1
|
Bogojevic M, Bansal V, Pattan V, Singh R, Tekin A, Sharma M, La Nou AT, LeMahieu AM, Hanson AC, Schulte PJ, Deo N, Qamar S, Zec S, Morales DJV, Perkins N, Kaufman M, Denson JL, Melamed R, Banner-Goodspeed VM, Christie AB, Tarabichi Y, Heavner S, Kumar VK, Walkey AJ, Gajic O, Bhagra S, Kashyap R, Lal A, Domecq JP. Association of hypothyroidism with outcomes in hospitalized adults with COVID-19: Results from the International SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry. Clin Endocrinol (Oxf) 2024; 101:85-93. [PMID: 35180316 PMCID: PMC9111656 DOI: 10.1111/cen.14699] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/12/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is associated with high rates of morbidity and mortality. Primary hypothyroidism is a common comorbid condition, but little is known about its association with COVID-19 severity and outcomes. This study aims to identify the frequency of hypothyroidism in hospitalized patients with COVID-19 as well as describe the differences in outcomes between patients with and without pre-existing hypothyroidism using an observational, multinational registry. METHODS In an observational cohort study we enrolled patients 18 years or older, with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between March 2020 and February 2021. The primary outcomes were (1) the disease severity defined as per the World Health Organization Scale for Clinical Improvement, which is an ordinal outcome corresponding with the highest severity level recorded during a patient's index COVID-19 hospitalization, (2) in-hospital mortality and (3) hospital-free days. Secondary outcomes were the rate of intensive care unit (ICU) admission and ICU mortality. RESULTS Among the 20,366 adult patients included in the study, pre-existing hypothyroidism was identified in 1616 (7.9%). The median age for the Hypothyroidism group was 70 (interquartile range: 59-80) years, and 65% were female and 67% were White. The most common comorbidities were hypertension (68%), diabetes (42%), dyslipidemia (37%) and obesity (28%). After adjusting for age, body mass index, sex, admission date in the quarter year since March 2020, race, smoking history and other comorbid conditions (coronary artery disease, hypertension, diabetes and dyslipidemia), pre-existing hypothyroidism was not associated with higher odds of severe disease using the World Health Organization disease severity index (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 0.92, 1.13; p = .69), in-hospital mortality (OR: 1.03; 95% CI: 0.92, 1.15; p = .58) or differences in hospital-free days (estimated difference 0.01 days; 95% CI: -0.45, 0.47; p = .97). Pre-existing hypothyroidism was not associated with ICU admission or ICU mortality in unadjusted as well as in adjusted analysis. CONCLUSIONS In an international registry, hypothyroidism was identified in around 1 of every 12 adult hospitalized patients with COVID-19. Pre-existing hypothyroidism in hospitalized patients with COVID-19 was not associated with higher disease severity or increased risk of mortality or ICU admissions. However, more research on the possible effects of COVID-19 on the thyroid gland and its function is needed in the future.
Collapse
Affiliation(s)
- Marija Bogojevic
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care Group (METRIC), Mayo Clinic, Rochester, MN, USA
| | - Vikas Bansal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care Group (METRIC), Mayo Clinic, Rochester, MN, USA
| | - Vishwanath Pattan
- Department of Medicine, Division of Endocrinology and Metabolism, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Romil Singh
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mayank Sharma
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Abigail T. La Nou
- Division of Critical Care Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
| | - Allison M. LeMahieu
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Andrew C. Hanson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Phillip J. Schulte
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Neha Deo
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Shahraz Qamar
- Post-baccalaureate Research Education Program, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Simon Zec
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care Group (METRIC), Mayo Clinic, Rochester, MN, USA
| | - Diana J. Valencia Morales
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care Group (METRIC), Mayo Clinic, Rochester, MN, USA
| | | | - Margit Kaufman
- Department of Anesthesiology & Critical Care, Englewood Hospital and Medical Center, Englewood, NJ, USA
| | - Joshua L. Denson
- Section of Pulmonary Diseases, Critical Care, and Environmental Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Roman Melamed
- Department of Critical Care, Abbott Northwestern Hospital, Allina Health, Minneapolis, MN, USA
| | - Valerie M. Banner-Goodspeed
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA, USA
| | - Amy B. Christie
- Department of Trauma/Critical Care, The Medical Center Navicent Health, Mercer University School of Medicine, Macon, GA, USA
| | - Yasir Tarabichi
- Division of Pulmonary and Critical Care Medicine, MetroHealth, Cleveleland, OH, USA
| | - Smith Heavner
- Department of Public Health Science, Clemson University, Clemson, SC, USA
| | | | - Allan J. Walkey
- Pulmonary Center, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Ognjen Gajic
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care Group (METRIC), Mayo Clinic, Rochester, MN, USA
| | - Sumit Bhagra
- Division of Endocrinology, Mayo Clinic Health System, Austin, MN, USA
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Amos Lal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care Group (METRIC), Mayo Clinic, Rochester, MN, USA
| | - Juan Pablo Domecq
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | |
Collapse
|
2
|
Hata T, Goto T, Yamanaka S, Matsumoto T, Yamamura O, Hayashi H. Prognostic value of initial serum sodium level in predicting disease severity in patients with COVID-19: A multicenter retrospective study. J Infect Chemother 2024; 30:181-187. [PMID: 37802152 DOI: 10.1016/j.jiac.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/09/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Early prediction of coronavirus disease (COVID-19) severity is crucial. Hyponatremia has been linked to poor outcomes in hospitalized COVID-19 patients, but its association with mild cases is unclear. This study aimed to investigate whether initial serum sodium level is a risk factor for COVID-19 severity in patients with mild-to-moderate disease. METHODS A multicenter retrospective cohort study was conducted in 10 hospitals in Fukui City, Japan, from July 1, 2020, to October 31, 2021. The study included 1055 adult patients with asymptomatic, mild, or moderate COVID-19 confirmed by a positive RT-PCR test. The primary outcome was the need for oxygen therapy after hospitalization, and the secondary outcome was the composite of in-hospital death and critical care interventions. The association between initial serum sodium level (at the emergency department or on admission) and outcomes was examined, adjusting for age, sex, hypertension, and pneumonia presence. RESULTS Of the 1267 patients diagnosed with COVID-19 during the study period, 1055 were eligible (median age: 45 years; 54 % male). Hyponatremia was observed in 5.2 % of patients upon admission. A lower initial serum sodium level was associated with an increased risk of the need for oxygen therapy after hospitalization (adjusted odds ratio [OR] per 1 mmol/L lower, 1.12 [95 % confidence interval {CI}, 1.05-1.19]) and the composite of critical care and in-hospital death (adjusted OR per 1 mmol/L lower, 1.09 [95 % CI, 0.99-1.20]). CONCLUSIONS Among patients with mild COVID-19, lower initial serum sodium level was a risk factor for COVID-19 progression.
