 2022; 150:e106. [PMID: 35570587 PMCID: PMC9171060 DOI: 10.1017/s095026882200022x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This study is performed to figure out how the presence of diabetes affects the infection, progression and prognosis of 2019 novel coronavirus disease (COVID-19), and the effective therapy that can treat the diabetes-complicated patients with COVID-19. A multicentre study was performed in four hospitals. COVID-19 patients with diabetes mellitus (DM) or hyperglycaemia were compared with those without these conditions and matched by propensity score matching for their clinical progress and outcome. Totally, 2444 confirmed COVID-19 patients were recruited, from whom 336 had DM. Compared to 1344 non-DM patients with age and sex matched, DM-COVID-19 patients had significantly higher rates of intensive care unit entrance (12.43% vs. 6.58%, P = 0.014), kidney failure (9.20% vs. 4.05%, P = 0.027) and mortality (25.00% vs. 18.15%, P < 0.001). Age and sex-stratified comparison revealed increased susceptibility to COVID-19 only from females with DM. For either non-DM or DM group, hyperglycaemia was associated with adverse outcomes, featured by higher rates of severe pneumonia and mortality, in comparison with non-hyperglycaemia. This was accompanied by significantly altered laboratory indicators including lymphocyte and neutrophil percentage, C-reactive protein and urea nitrogen level, all with correlation coefficients >0.35. Both diabetes and hyperglycaemia were independently associated with adverse prognosis of COVID-19, with hazard ratios of 10.41 and 3.58, respectively.
Collapse
|
30
|
Boden I, Bernabeu MO, Dhillon B, Dorward DA, MacCormick I, Megaw R, Tochel C. Pre-existing diabetic retinopathy as a prognostic factor for COVID-19 outcomes amongst people with diabetes: A systematic review. Diabetes Res Clin Pract 2022; 187:109869. [PMID: 35395248 PMCID: PMC8982479 DOI: 10.1016/j.diabres.2022.109869] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 01/11/2023]
Abstract
AIMS Certain patients with Diabetes Mellitus (DM) have high risk for complications from COVID-19. We aimed to test the hypothesis that pre-existing diabetic retinopathy (DR), a microvascular disease, is a prognostic indicator for poor COVID-19 outcome in this heterogeneous population. METHODS Seven databases (including MEDLINE) and grey literature were searched, identifying eligible studies using predetermined selection criteria. The Quality in Prognosis Studies (QUIPS) tool was used for quality assessment, followed by narrative synthesis of included studies. RESULTS Eight cohort studies were identified. Three showed significant positive associations between DR and poor COVID-19 outcomes. The highest quality study, McGurnaghan, found increased risk of the combined outcome fatal or critical care unit (CCU)-treated COVID-19 with referable-grade DR (OR 1.672, 95% CI 1.38-2.03). Indirectly, four studies reported positive associations with microvascular disease and poorer prognosis. Variability between studies limited comparability. CONCLUSIONS The current literature suggests an independent association between DR and poorer COVID-19 prognosis in patients with DM after controlling for key variables such as age. The use of standardised methodology in future studies would establish the predictive value of DR with greater confidence. Researchers should consider comparing the predictive value of DR and its severity, to other microvascular complications of DM.
Collapse
Affiliation(s)
- Isabel Boden
- Edinburgh Medical School, Chancellor's Building, Edinburgh Bioquarter, EH16 4SB, United Kingdom.
| | - Miguel O Bernabeu
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, EH16 4UX, United Kingdom; The Bayes Centre, University of Edinburgh, Edinburgh EH8 9BT, United Kingdom
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, Chancellor's Building, University of Edinburgh, EH16 4SB, United Kingdom
| | - David A Dorward
- Department of Pathology, Royal Infirmary Edinburgh, Edinburgh EH16 4SA, United Kingdom
| | - Ian MacCormick
- Deanery of Clinical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, EH16 4SB, United Kingdom
| | - Roly Megaw
- MRC Human Genetics Unit, University of Edinburgh, EH4 2XU, United Kingdom; Princess Alexandra Eye Pavilion, NHS Lothian, Chalmers St, Edinburgh EH3 9HA, United Kingdom
| | - Claire Tochel
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, EH16 4UX, United Kingdom.
