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Papadaki A, Coy EM, Anastasilakis DA, Peradze N, Mantzoros CS. The role of plant-based dietary patterns in reducing COVID-19 risk and/or severity in adults: A systematic review and meta-analysis of observational studies. Clin Nutr 2024; 43:1657-1666. [PMID: 38810425 DOI: 10.1016/j.clnu.2024.05.033] [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] [Received: 07/27/2023] [Revised: 04/21/2024] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND & AIMS Plant-based dietary patterns (PBDs) might protect against COVID-19 risk and reduce severity of infection. This systematic review with meta-analysis aimed to examine the association between PBDs and risk of COVID-19 infection, hospitalization, intensive care unit (ICU) admission, and/or mortality, in adults. METHODS Pubmed, Embase, CINAHL and Web of Science were searched for observational studies, published in English up to 3rd April 2023, comparing the highest with the lowest adherence to a specific PBD. Data were screened, extracted, and risk of bias assessed using the Newcastle-Ottawa Quality Assessment Scale, by independent reviewers. RESULTS Seven studies (one cross-sectional, three case-control, and three prospective cohort), reporting on 649,315 participants, were eligible. Across them, there were 8512 events of COVID-19 infection (six studies), and 206 events of COVID-19 hospitalization (four studies), in addition to one study reporting on a composite hospitalization outcome (740 events). The pooled analysis showed that PBDs are associated with a 59% (odds ratio (OR) = 0.41, 95% confidence intervals (CI) 0.23-0.59; two studies) and 18% (OR = 0.82, 95% CI 0.78-0.85; three studies) reduction in COVID-19 infection risk in case-control and cohort studies, respectively. The pooled analysis of one case-control and two cohort studies showed an inverse association between high adherence to a PBD and risk of COVID-19 hospitalization (OR = 0.38, 95% CI 0.04-0.72). CONCLUSION Findings suggest a protective role of PBDs against the risk of COVID-19 infection and severity. More studies are needed to establish the association between PBDs and risk of ICU admission and mortality due to COVID-19.
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Affiliation(s)
- Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK; Department of Medicine, Division of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Eimear Mc Coy
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Dimitrios A Anastasilakis
- Department of Medicine, Division of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; First Laboratory of Pharmacology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Natia Peradze
- Department of Medicine, Division of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christos S Mantzoros
- Department of Medicine, Division of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Endocrinology, Boston VA Healthcare System, Boston, MA, USA
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Cantrell SA. Reducing disparities in medication use: Responding to managed care pharmacy's imperatives. J Manag Care Spec Pharm 2024; 30:747-751. [PMID: 38950162 PMCID: PMC11217862 DOI: 10.18553/jmcp.2024.30.7.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
Although disparities and inequities in health status and access to health care services have long existed in our nation, the COVID-19 pandemic cast a bright spotlight on them. Communities of color and socioeconomically disadvantaged populations were disproportionally affected by the pandemic. These same populations suffer from higher prevalences of chronic illnesses, which puts them at greater risk for poor outcomes associated with SARS-CoV-2. At long last, in the wake of the pandemic, the health care community began to acknowledge improving health equity as a public health imperative. In a November 2020 JMCP Viewpoints article, Dr Stephen Kogut of the University of Rhode Island College of Pharmacy presented an insightful analysis of disparities in medication use (DMU) and offered 4 suggestions on how the managed care pharmacy community can help eliminate DMU. This Viewpoints article assesses what progress has been made in addressing those imperatives and proposes further steps that should be taken. Although the managed care pharmacy community has broadly acknowledged the existence of DMU and taken steps to mitigate them, there is much work to do in examining and improving benefit design and coverage policies; collecting and reporting data on race and ethnicity and DMU; incorporating the perspectives of patients, including those representing minority populations, in benefit design and coverage policies; and addressing the challenges associated with traditional cost-sharing models. The entire managed care pharmacy community, including AMCP and other membership organizations, must remain steadfast in its efforts to improve health equity and eliminate DMU.
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Wang H, Grech L, Wong J, Hoffman D, de Courten B, Sillars B, Savage M, Kwok A, Nguyen M, Bain N, Day D, Segelov E. COVID-19 Vaccine Acceptance, Hesitancy, and Uptake in People with Diabetes in Australia. Vaccines (Basel) 2024; 12:662. [PMID: 38932391 PMCID: PMC11209119 DOI: 10.3390/vaccines12060662] [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: 04/20/2024] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Background: This study explored vaccination hesitancy, diabetes-specific COVID-19 vaccination concerns, and whether they predicted vaccination uptake in people with diabetes. Methods: Quantitative, cross-sectional, and predictive approaches were used. An online survey was conducted with people with diabetes attending four Australian health services, using convenience sampling (n = 842). The survey data collected included clinico-demographic characteristics, COVID-19 vaccine hesitancy, and attitudes around COVID-19 vaccine confidence and complacency. Clinico-demographic characteristics that predicted vaccination status, vaccine hesitancy, and vaccine-related attitudes were identified using regression analyses. Results: Most participants received at least one COVID-19 vaccine dose. Younger age and type 1 diabetes were associated with lower vaccination status, and they were partially mediated through higher vaccine hesitancy. Younger age and English as a dominant language were associated with higher negative attitudes towards speed of vaccine development. Conclusions: Despite an overall high vaccination rate, general and diabetes-specific COVID-19 vaccine concerns are a barrier to uptake for some people with diabetes, particularly in those who are younger or have type 1 diabetes. A detailed understanding of concerns for particular subgroups can help tailor information to increase vaccine acceptance, particularly in the context of requiring booster doses.
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Affiliation(s)
- Holly Wang
- Department of Diabetes, Monash Health, Clayton, VIC 3168, Australia (J.W.)
| | - Lisa Grech
- School of Psychology, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Jennifer Wong
- Department of Diabetes, Monash Health, Clayton, VIC 3168, Australia (J.W.)
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | | | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3085, Australia
| | - Brett Sillars
- Department of Endocrinology, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
| | - Mark Savage
- Department of Endocrinology, Bendigo Health, Bendigo, VIC 3550, Australia;
| | - Alastair Kwok
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Mike Nguyen
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Nathan Bain
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Daphne Day
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Oncology, Monash Health, Clayton, VIC 3168, Australia
| | - Eva Segelov
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
- Department of Clinical Research, Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
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Lourenço AA, Amaral PHR, Paim AAO, Marques GF, Gomes-de-Pontes L, da Mata CPSM, da Fonseca FG, Pérez JCG, Coelho-dos-Reis JGA. Algorithms for predicting COVID outcome using ready-to-use laboratorial and clinical data. Front Public Health 2024; 12:1347334. [PMID: 38807995 PMCID: PMC11130428 DOI: 10.3389/fpubh.2024.1347334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging crisis affecting the public health system. The clinical features of COVID-19 can range from an asymptomatic state to acute respiratory syndrome and multiple organ dysfunction. Although some hematological and biochemical parameters are altered during moderate and severe COVID-19, there is still a lack of tools to combine these parameters to predict the clinical outcome of a patient with COVID-19. Thus, this study aimed at employing hematological and biochemical parameters of patients diagnosed with COVID-19 in order to build machine learning algorithms for predicting COVID mortality or survival. Patients included in the study had a diagnosis of SARS-CoV-2 infection confirmed by RT-PCR and biochemical and hematological measurements were performed in three different time points upon hospital admission. Among the parameters evaluated, the ones that stand out the most are the important features of the T1 time point (urea, lymphocytes, glucose, basophils and age), which could be possible biomarkers for the severity of COVID-19 patients. This study shows that urea is the parameter that best classifies patient severity and rises over time, making it a crucial analyte to be used in machine learning algorithms to predict patient outcome. In this study optimal and medically interpretable machine learning algorithms for outcome prediction are presented for each time point. It was found that urea is the most paramount variable for outcome prediction over all three time points. However, the order of importance of other variables changes for each time point, demonstrating the importance of a dynamic approach for an effective patient's outcome prediction. All in all, the use of machine learning algorithms can be a defining tool for laboratory monitoring and clinical outcome prediction, which may bring benefits to public health in future pandemics with newly emerging and reemerging SARS-CoV-2 variants of concern.
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Affiliation(s)
- Alice Aparecida Lourenço
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Adriana Alves Oliveira Paim
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Geovane Ferreira Marques
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leticia Gomes-de-Pontes
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Flávio Guimarães da Fonseca
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- CT Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juan Carlos González Pérez
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jordana Grazziela Alves Coelho-dos-Reis
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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5
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Yu H, Luo C, Linghu R, Yang J, Wu H. Ezrin Contributes to the Damage of Airway Epithelial Barrier Related to Diabetes Mellitus. J Inflamm Res 2024; 17:2609-2621. [PMID: 38689797 PMCID: PMC11060175 DOI: 10.2147/jir.s449487] [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: 11/12/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Background Diabetes mellitus predisposes individuals to respiratory infections. The airway epithelial barrier provides defense against inhaled antigens and pathogens. Ezrin, is a component of the membrane-cytoskeleton that maintains the cellular morphology, intercellular adhesion, and barrier function of epithelial cells. This study aimed to explore the role of ezrin in airway epithelial barrier damage and correlate its expression and activation with diabetes mellitus. Methods This study was performed in a murine model of diabetes mellitus and with human bronchial epithelial BEAS-2B cells using real-time PCR, Western blotting, immunohistochemical and immunofluorescence staining. Ezrin was knocked down in BEAS-2B cells using siRNA. Ezrin phosphorylation levels were measured to determine activation status. The integrity of the airway epithelial barrier was assessed in vivo by characterizing morphological structure, and in vitro in BEAS-2B cells by measuring tight junction protein expression, transepithelial electrical resistance (TER) and permeability. Results We demonstrated that ezrin expression levels were lower in the lung tissue and airway epithelium of diabetic mice than those in control mice. The morphological structure of the airway epithelium was altered in diabetic mice. High glucose levels downregulated the expression and distribution of ezrin and connexin 43, reduced the expression of tight junction proteins, and altered the epithelial barrier characteristics of BEAS-2B cells. Ezrin knockdown had effects similar to those of high glucose levels. Moreover, a specific inhibitor of ezrin Thr567 phosphorylation (NSC305787) inhibited epithelial barrier formation. Conclusion These results demonstrate that ezrin expression and activation are associated with airway epithelial damage in diabetes mellitus. These findings provide new insights into the molecular pathogenesis of pulmonary infections in diabetes mellitus and may lead to novel therapeutic interventions for airway epithelial barrier damage.
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Affiliation(s)
- Hongmei Yu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Cheng Luo
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ru Linghu
- Department of Internal Medicine, Hospital of Chongqing University, Chongqing, People’s Republic of China
| | - Juan Yang
- Department of Respiratory Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, People’s Republic of China
| | - Haiqiao Wu
- Department of Respiratory Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, People’s Republic of China
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Irizar P, Pan D, Taylor H, Martin CA, Katikireddi SV, Kannangarage NW, Gomez S, La Parra Casado D, Srinivas PN, Diderichsen F, Baggaley RF, Nellums LB, Koller TS, Pareek M. Disproportionate infection, hospitalisation and death from COVID-19 in ethnic minority groups and Indigenous Peoples: an application of the Priority Public Health Conditions analytical framework. EClinicalMedicine 2024; 68:102360. [PMID: 38545088 PMCID: PMC10965404 DOI: 10.1016/j.eclinm.2023.102360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 04/21/2024] Open
Abstract
The COVID-19 pandemic has resulted in disproportionate consequences for ethnic minority groups and Indigenous Peoples. We present an application of the Priority Public Health Conditions (PPHC) framework from the World Health Organisation (WHO), to explicitly address COVID-19 and other respiratory viruses of pandemic potential. This application is supported by evidence that ethnic minority groups were more likely to be infected, implying differential exposure (PPHC level two), be more vulnerable to severe disease once infected (PPHC level three) and have poorer health outcomes following infection (PPHC level four). These inequities are driven by various interconnected dimensions of racism, that compounds with socioeconomic context and position (PPHC level one). We show that, for respiratory viruses, it is important to stratify levels of the PPHC framework by infection status and by societal, community, and individual factors to develop optimal interventions to reduce inequity from COVID-19 and future infectious diseases outbreaks.