Collapse
Affiliation(s)
- Tatsuhiko Hata
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| | - Tadahiro Goto
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan; TXP Medical, Co. Ltd., Tokyo, Japan.
| | - Syunsuke Yamanaka
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| | - Tatsuki Matsumoto
- School of Knowledge and Information Systems, College of Sustainable System Sciences, Osaka Metropolitan University, Osaka, Japan.
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan; Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan.
| | - Hiroyuki Hayashi
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| |
Collapse
|
3
|
Sonnweber T, Grubwieser P, Pizzini A, Boehm A, Sahanic S, Luger A, Schwabl C, Widmann G, Egger A, Hoermann G, Wöll E, Puchner B, Kaser S, Theurl I, Nairz M, Tymoszuk P, Weiss G, Joannidis M, Löffler-Ragg J, Tancevski I. Pulmonary recovery from COVID-19 in patients with metabolic diseases: a longitudinal prospective cohort study. Sci Rep 2023; 13:2599. [PMID: 36788324 PMCID: PMC9926446 DOI: 10.1038/s41598-023-29654-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
The severity of coronavirus disease 2019 (COVID-19) is related to the presence of comorbidities including metabolic diseases. We herein present data from the longitudinal prospective CovILD trial, and investigate the recovery from COVID-19 in individuals with dysglycemia and dyslipidemia. A total of 145 COVID-19 patients were prospectively followed and a comprehensive clinical, laboratory and imaging assessment was performed at 60, 100, 180, and 360 days after the onset of COVID-19. The severity of acute COVID-19 and outcome at early post-acute follow-up were significantly related to the presence of dysglycemia and dyslipidemia. Still, at long-term follow-up, metabolic disorders were not associated with an adverse pulmonary outcome, as reflected by a good recovery of structural lung abnormalities in both, patients with and without metabolic diseases. To conclude, dyslipidemia and dysglycemia are associated with a more severe course of acute COVID-19 as well as delayed early recovery but do not impair long-term pulmonary recovery.
Collapse
Affiliation(s)
- Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| | - Philipp Grubwieser
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Bernhard Puchner
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
- The Karl Landsteiner Institute, Reha Zentrum Münster, Münster, Austria
| | - Susanne Kaser
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Igor Theurl
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| |
Collapse
|
4
|
Ageev AA, Kozhevnikova MV, Emelyanov AV, Krivova AV, Shumskaya YF, Musaeva LM, Popova LV, Naymann YI, Abdullaeva GB, Privalova EV, Belenkov YN. The Effect of COVID-19 on Long-Term Cardiac Function in Patients With Chronic Heart Failure. KARDIOLOGIIA 2022; 62:23-29. [PMID: 36636973 DOI: 10.18087/cardio.2022.12.n2265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/16/2022] [Indexed: 01/14/2023]
Abstract
Aim To evaluate functional changes in the heart in the long-term following COVID-19 in patients with chronic heart failure (CHF).Material and methods Case reports of 54 patients aged 69.1±9.7 years who had COVID-19 from January 2021 through January 2022 and had been previously diagnosed with NYHA functional class II-III CHF were studied. Two comparison groups were isolated: HF with LV EF >50 % (n=39) and <50 % (n=15). Echocardiography was used to evaluate changes in LV EF and pulmonary artery systolic pressure (PASP) 5-6 months following COVID-19.Results In all CHF patients after COVID-19 at 5.8 months on average, LV EF decreased (median difference, 2.5 %; 95 % confidence interval (CI): 6.99×10-5- 4.99) and PASP increased (median difference, 8 mm Hg; 95 % CI: 4.5-12.9). In the HF group with LV EF <50 %, the decrease in EF was greater than in the group with LV EF >50 % (6.9 and 0.7 %, respectively; p=0.037); furthermore, the CHF phenotype did not influence the change in PASP (p=0.4). The one-factor regression analysis showed that the dynamics of LV EF decrease was significantly influenced by the baseline decrease in LV EF, whereas the change in PASP was influenced by the dynamics of LV EF decrease, presence of dyslipidemia, and statin treatment. Furthermore, the multifactorial analysis showed that prognostically significant factors for long-term changes in LV EF following COVID-19 were male gender (odds ratio (OR), 5.92; 95 % CI: 1.31-26.75; p=0.014), LV EF at baseline <50 % (OR, 0.88; 95 % CI: 0.8-0.96; p<0.001); changes in PASP depended on the presence of dyslipidemia (OR, 0.08; 95 % CI: 0.01-0.84; p=0.018).Conclusion This study showed that COVID-19 in the long term can influence the course of CHF; in this process, HF patients with EF <50 % have progression of systolic dysfunction and PASP, whereas patients with EF >50 % have an isolated increase in PASP.