| |
Collapse
|
31
|
Olarte Carrillo I, Ramos Peñafiel CO, Mendoza Salas I, Cerón Maldonado R, García Laguna AI, De la Cruz Rosas A, Martinez Murrillo C, Martinez Tovar A. Impact of the ABCB1 Drug Resistance Gene on the Risk Factors of Patients with COVID-19 and Its Relationship with the Drugs Used. Infect Drug Resist 2022; 15:2661-2669. [PMID: 35637928 PMCID: PMC9147417 DOI: 10.2147/idr.s358389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022] Open
Abstract
Objective In the last two years progress was made in molecular, physio pathological understanding and the form of transmission of COVID-19, and different therapeutic strategies have been explored to deal with the situation of the pandemic. However, the evaluation of certain genes that participate in the metabolism and transport of these drugs has not been fully explored. A lack of response to treatment and a lower survival have been observed that may be due to the presence of the ABCB1 drug resistance gene. Our research group analyzed whether the expression levels of the ABCB1 gene are associated with comorbidities, treatments, overall survival and risk of death in patients with severe COVID-19. Methods The expression levels of the ABCB1 gene were analyzed by RT-qPCR in 61 patients diagnosed with COVID-19. The association between the levels of expression, the risk variables and different treatments were determined by the Chi-Square test and the Fisher’s exact test. Global Survival (GS) was determined by the Kaplan–Meier method. The impact of high levels of expression and the risk of death was performed by odds ratio. Results The different risk variables showed that patients with either high or absent levels of ABCB1 gene expression presented a greater risk of death (OR 3.08, 95%, CI 1.02–9.26) as well as need for ventilatory support (OR 2.8, 95%, CI 0.98 −8.5). Patients with diabetes and COVID-19, treated with metformin, were associated with a lower risk of death (OR 1.11, 95%, CI 0.38–3.22). OS with respect to high or absent levels of expression of the ABCB1 gene was lower. Conclusion High levels or null expression of the ABCB1 gene are associated with a higher risk of death or progression of the disease, the use of metformin in patients with COVID-19 confers a lower risk of death.
Collapse
Affiliation(s)
- Irma Olarte Carrillo
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | | | - Iveth Mendoza Salas
- Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | - Rafael Cerón Maldonado
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | - Anel Irais García Laguna
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | - Adrián De la Cruz Rosas
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | - Carlos Martinez Murrillo
- Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
| | - Adolfo Martinez Tovar
- Laboratorio de Biología Molecular, Servicio de Hematología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Mexico
- Correspondence: Adolfo Martinez Tovar, Labortororio de Biología Molecular, Servicio de Hematología, Hospital General de Mexico “Dr. Eduardo Liceaga”, Ciudad de México, Mexico, Email
| |
Collapse
|
32
|
Diabetes might not be a risk factor for worse prognosis among hospitalized patients due to COVID-19 in a Mediterranean area. NUTR HOSP 2022; 39:547-553. [PMID: 35485382 DOI: 10.20960/nh.03855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM type-2 diabetes (T2DM) seems to worsen the prognosis of patients admitted for COVID-19, although most studies included Asiatic patients. We aimed to assess whether this condition applies for Mediterranean patients. METHODS a total of 90 patients admitted for COVID-19 with T2DM were retrospectively compared with 50 patients without T2DM. RESULTS subjects with T2DM were older than their counterparts (73.3 ± 12.4 vs 53 ± 15.7 years; p < 0.0001). Either absolute lymphocyte count (1.1 ± 0.6 vs 1.3 ± 0.7 x 109/L; p = 0.005) or hemoglobin (11.9 ± 1.6 vs 13.1 ± 2.1 g/dL; p < 0.0001) were lower among subjects with T2DM. CRP and procalcitonin were higher among subjects with T2DM (91.9 ± 71.2 vs 70.1 ± 63.3 mg/L; p = 0.002 and 0.8 ± 0.3 vs 0.4 ± 0.1 ng/mL; p < 0.0001, respectively). Albumin was lower among patients with T2DM (3.4 ± 0.5 vs 3.8 ± 0.5 g/L: p < 0.001). Length of stay was longer among subjects with T2DM (11.7 ± 7.7 vs 9.7 ± 8.6 days; p = 0.01). However, both groups were comparable regarding both the proportion of subjects who were admitted to the ICU (16.5 % vs 8 %; p = 0.1) and mortality (11 % vs 4 %; p = 0.2). CONCLUSIONS in a Mediterranean sample, despite of age, comorbidities, nutritional status, and inflammatory markers, subjects with T2DM with a proper glycemic control admitted for COVID-19 had similar prognostic outcomes than patients without this metabolic condition.
Collapse
|
33
|
Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
34
|
Gerganova A, Assyov Y, Kamenov Z. Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:826006. [PMID: 36992767 PMCID: PMC10012081 DOI: 10.3389/fcdhc.2022.826006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/07/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory distress syndrome-coronavirus 2 (SARS-CoV-2) has caused one of the most substantial pandemics that has affected humanity in the last century. At the time of the preparation of this review, it has caused the death of around 5 million people around the globe. There is ample evidence linking higher mortality risk rates from Coronavirus disease-19 (COVID-19) with male gender, advancing age and comorbidities, such as obesity, arterial hypertension, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, and cancer. Hyperglycemia has been found to be accompanying COVID-19 not only in individuals with overt diabetes. Many authors claim that blood glucose levels should also be monitored in non-diabetic patients; moreover, it has been confirmed that hyperglycemia worsens the prognosis even without pre-existing diabetes. The pathophysiological mechanisms behind this phenomenon are complex, remain controversial, and are poorly understood. Hyperglycemia in the setting of COVID-19 could be a consequence of deterioration in pre-existing diabetes, new-onset diabetes, stress-induced or iatrogenic due to substantial usage of corticosteroids within the context of a severe COVID-19 infection. It is also plausible that it might be a result of adipose tissue dysfunction and insulin resistance. Last but not least, SARS-CoV-2 is also claimed to trigger sporadically direct β-cell destruction and β-cell autoimmunity. Pending further validations with longitudinal data are needed to legitimize COVID-19 as a potential risk factor for the development of diabetes. Hereby, we present an emphasized critical review of the available clinical data in an attempt to unravel the complex mechanisms behind hyperglycemia in COVID-19 infection. The secondary endpoint was to evaluate the bidirectional relationship between COVID-19 and diabetes mellitus. As the worldwide pandemic is still expanding, demand for answering these questions is arising. It will be of immense help for the management of COVID-19 patients, as well as for the implementation of post-discharge policies for patients with a high risk of developing diabetes.