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Affiliation(s)
- Patricia Irizar
- Faculty of Humanities, School of Social Sciences, University of Manchester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, UK
- Leicester NIHR Biomedical Research Centre, UK
- Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK
- Development Centre for Population Health, University of Leicester, UK
- Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, UK
| | - Harry Taylor
- Department of Global Health and Social Medicine, King’s College London, UK
| | - Christopher A. Martin
- Department of Respiratory Sciences, University of Leicester, UK
- Leicester NIHR Biomedical Research Centre, UK
- Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK
- Development Centre for Population Health, University of Leicester, UK
| | | | | | | | | | | | | | - Rebecca F. Baggaley
- Leicester NIHR Biomedical Research Centre, UK
- Development Centre for Population Health, University of Leicester, UK
- Department of Population Health Sciences, University of Leicester, UK
| | - Laura B. Nellums
- Lifespan and Population Sciences, School of Medicine, University of Nottingham, UK
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, UK
- Leicester NIHR Biomedical Research Centre, UK
- Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK
- Development Centre for Population Health, University of Leicester, UK
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7
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Eryilmaz-Eren E, Ture Z, Kilinç-Toker A, Korkmaz S, Çelik İ. The course of COVID-19 in patients with hematological malignancies and risk factors affecting mortality: A cross-sectional study. Hematol Transfus Cell Ther 2024; 46:3-7. [PMID: 36474859 PMCID: PMC9715489 DOI: 10.1016/j.htct.2022.10.001] [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: 01/25/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE This study aimed to determine the clinical outcomes and risk factors affecting mortality in patients with COVID-19 following hematological malignancy (HM). METHODS Patients diagnosed with HM and hospitalized for COVID-19 were included in this retrospective study. The age, demographic and clinical characteristics, prognosis and treatment of surviving and non-surviving patients were compared. RESULTS A total of 49 patients were included in this study, 17 (34.6%) of whom died within 28 days of being diagnosed with COVID-19. Older age (p = 0.001), diabetes (p = 0.001), chronic obstructive pulmonary disease (p = 0.002), secondary infection (p < 0.001) and secondary bacterial infection (p = 0.005) were statistically significantly higher in non-survivors. The remission status of HM was higher in surviving patients (p < 0.001). In multivariate regression analysis, age (OR: 1.102, p = 0.035) and secondary infection (OR: 16.677, p = 0.024) were risk factors increasing mortality, the remission status of HM (OR: 0.093, p = 0.047) was a protective factor from mortality. CONCLUSION The older age, the remission status of HM and secondary infection due to COVID-19 were determined as prognostic factors predicting mortality in HM patients with following COVID-19.
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Affiliation(s)
| | - Zeynep Ture
- Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | | | - Serdal Korkmaz
- Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - İlhami Çelik
- Kayseri City Education and Research Hospital, Kayseri, Turkey
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8
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Yassin Z, Farid A, Ahmadi S, Emamikhah M, Motamedi O, Jafari M, Goodarzi A. Coronavirus disease 2019 (COVID-19)-associated brain abscesses caused by Pseudomonas aeruginosa and Aspergillus fumigatus: two case and a review of the literature. J Med Case Rep 2023; 17:520. [PMID: 38049820 PMCID: PMC10694943 DOI: 10.1186/s13256-023-04206-3] [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] [Received: 05/25/2022] [Accepted: 10/09/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Bacterial and fungal superinfections are commonly reported in patients with coronavirus disease 2019. CASE PRESENTATION We report the first case of brain and intramedullary abscesses caused by Pseudomonas aeruginosa and a rare case of brain abscesses caused by Aspergillus fumigatus in two post-coronavirus disease 2019 patients. The first patient-34-year-old Iranian woman-presented with weakness of the left upper limb, headaches, and lower limb paresthesia. She had a history of undiagnosed diabetes and had received corticosteroid therapy. The second patient-45-year-old Iranian man-presented with right-sided weakness and had a history of intensive care unit admission. Both patients passed away despite appropriate medical therapy. CONCLUSION The immune dysregulation induced by coronavirus disease 2019 and its' treatments can predispose patients, especially immunosuppressed ones, to bacterial and fungal infections with unusual and opportunistic pathogens in the central nervous system. Pseudomonas aeruginosa and Aspergillus fumigatus should be considered as potential causes of brain infection in any coronavirus disease 2019 patient presenting with neurological symptoms and evidence of brain abscess in imaging, regardless of sinonasal involvement. These patients should get started on appropriate antimicrobial therapy as soon as possible, as any delay in diagnosis or treatment can be associated with adverse outcomes.
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Affiliation(s)
- Zeynab Yassin
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Farid
- School of Medicine, Iran University of Medical Sciences, Bisotun Street, 6.1 Alley, No 56, Tehran, 1431644311, Iran
| | - Sayedali Ahmadi
- Department of Neurosurgery, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Ave, Tehran, 1431644311, Iran
| | - Maziar Emamikhah
- Department of Neurosurgery, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Ave, Tehran, 1431644311, Iran
| | - Omid Motamedi
- Department of Radiology, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, 1445613131, Iran
| | - Mohammadamin Jafari
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, 1445613131, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, 1445613131, Iran.
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Izzo R, Pacella D, Trimarco V, Manzi MV, Lombardi A, Piccinocchi R, Gallo P, Esposito G, Lembo M, Piccinocchi G, Morisco C, Santulli G, Trimarco B. Incidence of type 2 diabetes before and during the COVID-19 pandemic in Naples, Italy: a longitudinal cohort study. EClinicalMedicine 2023; 66:102345. [PMID: 38143804 PMCID: PMC10746394 DOI: 10.1016/j.eclinm.2023.102345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/26/2023] Open
Abstract
Background The association of COVID-19 with the development of new-onset diabetes has been recently investigated by several groups, yielding controversial results. Population studies currently available in the literature are mostly focused on type 1 diabetes (T1D), comparing patients with a SARS-CoV-2 positive test to individuals without COVID-19, especially in paediatric populations. In this study, we sought to determine the incidence of type 2 diabetes (T2D) before and during the COVID-19 pandemic. Methods In this longitudinal cohort study, we analysed a cohort followed up over a 6-year period using an Interrupted Time Series approach, i.e. 3-years before and 3-years during the COVID-19 pandemic. We analysed data obtained from >200,000 adults in Naples (Italy) from January 1st 2017 to December 31st 2022. In this manner, we had the opportunity to compare the incidence of newly diagnosed T2D before (2017-2019) and during (2020-2022) the COVID-19 pandemic. The key inclusion criteria were age >18-year-old and data availability for the period of observation; patients with a diagnosis of diabetes obtained before 2017 were excluded. The main outcome of the study was the new diagnosis of T2D, as defined by the International Classification of Diseases 10 (ICD-X), including prescription of antidiabetic therapies for more than 30 days. Findings A total of 234,956 subjects were followed-up for at least 3-years before or 3-years during the COVID-19 pandemic and were included in the study; among these, 216,498 were analysed in the pre-pandemic years and 216,422 in the pandemic years. The incidence rate of T2D was 4.85 (95% CI, 4.68-5.02) per 1000 person-years in the period 2017-2019, vs 12.21 (95% CI, 11.94-12.48) per 1000 person-years in 2020-2022, with an increase of about twice and a half. Moreover, the doubling time of the number of new diagnoses of T2D estimated by unadjusted Poisson model was 97.12 (95% CI, 40.51-153.75) months in the prepandemic period vs 23.13 (95% CI, 16.02-41.59) months during the COVID-19 pandemic. Interestingly, these findings were also confirmed when examining patients with prediabetes. Interpretation Our data from this 6-year study on more than 200,000 adult participants indicate that the incidence of T2D was significantly higher during the pandemic compared to the pre-COVID-19 phase. As a consequence, the epidemiology of the disease may change in terms of rates of outcomes as well as public health costs. COVID-19 survivors, especially patients with prediabetes, may require specific clinical programs to prevent T2D. Funding The US National Institutes of Health (NIH: NIDDK, NHLBI, NCATS), Diabetes Action Research and Education Foundation, Weill-Caulier and Hirschl Trusts.
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Affiliation(s)
- Raffaele Izzo
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, “Federico II” University, Naples, Italy
| | - Valentina Trimarco
- Department of Neuroscience, Reproductive Sciences, and Dentistry, “Federico II” University, Naples, Italy
| | - Maria Virginia Manzi
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Angela Lombardi
- Department of Microbiology and Immunology, Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York City, NY, USA
| | | | - Paola Gallo
- Department of Public Health, “Federico II” University, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Maria Lembo
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Gaetano Piccinocchi
- COMEGEN Primary Care Physicians Cooperative, Italian Society of General Medicine (SIMG), Naples, Italy
| | - Carmine Morisco
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
- International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, Naples, Italy
- Italian Society for Cardiovascular Prevention (SIPREC), Rome, Italy
| | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
- International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, Naples, Italy
- Department of Medicine, Wilf Family Cardiovascular Research Institute, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Albert Einstein College of Medicine, New York City, NY, USA
- Department of Molecular Pharmacology, Einstein Institute for Aging Research, Institute for Neuroimmunology and Inflammation (INI), Albert Einstein College of Medicine, New York City, NY, USA
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
- International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, Naples, Italy
- Italian Society for Cardiovascular Prevention (SIPREC), Rome, Italy
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10
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Phan AT, Ucar A, Malkoc A, Nagori E, Qadir A, Khosravi C, Tseng A, Nguyễ˜ên JPT, Modi AP, Deshpande O, Lay J, Ku A, Dong F, Ogunyemi D, Arabian S. The impact of impaired insulin regulation on severity of SARS-CoV-2 infection: a 2-year retrospective single-center analysis. Ann Med Surg (Lond) 2023; 85:5350-5354. [PMID: 37915687 PMCID: PMC10617851 DOI: 10.1097/ms9.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
Background The COVID-19 pandemic has caused an international healthcare crisis and produced a large healthcare burden. Diabetes mellitus (DM) is a common disease that can be controlled via pharmacologic agents; however, many patients have poor glycemic control, leading to disease-related complications. DM has been reported in the literature to be associated with increasing morbidity and mortality in COVID-19 patients. The authors aim to assess the associations between glucose homoeostasis and COVID-19 disease severity and mortality. Methods A retrospective chart review of patients ages 18-100 years of age admitted with COVID-19 between January 2020 and December 2021 was performed. The primary outcome was COVID-19 mortality with respect to haemoglobin A1C levels of less than 5.7%, 5.7-6.4%, and 6.5% and greater. Disease severity was determined by degree of supplemental oxygen requirements (ambient air, low-flow nasal cannula, high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation). COVID-19 mortality and severity were also compared to blood glucose levels on admission as grouped by less than 200 mg/dl and greater than or equal to 200 mg/dl. Results A total of 1156 patients were included in the final analysis. There was a statistically significant association between diabetic status and mortality (P=0.0002). Statistical significance was also noted between admission blood glucose ≥200 mg/dl and mortality (P=0.0058) and respiratory disease severity (P=0.0381). A multivariate logistic regression for predicting mortality showed increasing haemoglobin A1C was associated with increased mortality (odds ratio 1.72 with 95% CI of 1.122-2.635). Conclusions In our 2-year retrospective analysis, there was an association between a diagnosis of DM and COVID-19-related mortality. Hyperglycaemia on admission was found to be statistically significant with mortality in patients diagnosed with COVID-19. Glucose homoeostasis and insulin dysregulation likely play a contributing factor to COVID-19 disease severity and mortality.