Collapse
Affiliation(s)
- A A Ageev
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - M V Kozhevnikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A V Emelyanov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - A V Krivova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu F Shumskaya
- Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, Moscow
| | - L M Musaeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - L V Popova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu I Naymann
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - G B Abdullaeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - E V Privalova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| | - Yu N Belenkov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow
| |
Collapse
|
5
|
Kumar R, Kumar V, Arya R, Anand U, Priyadarshi RN. Association of COVID-19 with hepatic metabolic dysfunction. World J Virol 2022; 11:237-251. [PMID: 36188741 PMCID: PMC9523326 DOI: 10.5501/wjv.v11.i5.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 06/20/2022] [Indexed: 02/05/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic continues to be a global problem with over 438 million cases reported so far. Although it mostly affects the respiratory system, the involvement of extrapulmonary organs, including the liver, is not uncommon. Since the beginning of the pandemic, metabolic com-orbidities, such as obesity, diabetes, hypertension, and dyslipidemia, have been identified as poor prognostic indicators. Subsequent metabolic and lipidomic studies have identified several metabolic dysfunctions in patients with COVID-19. The metabolic alterations appear to be linked to the course of the disease and inflammatory reaction in the body. The liver is an important organ with high metabolic activity, and a significant proportion of COVID-19 patients have metabolic comorbidities; thus, this factor could play a key role in orchestrating systemic metabolic changes during infection. Evidence suggests that metabolic dysregulation in COVID-19 has both short- and long-term metabolic implications. Furthermore, COVID-19 has adverse associations with metabolic-associated fatty liver disease. Due to the ensuing effects on the renin-angiotensin-aldosterone system and ammonia metabolism, COVID-19 can have significant implications in patients with advanced chronic liver disease. A thorough understanding of COVID-19-associated metabolic dysfunction could lead to the identification of important plasma biomarkers and novel treatment targets. In this review, we discuss the current understanding of metabolic dysfunction in COVID-19, focusing on the liver and exploring the underlying mechanistic pathogenesis and clinical implications.
Collapse
Affiliation(s)
- Ramesh Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Vijay Kumar
- Department of Medicine, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Rahul Arya
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Utpal Anand
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Rajeev Nayan Priyadarshi
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| |
Collapse
|
6
|
Clerbaux LA, Albertini MC, Amigó N, Beronius A, Bezemer GFG, Coecke S, Daskalopoulos EP, del Giudice G, Greco D, Grenga L, Mantovani A, Muñoz A, Omeragic E, Parissis N, Petrillo M, Saarimäki LA, Soares H, Sullivan K, Landesmann B. Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework. J Clin Med 2022; 11:4464. [PMID: 35956081 PMCID: PMC9369763 DOI: 10.3390/jcm11154464] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/10/2022] Open
Abstract
Addressing factors modulating COVID-19 is crucial since abundant clinical evidence shows that outcomes are markedly heterogeneous between patients. This requires identifying the factors and understanding how they mechanistically influence COVID-19. Here, we describe how eleven selected factors (age, sex, genetic factors, lipid disorders, heart failure, gut dysbiosis, diet, vitamin D deficiency, air pollution and exposure to chemicals) influence COVID-19 by applying the Adverse Outcome Pathway (AOP), which is well-established in regulatory toxicology. This framework aims to model the sequence of events leading to an adverse health outcome. Several linear AOPs depicting pathways from the binding of the virus to ACE2 up to clinical outcomes observed in COVID-19 have been developed and integrated into a network offering a unique overview of the mechanisms underlying the disease. As SARS-CoV-2 infectibility and ACE2 activity are the major starting points and inflammatory response is central in the development of COVID-19, we evaluated how those eleven intrinsic and extrinsic factors modulate those processes impacting clinical outcomes. Applying this AOP-aligned approach enables the identification of current knowledge gaps orientating for further research and allows to propose biomarkers to identify of high-risk patients. This approach also facilitates expertise synergy from different disciplines to address public health issues.