Collapse
Affiliation(s)
- Antonina Gerganova
- Department of Internal Medicine, Medical University - Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital Alexandrovska, Sofia, Bulgaria
| | - Yavor Assyov
- Department of Internal Medicine, Medical University - Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital Alexandrovska, Sofia, Bulgaria
| | - Zdravko Kamenov
- Department of Internal Medicine, Medical University - Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital Alexandrovska, Sofia, Bulgaria
- *Correspondence: Zdravko Kamenov, orcid.org/0000-0002-4829-9449
| |
Collapse
|
35
|
Huzum B, Curpan AS, Puha B, Serban DN, Veliceasa B, Necoara RM, Alexa O, Serban IL. Connections between Orthopedic Conditions and Oxidative Stress: Current Perspective and the Possible Relevance of Other Factors, Such as Metabolic Implications, Antibiotic Resistance, and COVID-19. Medicina (B Aires) 2022; 58:medicina58030439. [PMID: 35334615 PMCID: PMC8951198 DOI: 10.3390/medicina58030439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/06/2022] [Accepted: 03/10/2022] [Indexed: 12/15/2022] Open
Abstract
The general opinion in the literature is that these topics remain clearly understudied and underrated, with many unknown aspects and with controversial results in the respective areas of research. Based on the previous experience of our groups regarding such matters investigated separately, here we attempt a short overview upon their links. Thus, we summarize here the current state of knowledge regarding the connections between oxidative stress and: (a) orthopedic conditions; (b) COVID-19. We also present the reciprocal interferences among them. Oxidative stress is, of course, an interesting and continuously growing area, but what exactly is the impact of COVID-19 in orthopedic patients? In the current paper we also approached some theories on how oxidative stress, metabolism involvement, and even antibiotic resistance might be influenced by either orthopedic conditions or COVID-19. These manifestations could be relevant and of great interest in the context of this current global health threat; therefore, we summarize the current knowledge and/or the lack of sufficient evidence to support the interactions between these conditions.
Collapse
Affiliation(s)
- Bogdan Huzum
- Department of Orthopaedic and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (B.H.); (B.P.); (B.V.); (O.A.)
- Department of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Alexandrina Stefania Curpan
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University of Iasi, Carol I Avenue, 20A, 700554 Iasi, Romania
- Correspondence: (A.S.C.); (D.N.S.)
| | - Bogdan Puha
- Department of Orthopaedic and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (B.H.); (B.P.); (B.V.); (O.A.)
| | - Dragomir Nicolae Serban
- Department of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Correspondence: (A.S.C.); (D.N.S.)
| | - Bogdan Veliceasa
- Department of Orthopaedic and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (B.H.); (B.P.); (B.V.); (O.A.)
| | - Riana Maria Necoara
- Radiology-Imaging Clinic, “Sf. Spiridon” Clinical Emergency Hospital, 700111 Iasi, Romania;
| | - Ovidiu Alexa
- Department of Orthopaedic and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (B.H.); (B.P.); (B.V.); (O.A.)
| | - Ionela Lacramioara Serban
- Department of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| |
Collapse
|
36
|
Fathi M, Markazi Moghaddam N, Kheyrati L. Development and validation of models for two‐week mortality of inpatients with
COVID
‐19 infection: A large prospective cohort study. Stat Anal Data Min 2022. [DOI: 10.1002/sam.11572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Mohammad Fathi
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Anesthesiology, Faculty of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Nader Markazi Moghaddam
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Health Management and Economics, Faculty of Medicine AJA University of Medical Sciences Tehran Iran
| | - Leila Kheyrati
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| |
Collapse
|
37
|
Gao Q, Zhang W, Li T, Yang G, Zhu W, Chen N, Jin H. Interrelationship between 2019-nCov receptor DPP4 and diabetes mellitus targets based on protein interaction network. Sci Rep 2022; 12:188. [PMID: 34996987 PMCID: PMC8741798 DOI: 10.1038/s41598-021-03912-6] [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] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/10/2021] [Indexed: 01/08/2023] Open
Abstract
Patients with diabetes are more likely to be infected with Coronavirus disease 2019 (COVID-19), and the risk of death is significantly higher than ordinary patients. Dipeptidyl peptidase-4 (DPP4) is one of the functional receptor of human coronavirus. Exploring the relationship between diabetes mellitus targets and DPP4 is particularly important for the management of patients with diabetes and COVID-19. We intend to study the protein interaction through the protein interaction network in order to find a new clue for the management of patients with diabetes with COVID-19. Diabetes mellitus targets were obtained from GeneCards database. Targets with a relevance score exceeding 20 were included, and DPP4 protein was added manually. The initial protein interaction network was obtained through String. The targets directly related to DPP4 were selected as the final analysis targets. Importing them into String again to obtain the protein interaction network. Module identification, gene ontology (GO) analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis were carried out respectively. The impact of DPP4 on the whole network was analyzed by scoring the module where it located. 43 DPP4-related proteins were finally selected from the diabetes mellitus targets and three functional modules were found by the cluster analysis. Module 1 was involved in insulin secretion and glucagon signaling pathway, module 2 and module 3 were involved in signaling receptor binding. The scoring results showed that LEP and apoB in module 1 were the highest, and the scores of INS, IL6 and ALB of cross module associated proteins of module 1 were the highest. DPP4 is widely associated with key proteins in diabetes mellitus. COVID-19 may affect DPP4 in patients with diabetes mellitus, leading to high mortality of diabetes mellitus combined with COVID-19. DPP4 inhibitors and IL-6 antagonists can be considered to reduce the effect of COVID-19 infection on patients with diabetes.