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Affiliation(s)
- Alexander T. Phan
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Ari Ucar
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Aldin Malkoc
- General Surgery, Arrowhead Regional Medical Center
| | - Essam Nagori
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Aftab Qadir
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Chayanne Khosravi
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Alan Tseng
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Julie P. T. Nguyễ˜ên
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Arnav P. Modi
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Ojas Deshpande
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Johnson Lay
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Andrew Ku
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Fanglong Dong
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Dotun Ogunyemi
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
| | - Sarkis Arabian
- Departments of Internal Medicine
- Critical Care Medicine
- California University of Science and Medicine, Colton, CA
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11
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Rodrigues SN, Delevatti RS, Carvalho MTX, Bullo V, Bergamin M, Alberton CL. Cardiometabolic, functional, and psychosocial effects of a remotely supervised home-based exercise program in individuals with type 2 diabetes (RED study): study protocol for a randomized clinical trial. Trials 2023; 24:679. [PMID: 37858161 PMCID: PMC10588211 DOI: 10.1186/s13063-023-07704-3] [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] [Received: 03/20/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2D) is a serious global health problem, and exercise is considered an essential non-pharmacological tool in T2D prevention and treatment. During periods of social isolation experienced by the COVID-19 pandemic, home-based exercise programs were strongly recommended as a strategy to facilitate exercise practice and reduce the negative impacts of social isolation. Remotely supervised exercise stands out as an easily accessible strategy after the pandemic, as it is a tool that aims to facilitate access to exercise by this population. The purpose of the RED study is to verify the effects of a remotely supervised home-based exercise program compared to a control group on cardiometabolic, functional, and psychosocial outcomes in patients with T2D. METHODS Participants are randomized into the control group (CG) and the intervention group (IG). Participants allocated to the CG receive recommendations for the practice of physical activity based on information from chapters of the Physical Activity Guide for the Brazilian Population, while the IG will perform a 12-week home-based exercise program supervised remotely by video call. The intervention has a weekly frequency of two sessions per week on non-consecutive days during the first 6 weeks and three sessions per week on non-consecutive days for the remaining 6 weeks. The RED study has HbA1c as the primary outcome, and the participants' cardiometabolic, functional, and psychosocial parameters are assessed at baseline (week 0) and post-intervention (week 13). DISCUSSION Expected results of the proposed study will provide the knowledge base of health professionals and deliver more evidence for a growing area, i.e., home-based exercise and T2D. Additionally, this protocol aims to verify and demonstrate whether this program can be accessible and effective for different health outcomes in patients with T2D. TRIAL REGISTRATION The RED study protocol was prospectively registered at ClinicalTrials.gov (NCT05362071). Date registered April 6, 2022. https://clinicaltrials.gov/ct2/show/NCT05362071 .
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Affiliation(s)
| | | | | | | | - Marco Bergamin
- Department of Medicine, University of Padova, Padua, Italy
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12
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Jung H. Mental health status of individuals with diabetes in Korea before and during the COVID-19 pandemic: a comparison of data from the Korean national health and nutrition examination surveys of 2018-2019 and 2020-2021. BMJ Open 2023; 13:e074080. [PMID: 37827739 PMCID: PMC10582921 DOI: 10.1136/bmjopen-2023-074080] [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: 03/27/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES This study aimed to compare the mental health status of patients with diabetes before and after the COVID-19 pandemic and to determine the effect of COVID-19 on their mental health status. This study was the first to investigate the relationship between diabetes and mental health in the Korean population during the COVID-19 pandemic. DESIGN This retrospective cross-sectional study investigated the prevalence of mental health problems before (2018-2019) and during (2020-2021) the COVID-19 pandemic in individuals with diabetes aged 40 years or older who participated in the Korea National Health and Nutrition Examination Survey. Mental health problems were assessed using self-reported experiences of depression diagnosis, stress perception and suicide ideation. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Clinically significant depression requiring treatment was determined using an optimal cut-off score of 10 out of a total of 27 points. PARTICIPANTS There were 824 men and 763 women in the 2018-2019 survey and 882 men and 887 women in 2020-2021. RESULTS In the unadjusted analysis, women had a statistically significantly higher prevalence of suicide ideation in 2020-2021 (2.9, 95% CI: 1.5 to 4.2) than in 2018-2019 (1.0, 95% CI: 0.4 to 1.7, but p<0.0067). There was no statistically significant difference in both men and women in 2018-2019 after adjusting for age, education, economic activity, hypoglycaemic drug intake or insulin injection, current alcohol consumption, hypertension and hypercholesterolaemia. A comparison of the results of the PHQ-9 survey conducted in 2018-2019 and 2020-2021 found no statistically significant difference in the prevalence of depressive disorder among both men and women. CONCLUSIONS Long-term, retrospective observations and studies on the effects of COVID-19 on the mental health of patients with diabetes should be conducted in the future.
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Affiliation(s)
- Hyejin Jung
- Department of Meridian & Acupoint, College of Korean Medicine, Kyung Hee University, Seoul, Korea (the Republic of)
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13
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Davis GM, Hughes MS, Brown SA, Sibayan J, Perez-Guzman MC, Stumpf M, Thompson Z, Basina M, Patel RM, Hester J, Abraham A, Ly TT, Chaney C, Tan M, Hsu L, Kollman C, Beck RW, Lal R, Buckingham B, Pasquel FJ. Automated Insulin Delivery with Remote Real-Time Continuous Glucose Monitoring for Hospitalized Patients with Diabetes: A Multicenter, Single-Arm, Feasibility Trial. Diabetes Technol Ther 2023; 25:677-688. [PMID: 37578778 PMCID: PMC10611957 DOI: 10.1089/dia.2023.0304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Introduction: Multiple daily injection insulin therapy frequently fails to meet hospital glycemic goals and is prone to hypoglycemia. Automated insulin delivery (AID) with remote glucose monitoring offers a solution to these shortcomings. Research Design and Methods: In a single-arm multicenter pilot trial, we tested the feasibility, safety, and effectiveness of the Omnipod 5 AID System with real-time continuous glucose monitoring (CGM) for up to 10 days in hospitalized patients with insulin-requiring diabetes on nonintensive care unit medical-surgical units. Primary endpoints included the proportion of time in automated mode and percent time-in-range (TIR 70-180 mg/dL) among participants with >48 h of CGM data. Safety endpoints included incidence of severe hypoglycemia and diabetes-related ketoacidosis (DKA). Additional glycemic endpoints, CGM accuracy, and patient satisfaction were also explored. Results: Twenty-two participants were enrolled; 18 used the system for a total of 96 days (mean 5.3 ± 3.1 days per patient), and 16 had sufficient CGM data required for analysis. Median percent time in automated mode was 95% (interquartile range 92%-98%) for the 18 system users, and the 16 participants with >48 h of CGM data achieved an overall TIR of 68% ± 16%, with 0.17% ± 0.3% time <70 mg/dL and 0.06% ± 0.2% time <54 mg/dL. Sensor mean glucose was 167 ± 21 mg/dL. There were no DKA or severe hypoglycemic events. All participants reported satisfaction with the system at study end. Conclusions: The use of AID with a disposable tubeless patch-pump along with remote real-time CGM is feasible in the hospital setting. These results warrant further investigation in randomized trials.
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Affiliation(s)
- Georgia M. Davis
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael S. Hughes
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University, Stanford, California, USA
| | - Sue A. Brown
- Division of Endocrinology, Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA
| | - Judy Sibayan
- Jaeb Center for Health Research, Tampa, Florida, USA
| | - M. Citlalli Perez-Guzman
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Meaghan Stumpf
- Division of Endocrinology, Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA
| | | | - Marina Basina
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University, Stanford, California, USA
| | - Ronak M. Patel
- Division of Endocrinology, Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA
| | - Joi Hester
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Amalia Abraham
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Trang T. Ly
- Insulet Corporation, Acton, Massachusetts, USA
| | - Cherie Chaney
- Division of Endocrinology, Center for Diabetes Technology, University of Virginia, Charlottesville, Virginia, USA
| | - Marilyn Tan
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University, Stanford, California, USA
| | - Liana Hsu
- Division of Pediatric Endocrinology, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Craig Kollman
- Jaeb Center for Health Research, Tampa, Florida, USA
| | - Roy W. Beck
- Jaeb Center for Health Research, Tampa, Florida, USA
| | - Rayhan Lal
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University, Stanford, California, USA
- Division of Pediatric Endocrinology, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Bruce Buckingham
- Division of Pediatric Endocrinology, Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Francisco J. Pasquel
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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14
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Silina EV, Stupin VA, Manturova NE, Ivanova OS, Popov AL, Mysina EA, Artyushkova EB, Kryukov AA, Dodonova SA, Kruglova MP, Tinkov AA, Skalny AV, Ivanov VK. Influence of the Synthesis Scheme of Nanocrystalline Cerium Oxide and Its Concentration on the Biological Activity of Cells Providing Wound Regeneration. Int J Mol Sci 2023; 24:14501. [PMID: 37833949 PMCID: PMC10572590 DOI: 10.3390/ijms241914501] [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: 08/30/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
In the ongoing search for practical uses of rare-earth metal nanoparticles, cerium dioxide nanoparticles (nanoceria) have received special attention. The purpose of this research was to study the biomedical effects of nanocrystalline forms of cerium oxide obtained by different synthesis schemes and to evaluate the effect of different concentrations of nanoceria (from 10-2 to 10-6 M) on cells involved in the regeneration of skin cell structures such as fibroblasts, mesenchymal stem cells, and keratinocytes. Two different methods of nanoceria preparation were investigated: (1) CeO-NPs-1 by precipitation from aqueous solutions of cerium (III) nitrate hexahydrate and citric acid and (2) CeO-NPs-2 by hydrolysis of ammonium hexanitratocerate (IV) under conditions of thermal autoclaving. According to the X-ray diffraction, transmission electron microscopy, and dynamic light scattering data, CeO2-1 consists of individual particles of cerium dioxide (3-5 nm) and their aggregates with diameters of 60-130 nm. CeO2-2 comprises small aggregates of 8-20 nm in diameter, which consist of particles of 2-3 nm in size. Cell cultures of human fibroblasts, human mesenchymal stem cells, and human keratinocytes were cocultured with different concentrations of nanoceria sols (10-2, 10-3, 10-4, 10-5, and 10-6 mol/L). The metabolic activity of all cell types was investigated by MTT test after 48 and 72 h, whereas proliferative activity and cytotoxicity were determined by quantitative cell culture counting and live/dead test. A dependence of biological effects on the method of nanoceria preparation and concentration was revealed. Data were obtained with respect to the optimal concentration of sol to achieve the highest metabolic effect in the used cell cultures. Hypotheses about the mechanisms of the obtained effects and the structure of a fundamentally new medical device for accelerated healing of skin wounds were formulated. The method of nanoceria synthesis and concentration fundamentally and significantly change the biological activity of cell cultures of different types-from suppression to pronounced stimulation. The best biological activity of cell cultures was determined through cocultivation with sols of citrate nanoceria (CeO-NPs-1) at a concentration of 10-3-10-4 M.
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Affiliation(s)
- Ekaterina V. Silina
- Institute of Biodesign and Modeling of Complex Systems, Center of Bioelementology and Human Ecology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.K.); (A.A.T.); (A.V.S.)
| | - Victor A. Stupin
- Department of Hospital Surgery, Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
| | - Natalia E. Manturova
- Department of Plastic and Reconstructive Surgery, Cosmetology and Cell Technologies, Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
| | - Olga S. Ivanova
- Frumkin Institute of Physical Chemistry and Electrochemistry, Russian Academy of Sciences, 119071 Moscow, Russia;
| | - Anton L. Popov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, 142290 Pushchino, Russia; (A.L.P.); (E.A.M.)
| | - Elena A. Mysina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, 142290 Pushchino, Russia; (A.L.P.); (E.A.M.)
| | - Elena B. Artyushkova
- Research Institute of Experimental Medicine, Kursk State Medical University, 305041 Kursk, Russia; (E.B.A.); (A.A.K.); (S.A.D.)
| | - Alexey A. Kryukov
- Research Institute of Experimental Medicine, Kursk State Medical University, 305041 Kursk, Russia; (E.B.A.); (A.A.K.); (S.A.D.)
| | - Svetlana A. Dodonova
- Research Institute of Experimental Medicine, Kursk State Medical University, 305041 Kursk, Russia; (E.B.A.); (A.A.K.); (S.A.D.)
| | - Maria P. Kruglova
- Institute of Biodesign and Modeling of Complex Systems, Center of Bioelementology and Human Ecology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.K.); (A.A.T.); (A.V.S.)
| | - Alexey A. Tinkov
- Institute of Biodesign and Modeling of Complex Systems, Center of Bioelementology and Human Ecology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.K.); (A.A.T.); (A.V.S.)