Collapse
Affiliation(s)
- Laure-Alix Clerbaux
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | | | - Núria Amigó
- Biosfer Teslab SL., 43204 Reus, Spain;
- Department of Basic Medical Sciences, Universitat Rovira i Virgili (URV), 23204 Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Anna Beronius
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Gillina F. G. Bezemer
- Impact Station, 1223 JR Hilversum, The Netherlands;
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Sandra Coecke
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Evangelos P. Daskalopoulos
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Giusy del Giudice
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Dario Greco
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Lucia Grenga
- Département Médicaments et Technologies pour la Santé (DMTS), Université Paris-Saclay, CEA, INRAE, SPI, F-30200 Bagnols-sur-Ceze, France;
| | - Alberto Mantovani
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Amalia Muñoz
- European Commission, Joint Research Centre (JRC), 2440 Geel, Belgium;
| | - Elma Omeragic
- Faculty of Pharmacy, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Nikolaos Parissis
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Mauro Petrillo
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Laura A. Saarimäki
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Helena Soares
- Laboratory of Immunobiology and Pathogenesis, Chronic Diseases Research Centre, Faculdade de Ciências Médicas Medical School, University of Lisbon, 1649-004 Lisbon, Portugal;
| | - Kristie Sullivan
- Physicians Committee for Responsible Medicine, Washington, DC 20016, USA;
| | - Brigitte Landesmann
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| |
Collapse
|
7
|
Tumminia A, Romano R, Brugaletta G, Scicali R, Biondi G, Oliveri R, Romano M, San Lio PM. The impact of obesity and dyslipidemia on Remdesivir effectiveness in hospitalized patients with SARS-CoV-2-related pneumonia: An observational study. Nutr Metab Cardiovasc Dis 2022; 32:1635-1641. [PMID: 35508458 PMCID: PMC8994684 DOI: 10.1016/j.numecd.2022.04.005] [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: 11/25/2021] [Revised: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Remdesivir (GS-5734), an inhibitor of the viral RNA-dependent, RNA polymerase was early identified as a promising therapeutic candidate against COVID-19. Our aim was to evaluate the impact of several metabolic parameters on Remdesivir effectiveness among hospitalized COVID-19 patients. METHODS AND RESULTS We conducted an observational study on patients with SARS-CoV-2-related pneumonia admitted between May 2020 and September 2021 to the COVID-19 Units of Internal Medicine, Pneumology and Intensive Care of Garibaldi Hospital, Catania, Italy, and treated with Remdesivir. The "Ordinal Scale For Clinical Improvement" was used to assess patients' clinical improvement within 28 days of hospitalization. Short-term mortality rate was also evaluated. A total of 142 patients with SARS-CoV-2-related pneumonia were studied. The prevalence of obesity (20.7% vs. 41.9%, p = 0.03), the average BMI (27.1 ± 4.4 vs. 31.1 ± 6.1, p < 0.01) and the mean LDL-C levels (78 ± 19 mg/dl vs. 103 ± 18 mg/dl, p = 0.03) were significantly lower in early-improved (EI) compared to not-improved (NI) individuals. Obesity was negatively associated to clinical improvement after Remdesivir (OR 0.48, 95%CI 0.17-0.97, p = 0.04). Both obesity (OR 2.82, 95% CI 1.05-7.71, p = 0.04) and dyslipidemia (OR 2.78, 95%CI 1.17-7.16, p = 0.03) were significantly related to patients' mortality. Dyslipidemic subjects experienced a slower clinical improvement than non-dyslipidemic ones (Long-Rank p = 0.04). CONCLUSION Our study showed that unfavorable metabolic conditions such as obesity and dyslipidemia could predict a worse clinical response to Remdesivir as well as the mortality in hospitalized COVID-19 patients. Further prospective and larger-scale studies are needed to confirm these preliminary findings.
Collapse
Affiliation(s)
- Andrea Tumminia
- Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Hospital, 95122 Catania, Italy.
| | - Raffaella Romano
- Geriatrics Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy
| | | | - Roberto Scicali
- Geriatrics Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy; Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy
| | | | - Rosario Oliveri
- Pneumology Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy
| | - Marcello Romano
- Geriatrics Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy
| | - Paola Magnano San Lio
- Department of Clinical and Experimental Medicine, University of Catania, AOU Policlinico "G. Rodolico - San Marco", 95123 Catania, Italy
| |
Collapse
|
8
|
de Medeiros SF, Yamamoto MMW, de Medeiros MAS, Yamamoto AKLW, Barbosa BB. Polycystic ovary syndrome and risks for COVID-19 infection: A comprehensive review : PCOS and COVID-19 relationship. Rev Endocr Metab Disord 2022; 23:251-264. [PMID: 35218458 PMCID: PMC8881900 DOI: 10.1007/s11154-022-09715-y] [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] [Accepted: 02/01/2022] [Indexed: 01/08/2023]
Abstract
This comprehensive review aimed to evaluate the relationship between SARS-CoV-2 infection (the cause of coronavirus disease 2019, or COVID-19) and the metabolic and endocrine characteristics frequently found in women with polycystic ovary syndrome (PCOS). In the general population, COVID-19 is more severe in subjects with dyslipidemia, obesity, diabetes mellitus, and arterial hypertension. Because these conditions are comorbidities commonly associated with PCOS, it was hypothesized that women with PCOS would be at higher risk for acquiring COVID-19 and developing more severe clinical presentations. This hypothesis was confirmed in several epidemiological studies. The present review shows that women with PCOS are at 28%-50% higher risk of being infected with the SARS-CoV-2 virus at all ages and that, in these women, COVID-19 is associated with increased rates of hospitalization, morbidity, and mortality. We summarize the mechanisms of the higher risk of COVID-19 infection in women with PCOS, particularly in those with carbohydrate and lipid abnormal metabolism, hyperandrogenism, and central obesity.