Collapse
Affiliation(s)
- Qian Gao
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China.
| | - Wenjun Zhang
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China
| | - Tingting Li
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China
| | - Guojun Yang
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China
| | - Wei Zhu
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China
| | - Naijun Chen
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China
| | - Huawei Jin
- Affiliated Hospital of Shaoxing University of Endocrine and Metabolism Department, Zhejiang, China
| |
Collapse
|
38
|
Duan W, Li L, Li X, Zhu M, Wu L, Wu W, Li K, Liang Y, Ding R, You W, Wang Z, Huang B, Wu M, Zhang T, Li J, Li Y, Shao J, Lin C, Li P, Wang Q, Wang S, Xia X, Liu Y, Lyu S. Association of blood glucose level and prognosis of inpatients with coexistent diabetes and COVID-19. Endocrine 2022; 75:1-9. [PMID: 34716852 PMCID: PMC8556798 DOI: 10.1007/s12020-021-02923-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023]
Abstract
Type 2 diabetes (T2D) increases the risk of coronavirus disease (COVID-19). This study investigates the association between glucose control of COVID-19 patients with T2D in first 7 days after hospital admission and prognosis. A total of 252 infected inpatients with T2D in China were included. Well-controlled blood glucose was defined as stable fasting blood glucose (FBG) levels in the range of 3.9-7.8 mmol/L during first 7 days using indicators of average (FBGA), maximum (FBGM) or first-time (FBG1) FBG levels. The primary endpoint was admission to intensive care unit or death. Hazard ratio (HR) of poorly controlled glucose level group compared with well-controlled group were 4.96 (P = 0.021) for FBGM and 5.55 (P = 0.014) for FBGA. Well-controlled blood glucose levels in first 7 days could improve the prognosis of COVID-19 inpatients with diabetes.
Collapse
Affiliation(s)
- Weiwei Duan
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China.
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, China.
| | - Liangyu Li
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Xuesong Li
- Key Laboratory of Cardiovascular and Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Mengyan Zhu
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Lingxiang Wu
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Wei Wu
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Kening Li
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Yuan Liang
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Rong Ding
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Wenhua You
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Ziyu Wang
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Bin Huang
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Min Wu
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Tingting Zhang
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Jie Li
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Yan Li
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Jiaofang Shao
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Changsong Lin
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Pengping Li
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
| | - Qianghu Wang
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Shukui Wang
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xinyi Xia
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, China.
- Joint Expert Group for COVID-19, Department of Laboratory Medicine & Blood Transfusion, Wuhan Huoshenshan Hospital, Wuhan, Hubei, 430100, China.
| | - Yu Liu
- Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
| | - Sali Lyu
- Research Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China.
- Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China.
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
39
|
Pelle MC, Zaffina I, Provenzano M, Moirano G, Arturi F. COVID-19 and diabetes-Two giants colliding: From pathophysiology to management. Front Endocrinol (Lausanne) 2022; 13:974540. [PMID: 36060943 PMCID: PMC9437522 DOI: 10.3389/fendo.2022.974540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/01/2022] [Indexed: 01/08/2023] Open
Abstract
Since December 2019, a new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread around the world, causing the coronavirus 2019 (COVID-19) pandemic. From the beginning, SARS-CoV-2 has put a strain on the health system. In fact, many patients have had severe forms of the disease with the need for hospitalization due to respiratory failure. To contain the pandemic, the most widely used approach has been lockdowns. Social restrictions have been reduced thanks to the development of vaccines and targeted therapies. However, fatal events still occur among people at high risk of serious infection, such as patients with concomitant diabetes. Different mechanisms have been proposed to explain the poor prognosis of patients with diabetes and COVID-19, but the specific cause is unclear. It is now known that insulin resistance, inflammation, and cytokine storm are involved. Moreover, SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptors to enter cells. This receptor is expressed on pancreatic beta cells and, during infection, it appears that receptor involvement may induce hyperglycemia in patients with or without diabetes. In this study, we discuss the mechanisms underlying the poor prognosis in people with COVID-19 and diabetes and what may improve the outcome in these patients.