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, 150003 Yaroslavl, Russia
| | - Anatoly V. Skalny
- Institute of Biodesign and Modeling of Complex Systems, Center of Bioelementology and Human Ecology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (M.P.K.); (A.A.T.); (A.V.S.)
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, 150003 Yaroslavl, Russia
| | - Vladimir K. Ivanov
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, 119991 Moscow, Russia;
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15
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Jalota A, Hershberger CE, Patel MS, Mian A, Faruqi A, Khademi G, Rotroff DM, Hill BT, Gupta N. Host metabolome predicts the severity and onset of acute toxicities induced by CAR T-cell therapy. Blood Adv 2023; 7:4690-4700. [PMID: 36399526 PMCID: PMC10468366 DOI: 10.1182/bloodadvances.2022007456] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/04/2022] [Accepted: 08/20/2022] [Indexed: 11/19/2022] Open
Abstract
Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is a highly effective treatment option for patients with relapsed/refractory large B-cell lymphoma. However, widespread use is deterred by the development of clinically significant acute inflammatory toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), that induce significant morbidity and require close monitoring. Identification of host biochemical signatures that predict the severity and time-to-onset of CRS and ICANS may assist patient stratification to enable timely mitigation strategies. Here, we report pretreatment host metabolites that are associated with CRS and ICANS induced by axicabtagene ciloleucel or tisagenlecleucel therapy. Both untargeted metabolomics analysis and validation using targeted assays revealed a significant association between the abundance of specific pretreatment biochemical entities and an increased risk and/or onset of clinically significant CRS (q < .1) and ICANS (q < .25). Higher pretreatment levels of plasma glucose and lower levels of cholesterol and glutamate were associated with a faster onset of CRS. In contrast, low baseline levels of the amino acids proline and glycine and the secondary bile acid isoursodeoxycholate were significantly correlated with clinically significant CRS. Lower concentration of the amino acid hydroxyproline was associated with higher grade and faster onset of ICANS, whereas low glutamine was negatively correlated with faster development of ICANS. Overall, our data indicate that the pretreatment host metabolome has biomarker potential in determining the risk of clinically significant CRS and ICANS, and may be useful in risk stratification of patients before anti-CD19 CAR T-cell therapy.
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Affiliation(s)
- Akansha Jalota
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH
| | | | - Manishkumar S. Patel
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH
| | - Agrima Mian
- Department of Internal Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Aiman Faruqi
- Cleveland Clinic Lerner College of Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Gholamreza Khademi
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, OH
| | - Daniel M. Rotroff
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, OH
- Cleveland Clinic Lerner College of Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Brian T. Hill
- Cleveland Clinic Lerner College of Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Neetu Gupta
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland, OH
- Cleveland Clinic Lerner College of Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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16
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Si Y, Fei Y, Ma H, Xu Y, Ning L, Li X, Ren Q. The causal association between polycystic ovary syndrome and susceptibility and severity of COVID-19: a bidirectional Mendelian randomization study using genetic data. Front Endocrinol (Lausanne) 2023; 14:1229900. [PMID: 37745707 PMCID: PMC10515223 DOI: 10.3389/fendo.2023.1229900] [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] [Received: 05/27/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Observational studies have reported an association between polycystic ovary syndrome (PCOS) and COVID-19, but a definitive causal relationship has not been established. This study aimed to assess this association using two-way two-sample Mendelian randomization (MR). Methods A summary of PCOS characteristics was compiled using the PCOS summary statistics from the Apollo University of Cambridge Repository. COVID-19 susceptibility and severity statistics, including hospitalization and extremely severe disease, were obtained from genome-wide association studies from the COVID-19 Host Genetics Initiative. The primary analysis used the inverse variance-weighted method, supplemented by the weighted median, MR-Egger, and MR-PRESSO methods. Results The forward MR analysis showed no significant impact of PCOS on COVID-19 susceptibility, hospitalization, or severity (OR = 0.983, 1.011, 1.014; 95% CI = 0.958-1.008, 0.958-1.068, 0.934-1.101; and p = 0.173, 0.68, 0.733; respectively). Similarly, reverse MR analysis found no evidence supporting COVID-19 phenotypes as risk or protective factors for PCOS (OR = 1.041, 0.995, 0.944; 95% CI = 0.657-1.649, 0.85-1.164, 0.843-1.058; and p = 0.864, 0.945, 0.323; respectively). Consequently, no significant association between any COVID-19 phenotype and PCOS was established. Conclusion This MR study suggested that PCOS is not a causal risk factor for the susceptibility and severity of COVID-19. The associations identified in previous observational studies might be attributable to the presence of comorbidities in the patients.
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Affiliation(s)
| | | | | | | | | | | | - Qingling Ren
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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17
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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.
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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
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18
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Wu J, Ma M, Li Q, Guo X, Tarimo CS, Jia S, Zhou X, Wang M, Gu J, Miao Y, Ye B. Dynamic Trends and Underlying Factors of COVID-19 Vaccine Booster Hesitancy in Adults: Cross-Sectional Observational Study. JMIR Public Health Surveill 2023; 9:e44822. [PMID: 37526963 PMCID: PMC10395646 DOI: 10.2196/44822] [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: 12/05/2022] [Revised: 02/18/2023] [Accepted: 06/16/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND COVID-19 vaccine hesitancy reduces vaccination rates, which is detrimental to building herd immunity and halting the spread of COVID-19 and its variations. Most researches have simply identified the reasons affecting COVID-19 vaccination reluctance without delving into its dynamics, which makes forecasting future trends difficult. OBJECTIVE This study aimed to examine the current COVID-19 vaccine booster hesitancy rate in Chinese adults as well as the dynamics of vaccine hesitancy and its influencing factors. The results of this study will have practical implications for policy responses in mainland China, and effective COVID-19 booster vaccination in specific populations. METHODS The web-based survey was completed by creating questionnaires and using a stratified random sampling method to collect information from adults (≥18 years old) among 2556 households in 4 geographical regions of China. We collected sociodemographic information, health status, awareness of COVID-19 and its vaccine, self-perceptions, trust in medical staff and vaccine developers, and so on. The odds ratios and 95% CI for the statistical associations were estimated using logistic regression models. RESULTS Overall, 6659 participants (females: n=3540, 53.2%; males: n=3119, 46.8%) responded. In total, 533 (8%; 95% CI 7.4%-8.7%) participants presented a clear hesitancy in receiving the COVID-19 booster vaccination, while 736 (11.1%; 95% CI 10.3%-11.8%) expressed hesitancy in regular booster vaccination. A higher prevalence of vaccine hesitancy in both booster vaccination and regular booster vaccination was observed among participants with a history of allergies, experiencing chronic disease, lower levels of public health prevention measures or susceptibility or benefits or self-efficiency, higher levels of severity or barriers, and lower trust in both medical staff and vaccine developers (P<.05). The females and participants with higher education levels, higher levels of barriers, lower levels of susceptibility, and lower trust in vaccine developers preferred to have attitudinal changes from acceptance to hesitancy, while people with higher education levels, lower self-report health conditions, experiencing chronic disease, history of allergies, and lower trust in medical staff and developers were all positively associated with constant COVID-19 booster hesitancy. CONCLUSIONS The prevalence of COVID-19 vaccine booster hesitancy is not high in mainland China. However, there is a slight increment in hesitancy on regular booster vaccination. Conducting targeted information guidance for people with higher education levels and chronic diseases, as well as improving accessibility to booster vaccination and increasing trust in medical staff and vaccine producers may be highly effective in reducing vaccine hesitancy.
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Affiliation(s)
- Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Quanman Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Xinghong Guo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, United Republic of Tanzania
| | - Shiyu Jia
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Xue Zhou
- Department of Public Utilities Management, College of Health Management, Mudanjiang Medical University, Hei Longjiang, China
| | - Meiyun Wang
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Jianqin Gu
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Henan Province Engineering Research Center of Health Economy & Health Technology Assessment, Zhengzhou, China
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19
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de Araújo MFM, Monteiro FPM, de Araújo TM, Lira Neto JCG, Santos LFS, Rolim ILTP, Santos FS, Pascoal LM, Costa ACPDJ, Santos Neto M. Individual and mutual effects of diabetes, hypertension, and obesity on acute respiratory distress syndrome mortality rates in clinical patients: a multicentre study. Front Public Health 2023; 11:1219271. [PMID: 37415703 PMCID: PMC10320200 DOI: 10.3389/fpubh.2023.1219271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Patients with comorbidities are more vulnerable to severe clinical cases of acute respiratory distress syndrome (ARDS) and COVID-19 require complex health care. To analyse the association between the individual and combined effects of diabetes, hypertension, and obesity on ARDS mortality rates among patients receiving clinical care. A multicentre study encompassing retrospective data analysis and conducted with 21,121 patients from 6,723 health services across Brazil, during the 2020-2022 time period. The sample group consisted of clinical patients of both sexes and different age groups who received clinical care and showed at least one comorbidity. The data collected were analysed using binary logistic regressions and the Chi-square test. The overall mortality rate was 38.7%, with a higher predominance among males (p < 0.001), mixed-race individuals (p < 0.001), and older adults (p < 0.001). The main comorbidity variables associated with and leading to death from ARDS were arterial hypertension (p < 0.001), diabetes mellitus (p < 0.001), diabetes mellitus and arterial hypertension (p < 0.001), cardiovascular diseases (p < 0.001) and obesity (p < 0.001). Both the patients who progressed to recovery (48.4%) and to death (20.5%) presented only one comorbidity (χ2 (1,749) = 8, p < 0.001), respectively. The isolated comorbidities with the greatest impact on death outcomes were diabetes (95% CI 2.48-3.05, p < 0.001), followed by obesity (95% CI 1.85-2.41, p < 0.001) and hypertension (95% CI 1.05-1.22, p < 0.001), even after adjusting for sex and number of simultaneous comorbidities. Diabetes and obesity, as isolated conditions, had a greater influence on the number of deaths of clinical patients with ARDS compared to those with mutual diagnosis of diabetes, hypertension and obesity.
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Affiliation(s)
| | | | - Thiago Moura de Araújo
- Health Science Institute, University for International Integration of the Afro Brazilian Lusophony, Redenção, Brazil
| | | | | | | | - Floriacy Stabnow Santos
- Center for Social Science, Health and Technology, Federal University of Maranhão, Imperatriz, Brazil
| | - Livia Maia Pascoal
- Center for Social Science, Health and Technology, Federal University of Maranhão, Imperatriz, Brazil
| | | | - Marcelino Santos Neto
- Center for Social Science, Health and Technology, Federal University of Maranhão, Imperatriz, Brazil
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20
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Zhang S, Zhao W, Zeng J, He Z, Wang X, Zhu Z, Hu R, Liu C, Wang Q. Wearable non-invasive glucose sensors based on metallic nanomaterials. Mater Today Bio 2023; 20:100638. [PMID: 37128286 PMCID: PMC10148187 DOI: 10.1016/j.mtbio.2023.100638] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 05/03/2023] Open
Abstract
The development of wearable non-invasive glucose sensors provides a convenient technical means to monitor the glucose concentration of diabetes patients without discomfortability and risk of infection. Apart from enzymes as typical catalytic materials, the active catalytic materials of the glucose sensor are mainly composed of polymers, metals, alloys, metal compounds, and various metals that can undergo catalytic oxidation with glucose. Among them, metallic nanomaterials are the optimal materials applied in the field of wearable non-invasive glucose sensing due to good biocompatibility, large specific surface area, high catalytic activity, and strong adsorption capacity. This review summarizes the metallic nanomaterials used in wearable non-invasive glucose sensors including zero-dimensional (0D), one-dimensional (1D), and two-dimensional (2D) monometallic nanomaterials, bimetallic nanomaterials, metal oxide nanomaterials, etc. Besides, the applications of wearable non-invasive biosensors based on these metallic nanomaterials towards glucose detection are summarized in detail and the development trend of the wearable non-invasive glucose sensors based on metallic nanomaterials is also outlook.