Collapse
Affiliation(s)
- Sebastião Freitas de Medeiros
- Department of Gynecology and Obstetrics, Medical School, Federal University of Mato Grosso, Cuiabá, MT, Brazil.
- Tropical Institute of Reproductive Medicine, Cuiabá, MT, Brazil.
| | | | | | | | | |
Collapse
|
9
|
Zein AFMZ, Raffaello WM. Dipeptidyl peptidase-4 (DPP-IV) inhibitor was associated with mortality reduction in COVID-19 - A systematic review and meta-analysis. Prim Care Diabetes 2022; 16:162-167. [PMID: 34952805 PMCID: PMC8666291 DOI: 10.1016/j.pcd.2021.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This systematic review and meta-analysis aimed to synthesize the latest evidence on the effect of dipeptidyl peptidase-4 (DPP-IV) inhibitor in patients with COVID-19. METHODS We performed a systematic literature search from the PubMed, Scopus, Embase, and Clinicaltrials.gov up until 15 July 2021. Studies that met the following criteria were included: prospective or retrospective observational studies or case series or randomized controlled trials (RCTs) reporting DPP-IV inhibitor use in patients with COVID-19 and mortality. The intervention group was patients receiving DPP-IV inhibitor. The control group was patients that did not receive DPP-IV inhibitor. The outcome was mortality reported as odds ratio (OR). RESULTS There were 11 studies consisting of 5950 patients in this meta-analysis. DPP-IV inhibitor use was associated with reduced mortality (OR 0.75 [0.56, 0.99], p = 0.043, I2: 42.9, p = 0.064) compared to those that did not receive DPP-IV inhibitor. Sensitivity analysis using the fixed-effect model (OR 0.75 [0.63, 0.88], p < 0.001, I2: 42.9, p = 0.064) also showed mortality benefit. The association between DPP-IV inhibitor and mortality was not significantly affected by age (p = 0.540), sex (p = 0.054), hypertension (p = 0.320), location (continent; p = 0.532), and retrospective/prospective nature of the study (p = 0.840). However, the association was affected by metformin (OR 1.03 [95% CI 1.01, 1.06], p = 0.010) and ACEI/ARB use (OR 1.06 [95% CI 1.02, 1.10], p = 0.004). CONCLUSION This meta-analysis showed that DPP-IV inhibitor was associated with reduced mortality in patients with COVID-19.
Collapse
Affiliation(s)
- Ahmad Fariz Malvi Zamzam Zein
- Department of Internal Medicine, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia; Department of Internal Medicine, Waled General Hospital, Cirebon, Indonesia.
| | | |
Collapse
|
10
|
Clemente-Suárez VJ, Beltrán-Velasco AI, Ramos-Campo DJ, Mielgo-Ayuso J, Nikolaidis PA, Belando N, Tornero-Aguilera JF. Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic. Physiol Behav 2022; 244:113667. [PMID: 34861297 PMCID: PMC8632361 DOI: 10.1016/j.physbeh.2021.113667] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has shocked world health authorities generating a global health crisis. The present study aimed to analyze the different factors associated with physical activity that could have an impact in the COVID-19, providing a practical recommendation based on actual scientific knowledge. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding physical activity and physical activity related factors during the COVID-19 pandemic. The main online database used in the present research were PubMed, SciELO, and Google Scholar. COVID-19 has negatively influenced motor behavior, levels of regular exercise practice, eating and nutritional patterns, and the psychological status of citizens. These factors feed into each other, worsening COVID-19 symptoms, the risk of death from SARS-CoV-2, and the symptoms and effectiveness of the vaccine. The characteristics and symptoms related with the actual COVID-19 pandemic made the physical activity interventions a valuable prevention and treatment factor. Physical activity improves body composition, the cardiorespiratory, metabolic, and mental health of patients and enhancing antibody responses in vaccination.
Collapse
Affiliation(s)
- Vicente Javier Clemente-Suárez
- Universidad Europea de Madrid, Faculty of Sports Sciences, Tajo Street, s/n, Madrid, 28670 Spain; Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla,080002 Colombia; Department of Adapted Physical Activity, School of Physical Education, University of Campinas (UNICAMP). Av. Érico Veríssimo, 701. Cidade Universitária "Zeferino Vaz", Campinas - SP, Brazil.
| | | | | | - Juan Mielgo-Ayuso
- Department of health sciences. Faculty of health sciences, University of Burgos, Spain
| | | | - Noelia Belando
- Universidad Europea de Madrid, Faculty of Sports Sciences, Tajo Street, s/n, Madrid, 28670 Spain
| | - Jose Francisco Tornero-Aguilera
- Universidad Europea de Madrid, Faculty of Sports Sciences, Tajo Street, s/n, Madrid, 28670 Spain,Department of Adapted Physical Activity, School of Physical Education, University of Campinas (UNICAMP). Av. Érico Veríssimo, 701. Cidade Universitária "Zeferino Vaz", Campinas - SP, Brazil
| |
Collapse
|
11
|
Perović-Blagojević I, Bojanin D, Ristovski-Kornic D, Marković J, Aleksić P, Subošić B, Vekić J, Kotur-Stevuljević J. The role of laboratory biomarkers in diagnostics and management of COVID-19 patients. ARHIV ZA FARMACIJU 2022. [DOI: 10.5937/arhfarm72-36369] [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
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a highly transmittable and heterogenic infection of the respiratory tract, characterized by a broad spectrum of clinical manifestations with a different degree of severity. Medical laboratories play an important role in early diagnosis and management of Coronavirus Disease 2019 (COVID-19) patients. Indeed, the results of several laboratory tests are essential for assessing the severity of the disease, selecting appropriate therapeutic procedures and monitoring treatment response. Routine laboratory testing in COVID-19 patients includes biomarkers of acute phase reaction, hematological and biochemical parameters that indicate tissue injury. The aim of this review paper is to describe the role of these biomarkers in the diagnostics and management of adult and pediatric COVID-19 patients.