Collapse
Affiliation(s)
- Maria Chiara Pelle
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
| | - Isabella Zaffina
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
| | - Michele Provenzano
- Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giovenale Moirano
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
- *Correspondence: Franco Arturi,
| |
Collapse
|
40
|
Uranga A, Villanueva A, Lafuente I, González N, Legarreta MJ, Aguirre U, España PP, Quintana JM, García-Gutiérrez S. [Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study]. Rev Clin Esp 2022; 222:22-30. [PMID: 34054133 PMCID: PMC8141782 DOI: 10.1016/j.rce.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/25/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There is controversy regarding the best predictors of clinical deterioration in COVID-19. OBJECTIVE This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19. METHODS DESIGN Nested case-control study within a cohort. Setting: 13 acute care centers of the Osakidetza-Basque Health Service. Participants: Patients hospitalized for COVID-19 with clinical deterioration-defined as onset of severe ARDS, ICU admission, or death-were considered cases. Two controls were matched to each case based on age. Sociodemographic data; comorbidities; baseline treatment; symptoms; date of onset; previous consultations; and clinical, analytical, and radiological variables were collected. An explanatory model of clinical deterioration was created by means of conditional logistic regression. RESULTS A total of 99 cases and 198 controls were included. According to the logistic regression analysis, the independent variables associated with clinical deterioration were: emergency department O2 saturation ≤90% (OR 16.6; 95%CI 4-68), pathological chest X-ray (OR 5.6; 95%CI 1.7-18.4), CRP >100 mg/dL (OR 3.62; 95%CI 1.62-8), thrombocytopenia with < 150,000 platelets (OR 4; 95%CI 1.84-8.6); and a medical history of acute myocardial infarction (OR 15.7; 95%CI, 3.29-75.09), COPD (OR 3.05; 95%CI 1.43-6.5), or HT (OR 2.21; 95%CI 1.11-4.4). The model's AUC was 0.86. On the univariate analysis, female sex and presence of dry cough and sore throat were associated with better clinical progress, but were not found to be significant on the multivariate analysis. CONCLUSION The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes.
Collapse
Affiliation(s)
- A Uranga
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - A Villanueva
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - I Lafuente
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - N González
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| | - M J Legarreta
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - U Aguirre
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| | - P P España
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - J M Quintana
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| | - S García-Gutiérrez
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| |
Collapse
|
41
|
Chabuck ZG, Abed T. The interrelationship between diabetes mellitus and COVID-19. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_11_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
42
|
Uranga A, Villanueva A, Lafuente I, González N, Legarreta MJ, Aguirre U, España PP, Quintana JM, García-Gutiérrez S. Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study. Rev Clin Esp 2022; 222:22-30. [PMID: 34556435 PMCID: PMC8426292 DOI: 10.1016/j.rceng.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/25/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There is controversy regarding the best predictors of clinical deterioration in COVID-19. OBJECTIVE This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19. METHODS DESIGN Nested case-control study within a cohort. SETTING 13 acute care centers of the Osakidetza-Basque Health Service. PARTICIPANTS patients hospitalized for COVID-19 with clinical deterioration-defined as onset of severe ARDS, ICU admission, or death-were considered cases. Two controls were matched to each case based on age. Sociodemographic data; comorbidities; baseline treatment; symptoms; date of onset; previous consultations; and clinical, analytical, and radiological variables were collected. An explanatory model of clinical deterioration was created by means of conditional logistic regression. RESULTS A total of 99 cases and 198 controls were included. According to the logistic regression analysis, the independent variables associated with clinical deterioration were: emergency department O2 saturation ≤90% (OR 16.6; 95%CI 4-68), pathological chest X-ray (OR 5.6; 95%CI 1.7-18.4), CRP > 100 mg/dL (OR 3.62; 95%CI 1.62-8), thrombocytopenia with <150,000 platelets (OR 4; 95%CI 1.84-8.6); and a medical history of acute myocardial infarction (OR 15.7; 95%CI, 3.29-75.09), COPD (OR 3.05; 95%CI 1.43-6.5), or HT (OR 2.21; 95%CI 1.11-4.4). The model's AUC was 0.86. On the univariate analysis, female sex and presence of dry cough and sore throat were associated with better clinical progress, but were not found to be significant on the multivariate analysis. CONCLUSION The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes.
Collapse
Affiliation(s)
- A Uranga
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - A Villanueva
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - I Lafuente
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - N González
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - M J Legarreta
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - U Aguirre
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - P P España
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - J M Quintana
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - S García-Gutiérrez
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.
| |
Collapse
|
43
|
Kamyshnyi O, Matskevych V, Lenchuk T, Strilbytska O, Storey K, Lushchak O. Metformin to decrease COVID-19 severity and mortality: Molecular mechanisms and therapeutic potential. Biomed Pharmacother 2021; 144:112230. [PMID: 34628168 PMCID: PMC8492612 DOI: 10.1016/j.biopha.2021.112230] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 09/09/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 has become a serious challenge for medicine and science. Analysis of the molecular mechanisms associated with the clinical manifestations and severity of COVID-19 has identified several key points of immune dysregulation observed in SARS-CoV-2 infection. For diabetic patients, factors including higher binding affinity and virus penetration, decreased virus clearance and decreased T cell function, increased susceptibility to hyperinflammation, and cytokine storm may make these patients susceptible to a more severe course of COVID-19 disease. Metabolic changes induced by diabetes, especially hyperglycemia, can directly affect the immunometabolism of lymphocytes in part by affecting the activity of the mTOR protein kinase signaling pathway. High mTOR activity can enhance the progression of diabetes due to the activation of effector proinflammatory subpopulations of lymphocytes and, conversely, low activity promotes the differentiation of T-regulatory cells. Interestingly, metformin, an extensively used antidiabetic drug, inhibits mTOR by affecting the activity of AMPK. Therefore, activation of AMPK and/or inhibition of the mTOR-mediated signaling pathway may be an important new target for drug therapy in COVID-19 cases mostly by reducing the level of pro-inflammatory signaling and cytokine storm. These suggestions have been partially confirmed by several retrospective analyzes of patients with diabetes mellitus hospitalized for severe COVID-19.