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Affiliation(s)
- Sheng Zhang
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
- NingboTech University, Ningbo, 315100, China
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, 315100, China
| | - Wenjie Zhao
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Junyan Zeng
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Zhaotao He
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Xiang Wang
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, 315100, China
| | - Zehui Zhu
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
| | - Runqing Hu
- NingboTech University, Ningbo, 315100, China
| | - Chen Liu
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, 315100, China
- Corresponding author. Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China.
| | - Qianqian Wang
- Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China
- NingboTech University, Ningbo, 315100, China
- Corresponding author. Ningbo Innovation Center, Zhejiang University, Ningbo, 315100, China.
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21
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Nagendra L, Bhattacharya S, Kalra S, Kapoor N. Metformin in COVID-19: Is There a Role Beyond Glycemic Control? Int J Endocrinol Metab 2023; 21:e132965. [PMID: 37654526 PMCID: PMC10467582 DOI: 10.5812/ijem-132965] [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: 11/12/2022] [Revised: 03/26/2023] [Accepted: 04/15/2023] [Indexed: 09/02/2023] Open
Abstract
Context The coronavirus disease 2019 (COVID-19) pandemic is still a cause of worldwide health concern. Diabetes and its associated comorbidities are risk factors for mortality and morbidity in COVID-19. Selecting the right antidiabetic drug to achieve optimal glycemic control might mitigate some of the negative impacts of diabetes. Metformin continues to be the most widely administered antidiabetic agent. There is evidence of its beneficial outcome in COVID-19 independent of its glucose-lowering effect. Evidence Acquisition A thorough literature search was conducted in PubMed, Google Scholar, Scopus, and Web of Science to identify studies investigating metformin in COVID-19. Results Several overlapping mechanisms have been proposed to explain its antiviral properties. It could bring about conformational changes in the angiotensin-converting enzyme-2 receptor and decrease viral entry. The effects on the mammalian target of the rapamycin pathway and cellular pH have been proposed to reduce viral protein synthesis and replication. The immunomodulatory effects of metformin might counter the detrimental effects of hyperinflammation associated with COVID-19. Conclusions These findings call for broader metformin usage to manage hyperglycemia in COVID-19.
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Affiliation(s)
- Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College and Hospital, JSS Academy of Higher Education & Research (JSS AHER), Mysore, Karnataka, India
| | | | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
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22
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Yu S, Wan R, Bai L, Zhao B, Jiang Q, Jiang J, Li Y. Transformation of chronic disease management: Before and after the COVID-19 outbreak. Front Public Health 2023; 11:1074364. [PMID: 37064686 PMCID: PMC10090362 DOI: 10.3389/fpubh.2023.1074364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Adults with chronic diseases often experience a decline in their quality of life along with frequent exacerbations. These diseases can cause anxiety and impose a significant economic burden. Self-management is a crucial aspect of treatment outside of the hospital and can improve quality of life and reduce the financial burden resulting from unexpected hospitalizations. With the COVID-19 pandemic, telehealth has become a vital tool for both medical professionals and patients; many in-person appointments have been canceled due to the pandemic, leading to increased reliance on online resources. This article aimed to discuss various methods of chronic disease management, both traditional self-management and modern telehealth strategies, comparing before and after the COVID-19 outbreak and highlighting challenges that have emerged.
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Affiliation(s)
- Steven Yu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Rongjun Wan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Lu Bai
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Bingrong Zhao
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Qiaoling Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Juan Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- Juan Jiang,
| | - Yuanyuan Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Yuanyuan Li,
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23
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Horozoglu F, Sener H, Evereklioglu C, Polat OA. Macular optical coherence tomography angiography analysis in diabetes mellitus patients with a history of Covid-19. Photodiagnosis Photodyn Ther 2023; 42:103513. [PMID: 36918077 PMCID: PMC10008179 DOI: 10.1016/j.pdpdt.2023.103513] [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: 11/24/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE There is evidence of decreased vessel density in optical coherence tomography angiography (OCTA) after Covid-19. We aimed to investigate whether the outcome of retinal vasculopathy would be worse if patients with diabetes mellitus (DM) were infected with coronavirus using OCTA to assess retinal vessels. METHODS One eye of each subject was included in the study. Diabetic patients without retinopathy and non-diabetic controls were divided into four groups according to their Covid-19 history: group 1=DM(-)Covid-19(-); group 2=DM(+)Covid-19(-); group 3=DM(-)Covid-19(+); and group 4=DM(+)Covid-19(+). All Covid-19 patients were not hospitalised. Macular OCTA scans were performed in a 6 × 6 mm area. RESULTS Diabetes had no effect on the area of the foveal avascular zone (FAZ), but Covid-19 caused an increase in FAZ area. Diabetes and Covid-19 had an effect on both the superficial capillary plexus (SCP) and the deep capillary plexus (DCP) in the fovea. Eta squared (ƞ2) is a measure of effect size. The effect size of Covid-19 (ƞ2=0.180) was found to be greater than that of diabetes (ƞ2=0.158) on the SCP, whereas the effect size of diabetes (ƞ2=0.159) was found to be greater than that of Covid-19 (ƞ2=0.091) on the DCP. CONCLUSIONS The percentage of vessel density was lower in the fovea and the FAZ area was enlarged in the diabetic patients who recovered from Covid-19. In diabetic patients Covid-19 may lead to deterioration of vascular metrics.
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Affiliation(s)
- Fatih Horozoglu
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hidayet Sener
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey.
| | - Cem Evereklioglu
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Osman Ahmet Polat
- Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey
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24
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Xiang F, Long B, He J, Cheng F, Zhang S, Liu Q, Chen Z, Li H, Chen M, Peng M, Yin W, Liu D, Ren H. Impaired antibody responses were observed in patients with type 2 diabetes mellitus after receiving the inactivated COVID-19 vaccines. Virol J 2023; 20:22. [PMID: 36750902 PMCID: PMC9902824 DOI: 10.1186/s12985-023-01983-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) have been reported to be more susceptible to 2019 novel coronavirus (2019-nCoV) and more likely to develop severe pneumonia. However, the safety and immunological responses of T2DM patients after receiving the inactivated vaccines are not quite definite. Therefore, we aimed to explore the safety, antibody responses, and B-cell immunity of T2DM patients who were vaccinated with inactivated coronavirus disease 2019 (COVID-19) vaccines. METHODS Eighty-nine patients with T2DM and 100 healthy controls (HCs) were enrolled, all of whom had received two doses of full-course inactivated vaccines. At 21-105 days after full-course vaccines: first, the safety of the vaccines was assessed by questionnaires; second, the titers of anti-receptor binding domain IgG (anti-RBD-IgG) and neutralizing antibodies (NAbs) were measured; third, we detected the frequency of RBD-specific memory B cells (RBD-specific MBCs) to explore the cellular immunity of T2DM patients. RESULTS The overall incidence of adverse events was similar between T2DM patients and HCs, and no serious adverse events were recorded in either group. Compared with HCs, significantly lower titers of anti-RBD-IgG (p = 0.004) and NAbs (p = 0.013) were observed in T2DM patients. Moreover, the frequency of RBD-specific MBCs was lower in T2DM patients than in HCs (p = 0.027). Among the 89 T2DM patients, individuals with lower body mass index (BMI) had higher antibody titers (anti-RBD-IgG: p = 0.009; NAbs: p = 0.084). Furthermore, we found that sex, BMI, and days after vaccination were correlated with antibody titers. CONCLUSIONS Inactivated COVID-19 vaccines were safe in patients with T2DM, but the antibody responses and memory B-cell responses were significantly decreased compared to HCs. TRIAL REGISTRATION NUMBER AND DATE NCT05043246. September 14, 2021. (Clinical Trials.gov).
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Affiliation(s)
- Feng Xiang
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Boyu Long
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jiaoxia He
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Feifei Cheng
- grid.203458.80000 0000 8653 0555Department of Endocrine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Sijing Zhang
- grid.203458.80000 0000 8653 0555Department of Endocrine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Qing Liu
- grid.203458.80000 0000 8653 0555Department of Endocrine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zhiwei Chen
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hu Li
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Min Chen
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Mingli Peng
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Wenwei Yin
- grid.203458.80000 0000 8653 0555Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Dongfang Liu
- Department of Endocrine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
| | - Hong Ren
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
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25
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Cordero Franco HF, Salinas Martínez AM, Martínez Martínez DL, Santiago Jarquin BR, Guzmán de la Garza FJ. Cessation of Face Mask Use after COVID-19 Vaccination in Patients with Diabetes: Prevalence and Determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2768. [PMID: 36833465 PMCID: PMC9956089 DOI: 10.3390/ijerph20042768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Studies on the cessation of face mask use after a COVID-19 vaccine in patients with diabetes are not available, despite their greater predisposition to complications. We estimated the prevalence of cessation of face mask use after receiving the COVID-19 vaccine in patients with diabetes and identified which factor was most strongly associated with non-use. This was a cross-sectional study in patients with diabetes 18-70 years with at least one dose of vaccine against COVID-19 (n = 288). Participants were asked to respond face-to-face to a questionnaire in a primary care center. Descriptive statistics, chi-square tests, and multivariate binary logistic regression were used for analyzing the association between vulnerability, benefits, barriers, self-efficacy, vaccine expectations (independent variables), and cessation of use (dependent variable), controlling for sociodemographic, smoking, medical, vaccine, and COVID-19 history. The prevalence of cessation of face masks was 25.3% (95% CI 20.2, 30.5). Not feeling vulnerable to hospitalization increased the odds of non-use (adjusted OR = 3.3, 95% CI 1.2, 8.6), while perceiving benefits did the opposite (adjusted OR = 0.4, 95% CI 0.2, 0.9). The prevalence was low, and only two factors were associated with the cessation of face mask use after COVID-19 vaccination in patients with type 2 diabetes.