Collapse
|
12
|
Sarzani R, Allevi M, Giulietti F, Di Pentima C, Re S, Giordano P, Spannella F. The Identikit of Patient at Risk for Severe COVID-19 and Death: The Dysregulation of Renin-Angiotensin System as the Common Theme. J Clin Med 2021; 10:5883. [PMID: 34945176 PMCID: PMC8704645 DOI: 10.3390/jcm10245883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/24/2022] Open
Abstract
Since the first months of the coronavirus disease 2019 (COVID-19) pandemic, several specific physiologic traits, such as male sex and older age, or health conditions, such as overweight/obesity, arterial hypertension, metabolic syndrome, and type 2 diabetes mellitus, have been found to be highly prevalent and associated with increased risk of adverse outcomes in hospitalized patients. All these cardiovascular morbidities are widespread in the population and often coexist, thus identifying a common patient phenotype, characterized by a hyper-activation of the "classic" renin-angiotensin system (RAS) and mediated by the binding of angiotensin II (Ang II) to the type 1-receptor. At the same time, the RAS imbalance was proved to be crucial in the genesis of lung injury after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, where angiotensin-converting-enzyme-2 (ACE2) is not only the receptor for SARS-CoV-2, but its down-regulation through internalization and shedding, caused by the virus binding, leads to a further dysregulation of RAS by reducing angiotensin 1-7 (Ang 1-7) production. This focused narrative review will discuss the main available evidence on the role played by cardiovascular and metabolic conditions in severe COVID-19, providing a possible pathophysiological link based on the disequilibrium between the two opposite arms of RAS.
Collapse
Affiliation(s)
- Riccardo Sarzani
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Massimiliano Allevi
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Chiara Di Pentima
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Serena Re
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
| | - Francesco Spannella
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| |
Collapse
|
13
|
Metabolic Syndrome and Its Components in Patients with COVID-19: Severe Acute Respiratory Syndrome (SARS) and Mortality. A Systematic Review and Meta-Analysis. J Cardiovasc Dev Dis 2021; 8:jcdd8120162. [PMID: 34940517 PMCID: PMC8708678 DOI: 10.3390/jcdd8120162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022] Open
Abstract
Recent meta-analysis studies have reported that metabolic comorbidities such as diabetes, obesity, dyslipidaemia and hypertension are associated with higher risk of severe acute respiratory syndrome (SARS) and mortality in patients with COVID-19. This meta-analysis aims to investigate the relationship between metabolic syndrome (MetS) and its components with SARS and mortality in COVID-19 patients. Methods: A systematic search was conducted in the several databases up until 1 September 2021. Primary observational longitudinal studies published in peer review journals were selected. Two independent reviewers performed title and abstract screening, extracted data and assessed the risk of bias using the Newcastle–Ottawa Scale. Results: The random effects meta-analysis showed that MetS was significantly associated with SARS with a pooled OR (95% CI) of 3.21 (2.88–3.58) and mortality with a pooled OR (95% CI) of 2.32 (1.16–4.63). According to SARS, the pooled OR for MetS was 2.19 (1.71–2.67), p < 0.001; significantly higher than the hypertension component. With regard to mortality, although the pooled OR for MetS was greater than for its individual components, no significant differences were observed. Conclusions: this meta-analysis of cohort studies, showed that MetS is better associated to SARS and mortality in COVID-19 patients than its individual components.
Collapse
|
14
|
Elevated Anti-SARS-CoV-2 Antibodies and IL-6, IL-8, MIP-1β, Early Predictors of Severe COVID-19. Microorganisms 2021; 9:microorganisms9112259. [PMID: 34835384 PMCID: PMC8624589 DOI: 10.3390/microorganisms9112259] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 12/27/2022] Open
Abstract
Viral and host immune kinetics during acute COVID-19 and after remission of acute symptoms need better characterization. SARS-CoV-2 RNA, anti-SARS-CoV-2 IgA, IgM, and IgG antibodies, and proinflammatory cytokines were measured in sequential samples from hospitalized COVID-19 patients during acute infection and six months following diagnosis. Twenty four laboratory confirmed COVID-19 patients with mild/moderate and severe COVID-19 were included. Most were males (83%) with a median age of 61 years. Twenty one percent were admitted to the intensive care unit (ICU) and eight of them (33.3%) met the criteria for severe COVID-19 disease. A delay in SARS-CoV-2 levels’ decline during the first six days of follow up, and viral load persistence until month 3 were related to severe COVID-19, but not viral load levels at the diagnosis. Higher levels of anti-SARS-CoV-2 IgA, IgM, IgG and the cytokines IL-6, IL-8 and MIP-1β at the diagnosis time were related to the severe COVID-19 outcome. Higher levels of MIP-1β, IL-1β, MIP-1α and IFN-γ were observed at month 1 and 3 during mild/moderate disease, compared to severe COVID-19. IgG persisted at low levels after six months of diagnosis. In conclusion, higher concentrations of IgA, IgM, and IgG, and IL-6, IL-8 and MIP-1β are identified as early predictors of COVID-19 severity, whereas no significant association is found between baseline SARS-COV-2 viral load and COVID-19 severity.