Collapse
Affiliation(s)
- Olexandr Kamyshnyi
- Department of Microbiology, Virology and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Victoriya Matskevych
- Department of Radiology and Radiation Medicine, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Tetyana Lenchuk
- Department of Radiology and Radiation Medicine, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Olha Strilbytska
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Kenneth Storey
- Department of Biology, Carleton University, Ottawa, Canada
| | - Oleh Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine; Research and Development University, Ivano-Frankivsk, Ukraine.
| |
Collapse
|
44
|
Sharifi Y, Payab M, Mohammadi-Vajari E, Aghili SMM, Sharifi F, Mehrdad N, Kashani E, Shadman Z, Larijani B, Ebrahimpur M. Association between cardiometabolic risk factors and COVID-19 susceptibility, severity and mortality: a review. J Diabetes Metab Disord 2021; 20:1743-1765. [PMID: 34222055 PMCID: PMC8233632 DOI: 10.1007/s40200-021-00822-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/23/2021] [Indexed: 02/08/2023]
Abstract
The novel coronavirus, which began spreading from China Wuhan and gradually spreaded to most countries, led to the announcement by the World Health Organization on March 11, 2020, as a new pandemic. The most important point presented by the World Health Organization about this disease is to better understand the risk factors that exacerbate the course of the disease and worsen its prognosis. Due to the high majority of cardio metabolic risk factors like obesity, hypertension, diabetes, and dyslipidemia among the population over 60 years old and higher, these cardio metabolic risk factors along with the age of these people could worsen the prognosis of the coronavirus disease of 2019 (COVID-19) and its mortality. In this study, we aimed to review the articles from the beginning of the pandemic on the impression of cardio metabolic risk factors on COVID-19 and the effectiveness of COVID-19 on how to manage these diseases. All the factors studied in this article, including hypertension, diabetes mellitus, dyslipidemia, and obesity exacerbate the course of Covid-19 disease by different mechanisms, and the inflammatory process caused by coronavirus can also create a vicious cycle in controlling these diseases for patients.
Collapse
Affiliation(s)
- Yasaman Sharifi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Yaas Diabetes and Metabolic Diseases Research Center, Indiana University School of Medicine, Indianapolis, IN 46202 US
| | - Moloud Payab
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Mohammadi-Vajari
- Student of Medicine, School of Medicine, Gilan University of Medical Sciences, Rasht, Iran
| | - Seyed Morsal Mosallami Aghili
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Kashani
- Department of Obstetrics and Gynecology, Golestan University of Medical Sciences, Golestan, Iran
| | - Zhaleh Shadman
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
45
|
Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: Propensity score analysis of a territory-wide cohort in Hong Kong. DIABETES & METABOLISM 2021; 48:101307. [PMID: 34863934 PMCID: PMC8632053 DOI: 10.1016/j.diabet.2021.101307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/21/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry, hence further evaluation on DPP4i is needed. METHODS 1214 Patients with T2DM were admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively. RESULTS DPP4i users (N = 107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI -6.80 to -2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p = 0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality. CONCLUSION DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19.
Collapse
|
46
|
Abstract
Diabetes mellitus (DM) is one of the most common comorbid conditions in persons with COVID-19 and a risk factor for poor prognosis. The reasons why COVID-19 is more severe in persons with DM are currently unknown although the scarce data available on patients with DM hospitalized because of COVID-19 show that glycemic control is inadequate. The fact that patients with COVID-19 are usually cared for by health professionals with limited experience in the management of diabetes and the need to prevent exposure to the virus may also be obstacles to glycemic control in patients with COVID-19. Effective clinical care should consider various aspects, including screening for the disease in at-risk persons, education, and monitoring of control and complications. We examine the effect of COVID-19 on DM in terms of glycemic control and the restrictions arising from the pandemic and assess management of diabetes and drug therapy in various scenarios, taking into account factors such as physical exercise, diet, blood glucose monitoring, and pharmacological treatment. Specific attention is given to patients who have been admitted to hospital and critically ill patients. Finally, we consider the role of telemedicine in the management of DM patients with COVID-19 during the pandemic and in the future.