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Affiliation(s)
- Hid Felizardo Cordero Franco
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey 64360, Mexico
| | - Ana María Salinas Martínez
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey 64360, Mexico
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico
| | - Diana Laura Martínez Martínez
- Vice-Rectory of Health Sciences, University of Monterrey, San Pedro Garza García 66238, Mexico
- Family Medicine Clinic No. 26, Mexican Institute of Social Security, Monterrey 64360, Mexico
| | | | - Francisco Javier Guzmán de la Garza
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey 64360, Mexico
- School of Medicine, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico
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Liu X, Huang X, Zhao J, Su Y, Shen L, Duan Y, Gong J, Zhang Z, Piao S, Zhu Q, Rong X, Guo J. Application of machine learning in Chinese medicine differentiation of dampness-heat pattern in patients with type 2 diabetes mellitus. Heliyon 2023; 9:e13289. [PMID: 36873141 PMCID: PMC9975099 DOI: 10.1016/j.heliyon.2023.e13289] [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: 11/17/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/15/2023] Open
Abstract
Background China has become the country with the largest number of people with type 2 diabetes mellitus (T2DM), and Chinese medicine (CM) has unique advantages in preventing and treating T2DM, while accurate pattern differentiation is the guarantee for proper treatment. Objective The establishment of the CM pattern differentiation model of T2DM is helpful to the pattern diagnosis of the disease. At present, there are few studies on dampness-heat pattern differentiation models of T2DM. Therefore, we establish a machine learning model, hoping to provide an efficient tool for the pattern diagnosis of CM for T2DM in the future. Methods A total of 1021 effective samples of T2DM patients from ten CM hospitals or clinics were collected by a questionnaire including patients' demographic and dampness-heat-related symptoms and signs. All information and the diagnosis of the dampness-heat pattern of patients were completed by experienced CM physicians at each visit. We applied six machine learning algorithms (Artificial Neural Network [ANN], K-Nearest Neighbor [KNN], Naïve Bayes [NB], Support Vector Machine [SVM], Extreme Gradient Boosting [XGBoost] and Random Forest [RF]) and compared their performance. And then we also utilized Shapley additive explanation (SHAP) method to explain the best performance model. Results The XGBoost model had the highest AUC (0.951, 95% CI 0.925-0.978) among the six models, with the best sensitivity, accuracy, F1 score, negative predictive value, and excellent specificity, precision, and positive predictive value. The SHAP method based on XGBoost showed that slimy yellow tongue fur was the most important sign in dampness-heat pattern diagnosis. The slippery pulse or rapid-slippery pulse, sticky stool with ungratifying defecation also performed an important role in this diagnostic model. Furthermore, the red tongue acted as an important tongue sign for the dampness-heat pattern. Conclusion This study constructed a dampness-heat pattern differentiation model of T2DM based on machine learning. The XGBoost model is a tool with the potential to help CM practitioners make quick diagnosis decisions and contribute to the standardization and international application of CM patterns.
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Affiliation(s)
- Xinyu Liu
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Guangdong TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Xiaoqiang Huang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jindong Zhao
- The First Affiliated Hospital of Anhui University of Chinese, Hefei, 230031, China
| | - Yanjin Su
- Shaanxi University of Chinese Medicine, Xi'an, 712046, China
| | - Lu Shen
- Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, 710003, China
| | - Yuhong Duan
- Affiliated Hospital of Shannxi University of Chinese Medicine, Xi'an, 712000, China
| | - Jing Gong
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhihai Zhang
- The First Affiliated Hospital of Xiamen University, Xiamen, 361003, China
| | - Shenghua Piao
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Guangdong TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Qing Zhu
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Guangdong TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Xianglu Rong
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Guangdong TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Jiao Guo
- Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Guangdong TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, 510006, China
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Ottone M, Bartolini L, Bonvicini L, Giorgi Rossi P. The effect of diabetes on COVID-19 incidence and mortality: Differences between highly-developed-country and high-migratory-pressure-country populations. Front Public Health 2023; 11:969143. [PMID: 36969620 PMCID: PMC10031649 DOI: 10.3389/fpubh.2023.969143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
The objective of this study was to compare the effect of diabetes and pathologies potentially related to diabetes on the risk of infection and death from COVID-19 among people from Highly-Developed-Country (HDC), including Italians, and immigrants from the High-Migratory-Pressure-Countries (HMPC). Among the population with diabetes, whose prevalence is known to be higher among immigrants, we compared the effect of body mass index among HDC and HMPC populations. A population-based cohort study was conducted, using population registries and routinely collected surveillance data. The population was stratified into HDC and HMPC, according to the place of birth; moreover, a focus was set on the South Asiatic population. Analyses restricted to the population with type-2 diabetes were performed. We reported incidence (IRR) and mortality rate ratios (MRR) and hazard ratios (HR) with 95% confidence interval (CI) to estimate the effect of diabetes on SARS-CoV-2 infection and COVID-19 mortality. Overall, IRR of infection and MRR from COVID-19 comparing HMPC with HDC group were 0.84 (95% CI 0.82-0.87) and 0.67 (95% CI 0.46-0.99), respectively. The effect of diabetes on the risk of infection and death from COVID-19 was slightly higher in the HMPC population than in the HDC population (HRs for infection: 1.37 95% CI 1.22-1.53 vs. 1.20 95% CI 1.14-1.25; HRs for mortality: 3.96 95% CI 1.82-8.60 vs. 1.71 95% CI 1.50-1.95, respectively). No substantial difference in the strength of the association was observed between obesity or other comorbidities and SARS-CoV-2 infection. Similarly for COVID-19 mortality, HRs for obesity (HRs: 18.92 95% CI 4.48-79.87 vs. 3.91 95% CI 2.69-5.69) were larger in HMPC than in the HDC population, but differences could be due to chance. Among the population with diabetes, the HMPC group showed similar incidence (IRR: 0.99 95% CI: 0.88-1.12) and mortality (MRR: 0.89 95% CI: 0.49-1.61) to that of HDC individuals. The effect of obesity on incidence was similar in both HDC and HMPC populations (HRs: 1.73 95% CI 1.41-2.11 among HDC vs. 1.41 95% CI 0.63-3.17 among HMPC), although the estimates were very imprecise. Despite a higher prevalence of diabetes and a stronger effect of diabetes on COVID-19 mortality in HMPC than in the HDC population, our cohort did not show an overall excess risk of COVID-19 mortality in immigrants.
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Oliveira P, Louro J, Gil P, Andrade L. [COVID-19 and Diabetes Mellitus: The Impact of Two Pandemics]. ACTA MEDICA PORT 2022; 35:925-926. [PMID: 36469954 DOI: 10.20344/amp.16758] [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: 06/20/2021] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Pedro Oliveira
- Serviço de Medicina Interna. Centro Hospitalar de Vila Nova de Gaia-Espinho. Vila Nova de Gaia. Portugal
| | - Joana Louro
- Serviço de Medicina Interna. Centro Hospitalar do Oeste. Caldas da Rainha. Portugal
| | - Pedro Gil
- Serviço de Medicina Interna. Centro Hospitalar de Vila Nova de Gaia-Espinho. Vila Nova de Gaia. Portugal
| | - Luís Andrade
- Serviço de Medicina Interna. Centro Hospitalar Entre Douro e Vouga. Santa Maria da Feira. Portugal
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Lai H, Yang M, Sun M, Pan B, Wang Q, Wang J, Tian J, Ding G, Yang K, Song X, Ge L. Risk of incident diabetes after COVID-19 infection: A systematic review and meta-analysis. Metabolism 2022; 137:155330. [PMID: 36220361 PMCID: PMC9546784 DOI: 10.1016/j.metabol.2022.155330] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND COVID-19 might be a risk factor for various chronic diseases. However, the association between COVID-19 and the risk of incident diabetes remains unclear. We aimed to meta-analyze evidence on the relative risk of incident diabetes in patients with COVID-19. METHODS In this systematic review and meta-analysis, the Embase, PubMed, CENTRAL, and Web of Science databases were searched from December 2019 to June 8, 2022. We included cohort studies that provided data on the number, proportion, or relative risk of diabetes after confirming the COVID-19 diagnosis. Two reviewers independently screened studies for eligibility, extracted data, and assessed risk of bias. We used a random-effects meta-analysis to pool the relative risk with corresponding 95 % confidence intervals. Prespecified subgroup and meta-regression analyses were conducted to explore the potential influencing factors. We converted the relative risk to the absolute risk difference to present the evidence. This study was registered in advance (PROSPERO CRD42022337841). MAIN FINDINGS Ten articles involving 11 retrospective cohorts with a total of 47.1 million participants proved eligible. We found a 64 % greater risk (RR = 1.64, 95%CI: 1.51 to 1.79) of diabetes in patients with COVID-19 compared with non-COVID-19 controls, which could increase the number of diabetes events by 701 (558 more to 865 more) per 10,000 persons. We detected significant subgroup effects for type of diabetes and sex. Type 2 diabetes has a higher relative risk than type 1. Moreover, men may be at a higher risk of overall diabetes than women. Sensitivity analysis confirmed the robustness of the results. No evidence was found for publication bias. CONCLUSIONS COVID-19 is strongly associated with the risk of incident diabetes, including both type 1 and type 2 diabetes. We should be aware of the risk of developing diabetes after COVID-19 and prepare for the associated health problems, given the large and growing number of people infected with COVID-19. However, the body of evidence still needs to be strengthened.
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Affiliation(s)
- Honghao Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Manli Yang
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Mingyao Sun
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Bei Pan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Quan Wang
- Ambulatory Surgery Center, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Jing Wang
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Guowu Ding
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xuping Song
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China.
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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30
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Wang YF, Liang FM, Liu M, Ding LC, Hui JJ, Xu HY, Liu LJ. Is compromised intestinal barrier integrity responsible for the poor prognosis in critically ill patients with pre-existing hyperglycemia? Diabetol Metab Syndr 2022; 14:172. [PMID: 36397109 PMCID: PMC9669527 DOI: 10.1186/s13098-022-00943-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Compromised intestinal barrier integrity can be independently driven by hyperglycemia, and both hyperglycemia and intestinal barrier injury are associated with poor prognosis in critical illness. This study investigated the intestinal barrier biomarkers in critically ill patients, to explore the role of compromised intestinal barrier integrity on the prognosis of critically ill patients with pre-existing hyperglycemia. METHODS This was a retrospective observational study. The relationships between intestinal barrier biomarkers and glycated hemoglobin A1c (HbA1c), fasting blood glucose (FBG), indicators of clinical characteristics, disease severity, and prognosis in critically ill patients were investigated. Then the metrics mentioned above were compared between survivors and non-survivors, the risk factors of 90-day mortality were investigated by logistic regression analysis. Further, patients were divided into HbA1c < 6.5% Group and HbA1c ≥ 6.5% Group, metrics mentioned above were compared between these two groups. RESULTS A total of 109 patients with critical illness were included in the study. D-lactate and lipopolysaccharide (LPS) were associated with sequential organ failure assessment (SOFA) score and 90-day mortality. LPS was an independent risk factor of 90-day mortality. DAO, NEU (neutrophil) proportion, temperature, lactate were lower in HbA1c ≥ 6.5% Group while D-lactate, LPS, indicators of disease severity and prognosis showed no statistical difference between HbA1c < 6.5% Group and HbA1c ≥ 6.5% Group. CONCLUSIONS Intestinal barrier integrity is associated with the disease severity and prognosis in critical illness. Compromised intestinal barrier integrity might be responsible for the poor prognosis in critically ill patients with pre-existing hyperglycemia.
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Affiliation(s)
- Yi-Feng Wang
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
- Department of Emergency and Critical Care Medicine, Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Feng-Ming Liang
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Min Liu
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Li-Cheng Ding
- Department of Emergency Medicine, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jiao-Jie Hui
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Hong-Yang Xu
- Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
| | - Li-Jun Liu
- Department of Emergency and Critical Care Medicine, Second Affiliated Hospital of Soochow University, Suzhou, China.
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31
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Song LG, Bai SR, Hui DH, Ding LP, Sun L. Association of COVID-19 patient’s condition with fasting blood glucose and body mass index: A retrospective study. Technol Health Care 2022; 30:1287-1298. [DOI: 10.3233/thc-220248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND: The COVID-19 pandemic broke out in 2019 and rapidly spread across the globe. Most of the severe and dead cases are middle-aged and elderly patients with chronic systemic diseases. OBJECTIVE: This study aimed to assess the association between fasting blood glucose (FPG) and body mass index (BMI) levels in patients with coronavirus disease 2019 (COVID-19) under different conditions. METHODS: Experimental-related information (age, gender, BMI, and FPG on the second day of admission) from 86 COVID-19 cases (47 males and 39 females) with an average age of (39 ± 17) years was collected in April and November 2020. These cases were divided into three groups according to the most severe classification of each case determined by the clinical early warning indicators of severe-critically illness, the degree of progression, and the treatment plan shown in the diagnosis and treatment plan of COVID-19 pneumonia. Statistical models were used to analyze the differences in the levels of FPG and BMI, age, and gender among the three groups. RESULTS: 1. Experimental group: 21 patients with asymptomatic or and mild symptoms (group A), 45 patients with common non-progression (group B), and 20 patients with common progression and severe symptoms (group C). 2. The age differences among the three groups were statistically significant and elderly patients had a higher risk of severe disease (t= 4.1404, 3.3933, 9.2123, P= 0.0001, 0.0012, 0.0000). There was a higher proportion of females than males in the normal progression and severe disease cases (χ2= 5.512, P= 0.019). 3. The level of FPG was significantly higher in group C than in group A (t= 3.1655, P= 0.0030) and B (t= 2.0212, P= 0.0475). The number of diabetes or IFG in group C was significantly higher than in group A (χ2= 5.979, P= 0.014) and group B (χ2= 6.088, P= 0.014). 4. BMI was significantly higher in group C than in groups A (t= 3.8839, P= 0.0004) and B (t= 3.8188, P= 0.0003). The number of overweight or obese patients in group C was significantly higher than in groups A (χ2= 8.838, P= 0.003) and B (χ2= 10.794, P= 0.001). 5. Patients’ age, gender, and FPG were independent risk factors for COVID-19 disease progression (β= 0.380, 0.191, 0.186; P= 0.000, 0.034, 0.045). CONCLUSION: The levels of FPG and BMI were significantly increased in the population with common progressive and severe COVID-19. FPG and age are independent risk factors for the progression of COVID-19.