Collapse
|
15
|
Surma S, Banach M, Lewek J. COVID-19 and lipids. The role of lipid disorders and statin use in the prognosis of patients with SARS-CoV-2 infection. Lipids Health Dis 2021; 20:141. [PMID: 34689776 PMCID: PMC8542506 DOI: 10.1186/s12944-021-01563-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
The global coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 coronavirus started in March 2020. The conclusions from numerous studies indicate that people with comorbidities, such as arterial hypertension, diabetes, obesity, underlying cardiovascular disease, are particularly vulnerable to the severe course of COVID-19. The available data also suggest that patients with dyslipidemia, the most common risk factor of cardiovascular diseases, are also at greater risk of severe course of COVID-19. On the other hand, it has been shown that COVID-19 infection has an influence on lipid profile leading to dyslipidemia, which might require appropriate treatment. Owing to antiviral, anti-inflammatory, immunomodulatory, and cardioprotective activity, statin therapy has been considered as valuable tool to improve COVID-19 outcomes. Numerous observational studies have shown potential beneficial effects of lipid-lowering treatment on the course of COVID-19 with significant improved prognosis and reduced mortality.
Collapse
Affiliation(s)
- Stanisław Surma
- Faculty of Medicial Sciences in Katowice, Medical University of Silesia in Katowice, Poland; Medyków 18, 40-752 Katowice, Poland
- Club of Young Hypertensiologists, Polish Society of Hypertension, Warsaw, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Rzgowska 281/289, 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338 Lodz, Poland
| | - Joanna Lewek
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Rzgowska 281/289, 93-338 Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338 Lodz, Poland
| |
Collapse
|
16
|
Corrêa RLGQ, dos Santos R, Albuquerque LJC, de Araujo GLB, Edwards-Gayle CJC, Ferreira FF, Costa FN. Ciprofibrate-Loaded Nanoparticles Prepared by Nanoprecipitation: Synthesis, Characterization, and Drug Release. Polymers (Basel) 2021; 13:3158. [PMID: 34578074 PMCID: PMC8468397 DOI: 10.3390/polym13183158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/17/2022] Open
Abstract
Ciprofibrate (CIP) is a highly lipophilic and poorly water-soluble drug, typically used for dyslipidemia treatment. Although it is already commercialized in capsules, no previous studies report its solid-state structure; thus, information about the correlation with its physicochemical properties is lacking. In parallel, recent studies have led to the improvement of drug administration, including encapsulation in polymeric nanoparticles (NPs). Here, we present CIP's crystal structure determined by PXRD data. We also propose an encapsulation method for CIP in micelles produced from Pluronic P123/F127 and PEO-b-PCL, aiming to improve its solubility, hydrophilicity, and delivery. We determined the NPs' physicochemical properties by DLS, SLS, ELS, SAXS and the loaded drug amount by UV-Vis spectroscopy. Micelles showed sizes around 10-20 nm for Pluronic and 35-45 nm for the PEO-b-PCL NPs with slightly negative surface charge and successful CIP loading, especially for the latter; a substantial reduction in ζ-potential may be evidenced. For Pluronic nanoparticles, we scanned different conditions for the CIP loading, and its encapsulation efficiency was reduced while the drug content increased in the nanoprecipitation protocol. We also performed in vitro release experiments; results demonstrate that probe release is driven by Fickian diffusion for the Pluronic NPs and a zero-order model for PEO-b-PCL NPs.
Collapse
Affiliation(s)
| | - Renan dos Santos
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André 09210-580, Brazil; (R.d.S.); (L.J.C.A.); (F.F.F.)
| | - Lindomar José Calumby Albuquerque
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André 09210-580, Brazil; (R.d.S.); (L.J.C.A.); (F.F.F.)
- Brazilian Synchrotron Light Laboratory (LNLS), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas 13083-170, Brazil
| | | | | | - Fabio Furlan Ferreira
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André 09210-580, Brazil; (R.d.S.); (L.J.C.A.); (F.F.F.)
- Nanomedicine Research Unit (NANOMED), Federal University of ABC (UFABC), Santo André 09210-580, Brazil
| | - Fanny Nascimento Costa
- Center for Natural and Human Sciences (CCNH), Federal University of ABC (UFABC), Santo André 09210-580, Brazil; (R.d.S.); (L.J.C.A.); (F.F.F.)