Collapse
|
47
|
Dos Santos T, Galipeau M, Schukarucha Gomes A, Greenberg M, Larsen M, Lee D, Maghera J, Mulchandani CM, Patton M, Perera I, Polishevska K, Ramdass S, Shayeganpour K, Vafaeian K, Van Allen K, Wang Y, Weisz T, Estall JL, Mulvihill EE, Screaton RA. Islet Biology during COVID-19: Progress and Perspectives. Can J Diabetes 2021; 46:419-427. [PMID: 35589534 PMCID: PMC8608413 DOI: 10.1016/j.jcjd.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023]
Abstract
The coronavirus-2019 (COVID-19) pandemic has had significant impact on research directions and productivity in the past 2 years. Despite these challenges, since 2020, more than 2,500 peer-reviewed articles have been published on pancreatic islet biology. These include updates on the roles of isocitrate dehydrogenase, pyruvate kinase and incretin hormones in insulin secretion, as well as the discovery of inceptor and signalling by circulating RNAs. The year 2020 also brought advancements in in vivo and in vitro models, including a new transgenic mouse for assessing beta-cell proliferation, a “pancreas-on-a-chip” to study glucose-stimulated insulin secretion and successful genetic editing of primary human islet cells. Islet biologists evaluated the functionality of stem-cell–derived islet-like cells coated with semipermeable biomaterials to prevent autoimmune attack, revealing the importance of cell maturation after transplantation. Prompted by observations that COVID-19 symptoms can worsen for people with obesity or diabetes, researchers examined how islets are directly affected by severe acute respiratory syndrome coronavirus 2. Herein, we highlight novel functional insights, technologies and therapeutic approaches that emerged between March 2020 and July 2021, written for both scientific and lay audiences. We also include a response to these advancements from patient stakeholders, to help lend a broader perspective to developments and challenges in islet research.
Collapse
Affiliation(s)
- Theodore Dos Santos
- Alberta Diabetes Institute & Department of Pharmacology, Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta, Canada
| | - Maria Galipeau
- Department of Molecular Biology, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; Institut de recherches cliniques de Montréal, Cardiometabolic Disease Centre, Montréal, Québec, Canada
| | - Amanda Schukarucha Gomes
- Alberta Diabetes Institute & Department of Pharmacology, Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Daniel Lee
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
| | - Jasmine Maghera
- Alberta Diabetes Institute & Department of Pharmacology, Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta, Canada
| | | | - Megan Patton
- Toronto General Hospital, Toronto, Ontario, Canada
| | - Ineli Perera
- Department of Biology and Institute of Biochemistry, Carleton University, Ottawa, Ontario, Canada
| | - Kateryna Polishevska
- Alberta Diabetes Institute and Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | | | - Kasra Shayeganpour
- Alberta Diabetes Institute and Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | | | - Kyle Van Allen
- Department of Biology and Institute of Biochemistry, Carleton University, Ottawa, Ontario, Canada
| | - Yufeng Wang
- University Health Network, Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Tom Weisz
- Toronto General Hospital, Toronto, Ontario, Canada
| | - Jennifer L Estall
- Department of Molecular Biology, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; Institut de recherches cliniques de Montréal, Cardiometabolic Disease Centre, Montréal, Québec, Canada
| | - Erin E Mulvihill
- Energy Substrate Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Biochemistry, Immunology and Microbiology, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert A Screaton
- Sunnybrook Research Institute, Department of Biochemistry, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
48
|
Katsiki N, Gómez‐Huelgas R, Mikhailidis DP, Pérez‐Martínez P. Narrative review on clinical considerations for patients with diabetes and COVID-19: More questions than answers. Int J Clin Pract 2021; 75:e14833. [PMID: 34510676 PMCID: PMC8646329 DOI: 10.1111/ijcp.14833] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/09/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND-AIM Diabetes, obesity and hypertension are common comorbidities associated with increased severity and mortality rates from Corona Virus Disease (COVID)-19. METHODS In this narrative review (using the PubMed database), we discuss epidemiological data and pathophysiological links between diabetes and COVID-19. The potential effects of glycaemic control and antidiabetic drugs on the prevalence and outcomes of COVID-19 are also reviewed, as well as the role of telemedicine and diabetes self-management in the post-COVID-19 era. RESULTS Diabetes has been linked to COVID-19 morbidity and mortality, although further research is needed to elucidate this association. In the meantime, physicians should be aware of the potential rise in the prevalence of diabetes (due to unhealthy lifestyle changes during the pandemic), its severity and complications and focus on achieving optimal diabetes prevention and management. Telemedicine and diabetes self-management may help towards this direction. Dipeptidyl-peptidase 4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose transporter 2 (SGLT2) inhibitors may affect viral entry and infection, and thus COVID-19 outcomes, as shown in observational studies. CONCLUSION Diabetes has been associated with COVID-19 development and progression. Certain antidiabetic drugs may influence COVID-19 prevention and management. The results of ongoing randomized clinical trials will shed more light on this field.