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Affiliation(s)
- Li-Gang Song
- Department of Endocrinology, HuLun Buir People’s Hospital, HuLun Buir, Inner Mongolia, China
| | - Su-Rong Bai
- Department of Endocrinology, HuLun Buir People’s Hospital, HuLun Buir, Inner Mongolia, China
| | - Deng-Hua Hui
- Department of Work Ability Appraisal, HuLun Buir Human Resources and Social Development, HuLun Buir, Inner Mongolia, China
| | - Li-Ping Ding
- Department of Endocrinology, HuLun Buir People’s Hospital, HuLun Buir, Inner Mongolia, China
| | - Lu Sun
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Muacevic A, Adler JR. COVID-19 and Diabetes Mellitus: From Pathophysiology to Clinical Management. Cureus 2022; 14:e31895. [PMID: 36579192 PMCID: PMC9792302 DOI: 10.7759/cureus.31895] [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: 09/15/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
An increase in the severity of the coronavirus disease 2019 (COVID-19) was observed in patients infected with the acute severe metabolism syndrome coronavirus type 2 (SARS-CoV-2). Patients who have COVID-19 infection may also be more susceptible to hyperglycemia. When paired with other risk factors, hyperglycemia might alter immune and inflammatory responses, predisposing people to significant COVID-19 and perhaps deadly outcomes. Angiotensin-converting accelerator 2 (ACE2), a component of the renin-angiotensin-aldosterone system (RAAS), is the principal entry receptor for SARS-CoV-2; nevertheless, dipeptidyl enzyme 4 (DPP4) may potentially serve as a binding target. However, preliminary data did not indicate a substantial effect on the susceptibility to SARS-CoV-2 using glucose-lowering DPP4 inhibitors. Because of their pharmacologic characteristics, salt-glucose cotransporter 2 (SGLT2) inhibitors should not be advised for COVID-19 patients because they may have adverse effects. Currently, taking a hypoglycemic drug should be the most efficient way to manage acute glycemia. The majority of market proof is said to categorize two diabetes mellitus (DM) and fails to distinguish between the two primary categories of DM due to its widespread use. For grouping one DM and COVID-19, there is now some constrained proof available. Most of those findings are just preliminary, so further research will undoubtedly be required to determine the best course of action for DM patients.
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Chandrashekhar Joshi S, Pozzilli P. COVID-19 induced Diabetes: A novel presentation. Diabetes Res Clin Pract 2022; 191:110034. [PMID: 35940303 PMCID: PMC9355745 DOI: 10.1016/j.diabres.2022.110034] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The COVID-19 pandemic disproportionately affected patients who had comorbid diabetes mellitus. COVID-19 patients with diabetes experience significantly higher rates of complications and mortality. COVID-induced diabetes is a novel phenomenon observed in critically ill patients. The aims of this review were to explore the literature about COVID-induced diabetes and the pathophysiological mechanisms that could lead to this novel presentation. METHODS A literature search was performed using PUBMED, Google Scholar, MEDLINE and Embase for original studies (meta-analyses, cross-sectional studies, case series, case reports) about new-onset diabetes following COVID infection, and the proposed biochemical pathways behind this presentation. It was assumed that the authors of the studies used the current diagnostic criteria for diagnosis of type 1 and type 2 diabetes. RESULTS COVID-19 causes dysregulation of glucose homeostasis leading to new-onset diabetes and hyperglycaemia. This is also seen in patients with no previous risk factors for diabetes mellitus. The atypical glycaemic parameters and increased rates of DKA suggest that COVID-induced diabetes is a novel form of diabetes. A spectrum of COVID-induced diabetes has also been noted. COVID-induced diabetes is associated with remarkably higher mortality rates and worse outcomes compared to COVID-19 patients with pre-existing diabetes. The novel presentation of COVID-induced diabetes could be due to beta cell damage and insulin resistance caused by SARS-CoV-2. CONCLUSION COVID-induced diabetes is essential to detect early, owing to its implications on prognosis. Further studies must include follow-up of these patients to better understand the trajectory of COVID-induced diabetes and the best management plan. It is also important to assess the beta cell function and insulin resistance of COVID-induced diabetes patients over time to better understand the underlying biochemical mechanisms.
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Affiliation(s)
| | - Paolo Pozzilli
- The Blizard Institute, Centre of Immunobiology, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, UK; Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Italy.
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de Kreutzenberg SV. Telemedicine for the Clinical Management of Diabetes; Implications and Considerations After COVID-19 Experience. High Blood Press Cardiovasc Prev 2022; 29:319-326. [PMID: 35579849 PMCID: PMC9111950 DOI: 10.1007/s40292-022-00524-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/07/2022] [Indexed: 12/15/2022] Open
Abstract
Telemedicine is a clinical approach that was seldom used in the day-to-day practice, if not only in certain settings, before the COVID-19 pandemic. As stated by the WHO, telemedicine is: the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies (ICT) for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, …. Telemedicine has actually represented the most useful and employed tool to maintain contacts between patients and physicians during the period of physical distance imposed by the pandemic, especially during the lockdown. Diabetes in particular, a chronic disease that often needs frequent confronting between patient and health professionals has taken advantage of the telehealth approach. Nowadays, technological tools are more and more widely used for the management of diabetes. In this review results obtained by telemendicine application in type 1 and type 2 diabetic individuals during COVID-19 are revised, and future perspectives for telemedicine use to manage diabetes are discussed.
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Duan L, Wang Y, Dong H, Song C, Zheng J, Li J, Li M, Wang J, Yang J, Xu J. The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021. Vaccines (Basel) 2022; 10:vaccines10050659. [PMID: 35632415 PMCID: PMC9148061 DOI: 10.3390/vaccines10050659] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/01/2023] Open
Abstract
The population with diabetes is more susceptible to severe acute respiratory syndrome-associated coronavirus (SARS-CoV)-2, and have a significantly higher coronavirus disease-2019 (COVID-19) mortality rate. Previous studies have shown low willingness for the COVID-19 vaccination, and there are limited reports on the behavior and relevance of the COVID-19 vaccination. This study aimed to determine the uptake behavior and associated factors of the COVID-19 vaccine. In our cross-sectional questionnaire-based clinical study, 645 diabetes patients affiliated with two affiliated hospitals of Changzhi Medical College completed the questionnaire between June to October 2021. The health belief model (HBM) was used in examining factors influencing vaccination behavior. After adjusting for covariates with significant differences in social background characteristics, a multivariable logistic regression was used to determine predictors related to uptake in COVID-19 vaccination. A total of 162 vaccinated and 483 unvaccinated eligible diabetic patients were recruited. Patients who believed that the COVID-19 syndrome is severe (aOR3.67, 95%CI 1.88−7.17; p < 0.001), believe that vaccination can significantly reduce the risk of SARS-Cov-2 infection (aOR3.48, 95%CI 1.80−6.73; p < 0.001), believe that vaccination is beneficial to themselves and others (aOR 4.53, 95%CI 1.71−11.99; p = 0.002), think that relatives’ vaccination status has a positive impact on their vaccination behavior (aOR 5.68, 95%CI 2.83−11.39; p < 0.001), and were more likely to be vaccinated; worrying about the adverse health effects of COVID-19 vaccination (aOR 0.18, 95%CI 0.09−0.35; p < 0.001) was negatively correlated with COVID-19 vaccination behavior. Health care workers should provide targeted informative interventions based on the safety and protective effects theory of HBM to improve vaccination behavior in patients with diabetes.
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Affiliation(s)
- Lingrui Duan
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Ying Wang
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Haoyu Dong
- Department of Endocrinology, Heping Hospital, Changzhi Medical College, Changzhi 046000, China;
| | - Congying Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China;
| | - Jinping Zheng
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046000, China;
| | - Jing Li
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China;
| | - Mufan Li
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Jiayu Wang
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Jianzhou Yang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046000, China;
- Correspondence: (J.Y.); (J.X.); Tel.: +86-355-315-1579 (J.Y.); +86-755-8392-3333-6646 (J.X.)
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China;
- Correspondence: (J.Y.); (J.X.); Tel.: +86-355-315-1579 (J.Y.); +86-755-8392-3333-6646 (J.X.)
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Стронгин ЛГ, Некрасова ТА, Беликина ДВ, Корнева КГ, Петров АВ. [Dysglycemia in COVID-19 and Type 2 Diabetes Mellitus: Peculiarities of the Glycemic Profile in Hospitalized Patients and the Role of Steroid-Induced Disorders]. PROBLEMY ENDOKRINOLOGII 2022; 68:56-65. [PMID: 35488757 PMCID: PMC9764269 DOI: 10.14341/probl12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is a lack of data on the features of dysglycemia in hospitalized patients with COVID-19 and concomitant diabetes mellitus (DM) confirmed by continuous glucose monitoring (CGM). AIM to study the glycemic profile in hospitalized patients with COVID-19 and type 2 diabetes mellitus by continuous glucose monitoring and the role of steroid therapy in dysglycemiadevelopment. MATERIALS AND METHODS We examined 21 patients with COVID-19 and DM 2 and 21 patients with DM 2 without COVID-19 (control group) using a professional 4-7-day CGM. We also compared two subgroups of patients with COVID-19 and DM 2: 1) patients received systemic glucocorticosteroids (GCS) during CGM and 2) patients in whomCGMwas performed after discontinuation of GCS. RESULTS Compared with controls, patients with COVID-19 and DM2 had lesser values of glycemic «time in range» (32.7 ± 20.40 vs 48.0 ± 15.60%, p = 0.026) andhigher parameters of mean glycemia (p <0.05) but similar proportion of patients with episodes of hypoglycemia (33.3% vs 38.1%, p = 0.75). Patients who received dexamethasone during CGM were characterized by higher hyperglycemia and the absence of episodes of hypoglycemia. In patients who hadCGM after dexamethasone discontinuation, hyperglycemia was less pronounced, but 60% of them had episodes of hypoglycemia, often nocturnal, clinically significant and not detected by routine methods. CONCLUSION Patients with COVID-19 and DM 2had severe and persistent hyperglycemia but a third of them hadalso episodes of hypoglycemia. During therapy with dexamethasone, they had the most pronounced hyperglycemia without episodes of hypoglycemia. In patients who underwent CGM after discontinuation of dexamethasone, hyperglycemia was less pronounced but 60% of them have episodes of hypoglycemia, often nocturnal, clinically significant and not diagnosed by routine methods. It would be advisable to recommend at least a 5-6-fold study of the blood glucose level (with its obligatory assessment at night) even for stable patients with COVID-19 and DM 2after the end of GCS treatment.