- Diamond Light Source, Harwell Science & Innovation Campus, Didcot, Oxfordshire OX11 0DE, UK;
| |
Collapse
|
17
|
Gurnani PK, Peksa GD, Panos NG, DeMott JM. Under the Microscope: A Look Into the Role of Critical Care Pharmacists During the COVID-19 Pandemic. J Pharm Pract 2021; 35:1007-1011. [PMID: 34000896 DOI: 10.1177/08971900211013991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Among disciplines, the COVID-19 pandemic has reinforced the importance of critical care pharmacists in assuming responsibility for managing medication therapy in direct patient care settings. Historically, pharmacists have been relied upon for prospective evaluation of drug therapy for appropriate indications, dosage, drug interactions, and drug allergies; monitoring patients' pharmacotherapeutic regimens for effectiveness and adverse effects; providing drug information to providers; and educating health professionals regarding drug therapies. Specific to COVID-19, pharmacists have been an integral member of the multidisciplinary rounding team, assisting with drug shortages and strategies for drug conservation; participating in emergencies, such as advanced cardiac life support (ACLS) and rapid sequence intubations; and creating as well as integrating evidence-based guidelines and pathways during the pandemic into clinical practice. The purpose of this article is to demonstrate the various roles of critical care pharmacists among the healthcare team in caring for critically ill COVID-19 patients.
Collapse
Affiliation(s)
- Payal K Gurnani
- Department of Pharmacy, 2468Rush University Medical Center, Chicago, IL, USA.,Department of Internal Medicine, Rush Medical College, Chicago, IL, USA
| | - Gary D Peksa
- Department of Pharmacy, 2468Rush University Medical Center, Chicago, IL, USA.,Department of Emergency Medicine, 2468Rush University Medical Center, Chicago, IL, USA
| | - Nicholas G Panos
- Department of Pharmacy, 2468Rush University Medical Center, Chicago, IL, USA
| | - Joshua M DeMott
- Department of Pharmacy, 2468Rush University Medical Center, Chicago, IL, USA.,Department of Emergency Medicine, 2468Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
18
|
Pérez-Torres I, Guarner-Lans V, Soria-Castro E, Manzano-Pech L, Palacios-Chavarría A, Valdez-Vázquez RR, Domínguez-Cherit JG, Herrera-Bello H, Castillejos-Suastegui H, Moreno-Castañeda L, Alanís-Estrada G, Hernández F, González-Marcos O, Márquez-Velasco R, Soto ME. Alteration in the Lipid Profile and the Desaturases Activity in Patients With Severe Pneumonia by SARS-CoV-2. Front Physiol 2021; 12:667024. [PMID: 34045976 PMCID: PMC8144632 DOI: 10.3389/fphys.2021.667024] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/13/2021] [Indexed: 12/19/2022] Open
Abstract
The kidnapping of the lipid metabolism of the host's cells by severe acute respiratory syndrome (SARS-CoV-2) allows the virus to transform the cells into optimal machines for its assembly and replication. Here we evaluated changes in the fatty acid (FA) profile and the participation of the activity of the desaturases, in plasma of patients with severe pneumonia by SARS-CoV-2. We found that SARS-CoV-2 alters the FA metabolism in the cells of the host. Changes are characterized by variations in the desaturases that lead to a decrease in total fatty acid (TFA), phospholipids (PL) and non-esterified fatty acids (NEFAs). These alterations include a decrease in palmitic and stearic acids (p ≤ 0.009) which could be used for the formation of the viral membranes and for the reparation of the host's own membrane. There is also an increase in oleic acid (OA; p = 0.001) which could modulate the inflammatory process, the cytokine release, apoptosis, necrosis, oxidative stress (OS). An increase in linoleic acid (LA) in TFA (p = 0.03) and a decreased in PL (p = 0.001) was also present. They result from damage of the internal mitochondrial membrane. The arachidonic acid (AA) percentage was elevated (p = 0.02) in the TFA and this can be participated in the inflammatory process. EPA was decreased (p = 0.001) and this may decrease of pro-resolving mediators with increase in the inflammatory process. The total of NEFAs (p = 0.03), PL (p = 0.001), cholesterol, HDL and LDL were decreased, and triglycerides were increased in plasma of the COVID-19 patients. Therefore, SARS-CoV-2 alters the FA metabolism, the changes are characterized by alterations in the desaturases that lead to variations in the TFA, PL, and NEFAs profiles. These changes may favor the replication of the virus but, at the same time, they are part of the defense system provided by the host cell metabolism in its eagerness to repair damage caused by the virus to cell membranes.
Collapse
Affiliation(s)
- Israel Pérez-Torres
- Departament of Cardiovascular Biomedicine, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Verónica Guarner-Lans
- Departament of Physiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Elizabeth Soria-Castro
- Departament of Cardiovascular Biomedicine, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Linaloe Manzano-Pech
- Departament of Cardiovascular Biomedicine, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Adrián Palacios-Chavarría
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Rafael Ricardo Valdez-Vázquez
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Jose Guillermo Domínguez-Cherit
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Tecnológico de Monterrey EMCS, Mexico City, Mexico
| | - Hector Herrera-Bello
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Humberto Castillejos-Suastegui
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Lidia Moreno-Castañeda
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Gabriela Alanís-Estrada
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Fabián Hernández
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center, Mexico City, Mexico
- American British Cowdray Medical Center, Mexico City, Mexico
| | - Omar González-Marcos
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Tecnológico de Monterrey EMCS, Mexico City, Mexico
| | - Ricardo Márquez-Velasco
- Departament of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - María Elena Soto
- American British Cowdray Medical Center, Mexico City, Mexico
- Departament of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| |
Collapse
|