Collapse
Affiliation(s)
- Niki Katsiki
- First Department of Internal MedicineDiabetes CenterDivision of Endocrinology and MetabolismAHEPA University HospitalThessalonikiGreece
| | - Ricardo Gómez‐Huelgas
- Internal Medicine DepartmentRegional University Hospital of MálagaInstituto de Investigación Biomédica de Málaga (IBIMA)Universidad de MalagaMalagaSpain
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN)Instituto de Salud Carlos IIIMadridSpain
| | - Dimitri P. Mikhailidis
- Department of Clinical BiochemistryRoyal Free Hospital CampusUniversity College London Medical SchoolUniversity College London (UCL)LondonUK
| | - Pablo Pérez‐Martínez
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN)Instituto de Salud Carlos IIIMadridSpain
- Lipids and Atherosclerosis UnitDepartment of MedicineIMIBIC/Hospital Universitario Reina Sofía/Universidad de CordobaCordobaSpain
| |
Collapse
|
49
|
Nassar M, Daoud A, Nso N, Medina L, Ghernautan V, Bhangoo H, Nyein A, Mohamed M, Alqassieh A, Soliman K, Alfishawy M, Sachmechi I, Misra A. Diabetes Mellitus and COVID-19: Review Article. Diabetes Metab Syndr 2021; 15:102268. [PMID: 34562865 PMCID: PMC8416292 DOI: 10.1016/j.dsx.2021.102268] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS We aim to cover most of the current evidence on the mutual effect of diabetes & COVID-19 infection on each other and the management of the COVID-19 patients with diabetes. METHODS We utilized databases to review the current evidence related to diabetes mellitus and COVID-19. RESULTS We discussed the most recent evidence of diabetes milieus and COVID-19 regarding risk factors, management, complications, and telemedicine. CONCLUSION Diabetes mellitus is associated with a significant risk of complications, extended hospital stays, and mortality in COVID-19 infected patients.
Collapse
Affiliation(s)
- Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Ahmed Daoud
- Internal Medicine Department, Faculty of Medicine Cairo University, Cairo, Egypt.
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Luis Medina
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Victoria Ghernautan
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Harangad Bhangoo
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens, New York, USA.
| | - Andrew Nyein
- New York Institute of Technology College of Osteopathic Medicine, NYC, USA.
| | - Mahmoud Mohamed
- Medicine department, North Mississippi Medical Center, Tupelo, MS, USA.
| | - Ahmed Alqassieh
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | - Karim Soliman
- Division of Nephrology, Department of Medicine and Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | - Mostafa Alfishawy
- Infectious Diseases Consultants and Academic Researchers of Egypt IDCARE, Egypt.
| | - Issac Sachmechi
- Chair of Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals/Queens USA.
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, Chairman, National Diabetes, Obesity, And Cholesterol Foundation (N-DOC), President, Diabetes Foundation (India) (DFI), USA.
| |
Collapse
|
50
|
Birtay T, Bahadir S, Kabacaoglu E, Yetiz O, Demirci MF, Genctoy G. Prognosis of patients hospitalized with a diagnosis of COVID-19 pneumonia in a tertiary hospital in Turkey. Ann Saudi Med 2021; 41:327-335. [PMID: 34873938 PMCID: PMC8650597 DOI: 10.5144/0256-4947.2021.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV2/COVID-19 emerged in China and caused a global pandemic in 2020. The mortality rate has been reported to be between 0% and 14.6% in all patients. In this study, we determined the clinical and laboratory parameters of COVID-19 related morbidity and mortality in our hospital. OBJECTIVES Investigate the relationship between demographic, clinical, and laboratory parameters on COVID-19-related morbidity and mortality. DESIGN Retrospective observational study. SETTINGS Tertiary care hospital. PATIENTS AND METHODS Patients diagnosed with COVID-19 pneumonia from March until the end of December were included in the study. MAIN OUTCOME MEASURES The relationship between demographic, clinical, and laboratory parameters and the morbidity and mortality rates of patients diagnosed with COVID-19. SAMPLE SIZE 124 patients RESULTS: The mortality rate was 9.6% (12/124). Coronary artery disease (P<.0001) diabetes mellitus (P=.04) fever (>38.3°C) at presentation (P=.04) hypertension (P<.0001), and positive smoking history (P<.0001) were significantly associated with mortality. Patients who died were older, had a higher comorbid disease index, pneumonia severity index, fasting blood glucose, baseline serum creatinine, D-dimer, and had lower baseline haemoglobin, SaO2, percentage of lymphocyte counts and diastolic blood pressure. Patients admitted to the ICU were older, had a higher comorbidity disease index, pneumonia severity index, C-reactive protein, WBC, D-dimer, creatinine, number of antibiotics used, longer O2 support duration, lower hemoglobin, lymphocyte (%), and baseline SaO2 (%). CONCLUSIONS Our results were consistent with much of the reported data. We suggest that the frequency, dosage, and duration of steroid treatment should be limited. LIMITATIONS Low patient number, uncertain reason of mortality, no standard treatment regimen, limited treatment options, like ECMO. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Tayfun Birtay
- From the Department of Anesthesia, Baskent University, Antalya, Turkey
| | - Suzan Bahadir
- From the Department of Anesthesia, Baskent University, Antalya, Turkey
| | - Ebru Kabacaoglu
- From the Department of Chest Diseases, Baskent University, Antalya, Turkey
| | - Ozgur Yetiz
- From the Department of Anesthesia, Baskent University, Antalya, Turkey
| | | | - Gultekin Genctoy
- From the Department of Nephrology, Baskent University, Antalya, Turkey
| |
Collapse
|