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Affiliation(s)
| | | | | | - К. Г. Корнева
- Приволжский исследовательский медицинский университет
| | - А. В. Петров
- Приволжский исследовательский медицинский университет
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Crossen SS, Bruggeman BS, Haller MJ, Raymond JK. Challenges and Opportunities in Using Telehealth for Diabetes Care. Diabetes Spectr 2022; 35:33-42. [PMID: 35308158 PMCID: PMC8914589 DOI: 10.2337/dsi21-0018] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The ongoing coronavirus pandemic led to a rapid and dramatic increase in the use of telehealth for diabetes care. In the wake of this transition, we examine new opportunities and ongoing challenges for using telehealth within diabetes management, based on data and experiences from the pre-pandemic and pandemic time frames.
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Affiliation(s)
- Stephanie S. Crossen
- Division of Pediatric Endocrinology, University of California, Davis, Sacramento, CA
- Corresponding author: Stephanie S. Crossen,
| | | | - Michael J. Haller
- Division of Pediatric Endocrinology, University of Florida, Gainesville, FL
| | - Jennifer K. Raymond
- Division of Pediatric Endocrinology, Children’s Hospital Los Angeles, Los Angeles, CA
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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.
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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.
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Romagnoli A, Santoleri F, Costantini A. The impact of COVID-19 on chronic therapies: the Pescara (ASL) local health authority experience in Italy. Curr Med Res Opin 2022; 38:311-316. [PMID: 34850662 DOI: 10.1080/03007995.2021.2012963] [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] [Indexed: 10/19/2022]
Abstract
INTRODUCTION At this time in history fraught with restrictions and issues stemming from the COVID-19 pandemic, the care and management of chronic therapies is a major concern for society. The objective of the following study was to assess whether adherence and persistence in patients treated with hypoglycaemic drugs and statins during 2020 changed in comparison with pre-pandemic years. MATERIALS AND METHODS A retrospective study was conducted, taking into account the drugs dispensed at pharmacies in the territory of the ASL (Local Health Authority) of Pescara from January 1, 2011 to December 2020 of all patients treated with ATC A10B (hypoglycaemic group) and ATC C10A (statin group). Adherence was calculated using the Proportion of days covered (PDC) method. Persistence to treatment was calculated as the difference in days between the start and end of therapy. RESULTS A total of 12,030 patients treated with hypoglycaemic drugs and 19,699 with statins were analysed. Adherence data ranged from values of 0.79 and 0.75 in 2012 to 0.92 and 0.79 in 2020 for the hypoglycaemic group and statin group, respectively. Persistence curves stratified by year showed a statistically significant difference for both groups under analysis (p < .0001). CONCLUSIONS The adherence figure did not change much, unlike the persistence figure. In fact, during 2020, the great impact that COVID-19 had on follow-up visits, on the availability of drugs, and on the difficulty of access to health facilities resulted in chronic patients abandoning therapy.
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Zein AFMZ, Raffaello WM. Effect of colchicine on mortality in patients with COVID-19 - A systematic review and meta-analysis. Diabetes Metab Syndr 2022; 16:102395. [PMID: 35078098 PMCID: PMC8752163 DOI: 10.1016/j.dsx.2022.102395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM This systematic review and meta-analysis aimed to evaluate the latest evidence on the association between colchicine and mortality in patients with COVID-19. METHODS We performed a comprehensive literature search from the PubMed, Scopus, Embase, EuropePMC, and Clinicaltrials.gov up until 02 January 2022. We include randomized controlled trials (RCTs) and observational studies reporting colchicine use in patients with COVID-19 and mortality within 30 days. The intervention group was patients given colchicine during the course of treatment. The control group was patients given placebo or standard of care at the respective institutions. The outcome was mortality. The effect estimate was reported as risk ratio (RR). RESULTS There were 12 studies comprising of 6953 patients included in this meta-analysis. Mortality rate was 0.18 [95%CI 0.10, 0.26] in the colchicine group and 0.26 [95%CI 0.15, 0.38] in the control group. Colchicine was associated with reduction in mortality (RR 0.66 [95%CI 0.53, 0.83], p < 0.001; I2: 42%). Sensitivity analysis using fixed-effect model (RR 0.73 [95%CI 0.63, 0.83], p < 0.001; I2: 42%. Subgroup analysis on the four RCTs showed non-significant result (RR 0.81 [95%CI 0.54, 1.20], p = 0.29; I2: 10%). Meta-regression showed that the association between colchicine and reduced mortality was not affected by age (p = 0.613) [Fig. 3], sex (p = 0.915), diabetes (p = 0.795), and hypertension (p = 0.403). CONCLUSION Though the meta-analysis showed decreased mortality with colchicine in patients with COVID-19, the meta-analysis of randomized trials did not show any significant effect of colchicine on mortality.
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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.
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Soetedjo NNM, Iryaningrum MR, Lawrensia S, Permana H. Antibody response following SARS-CoV-2 vaccination among patients with type 2 diabetes mellitus: A systematic review. Diabetes Metab Syndr 2022; 16:102406. [PMID: 35104750 PMCID: PMC8776339 DOI: 10.1016/j.dsx.2022.102406] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM DM patients' antibody response after the COVID-19 vaccine is still unknown amid the COVID-19 vaccination rollout. This study aimed to explore the SARS-CoV-2 antibody response or seropositivity among DM patients following the COVID-19 vaccine administration. METHODS We performed a systematic review of the literature consisting of observational or cross-sectional studies, which reported the antibody serology or seropositivity among DM patients by following the PRISMA 2020 guidelines. RESULTS Eight studies with a total of 64468 patients were identified, and 5156 (7.9%) of them had diabetes. Most studies showed that antibody response and seropositivity in DM patients were lower than healthy population after one until four weeks following full COVID-19 vaccination dose. CONCLUSION The antibody response and seropositivity after the COVID-19 vaccine in DM patients were lower than in healthy subjects. Therefore, DM patients are expected to receive vaccines according to the dose and schedule appropriately and might be prioritized to receive vaccine boosters.
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Affiliation(s)
- Nanny Natalia M Soetedjo
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr Hasan Sadikin Hospital, 38th Eyckman, Sukajadi, Pasteur, Bandung, West Java, 40161, Indonesia.
| | - Maria Riastuti Iryaningrum
- Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No.2, RT.21/RW.8, Penjaringan, Kec. Penjaringan, Kota Jakarta Utara, Daerah Khusus Ibukota Jakarta, 14440, Indonesia.
| | - Sherly Lawrensia
- Regional Public Hospital of Waikabubak, Jl. Adhyaksa Km 3, Diratana, Waikabubak District, West Sumba, East Nusa Tenggara, Indonesia.
| | - Hikmat Permana
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, 38th Eyckman, Sukajadi, Pasteur, Bandung, West Java, 40161, Indonesia.
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Chen Y, Lv X, Lin S, Arshad M, Dai M. The Association Between Antidiabetic Agents and Clinical Outcomes of COVID-19 Patients With Diabetes: A Bayesian Network Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:895458. [PMID: 35692410 PMCID: PMC9186017 DOI: 10.3389/fendo.2022.895458] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023] Open
Abstract
AIMS This study aimed to assess the impact of different antidiabetic agents on individuals with diabetes and COVID-19. METHODS We searched PubMed, Web of Science, Embase, and Cochrane Library databases from inception to October 31, 2021 and included seven antidiabetic agents. The data were pooled via traditional pairwise meta-analysis and Bayesian network meta-analysis. RESULTS The pairwise meta-analysis included 35 studies. Metformin (odds ratio (OR), 0.74; P=0.001), dipeptidyl peptidase-4 inhibitors (DPP4i) (OR, 0.88; P=0.04), sodium-glucose cotransporter-2 inhibitors (SGLT2i) (OR, 0.82; P=0.001), and glucagon-like peptide-1 receptor agonists (GLP1RA) (OR, 0.91; P=0.02) treatment were associated with lower COVID-19 mortality in individuals with diabetes compared to respective non-users. However, insulin treatment resulted in higher mortality (OR, 1.8; P=0.001). Mortality did not significantly differ in sulfonylurea (OR, 0.97; P=0.56) and thiazolidinediones (TZDs) (OR, 1.00; P=0.96) users. Furthermore, due to limited data, we analyzed five antidiabetic agents (metformin, DPP4i, sulfonylurea, insulin, and SGLT2i) and found no association between them and severe disease risk (all P>0.05). The Bayesian network meta-analysis included 18 studies. GLP1RA and SGLT2i had the highest first and second rank probability (67.3% and 62.5%, respectively). Insulin showed the maximum probability of ranking seventh (97.0%). Metformin had the third and fourth highest rank probability of 44.8% and 38.9%, respectively. Meanwhile, DPP4i had the fifth-highest rank probability of 42.4%, followed by sulfonylurea at 45.1%. CONCLUSION Metformin, DPP4i, SGLT2i, and GLP1RA treatments were highly possible to reduced COVID-19 mortality risk in individuals with diabetes, while insulin might be related to increased mortality risk. Sulfonylurea and TZDs treatments were not associated with mortality. None of the antidiabetic agents studied were associated with the risk of severe disease. Additionally, GLP1RA probably had the most significant protective effect against death, followed by SGLT2i and metformin. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42021288200).
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Affiliation(s)
- Yidan Chen
- Department of Rheumatology & Immunology, West China Hospital of Sichuan University, Chengdu, China
| | - Xingfei Lv
- Department of Orthopedics, People’s Hospital of Zhongjiang County, Deyang, China
| | - Sang Lin
- Department of Rheumatology& Immunology, China-Japan Friendship Hospital, Beijing, China
| | - Mohammad Arshad
- Department of Pediatrics Surgery, Lok Nayak Hospital, New Delhi, India
| | - Mengjun Dai
- Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Mengjun Dai,
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Raicevic M, Samardzic M, Soldatovic I, Curovic Popovic N, Vukovic R. Trends in nationwide incidence of pediatric type 1 diabetes in Montenegro during the last 30 years. Front Endocrinol (Lausanne) 2022; 13:991533. [PMID: 36147568 PMCID: PMC9485557 DOI: 10.3389/fendo.2022.991533] [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: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
Significant and unexplained variations in type 1 diabetes (T1D) incidence through the years were observed all around the world. The update on this disorder's incidence is crucial for adequate healthcare resource planning and monitoring of the disease. The aim of this study was to give an update on the current incidence of pediatric T1D in Montenegro and to analyze incidence changes over time and how the exposure to different factors might have affected it. This retrospective cohort study included a total of 582 patients younger than 15 years who were newly diagnosed with T1D during the past 30 years. The average age at diagnosis was 8.4 ± 3.91 years. The mean annual incidence of T1D in the Montenegro population during the whole study period of 30 years was 15.2/100,000 person-years. Slightly higher incidence rates were observed in male compared to female individuals, and the incidence increased with age, with the highest incidence in the 10-14 age group. If the model is observed as one without jointpoints, the annual percentage change (APC) for the total population is 3.1 (1.8-4.4); for male individuals, 3.8 (2.1-5.5); and for female individuals, 2.1 (0.6-3.5). In 2020, the first year of the coronavirus disease of 2019 (COVID-19) pandemic, in comparison to 2019, the incidence rate increased from 19.7/100,000 to 21.5/100,000, with the highest increase in the age group of 5-9 years. This is the first nationwide report on a 30-year period of T1D incidence trend in Montenegro. It suggests that T1D incidence among Montenegrin children is rising again and that there is a short-term influence of COVID-19 on new-onset T1D.
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Affiliation(s)
- Maja Raicevic
- Department of Endocrinology, Institute for Children’s Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro
- *Correspondence: Maja Raicevic,
| | - Mira Samardzic
- Department of Endocrinology, Institute for Children’s Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro
- Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Ivan Soldatovic
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa Curovic Popovic
- Department of Endocrinology, Institute for Children’s Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro
| | - Rade Vukovic
- Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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Pranata R, Huang I, Lim MA, Yonas E, Vania R, Lukito AA, Nasution SA, Siswanto BB, Kuswardhani RAT. Elevated De Ritis Ratio Is Associated With Poor Prognosis in COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:676581. [PMID: 35004709 PMCID: PMC8729881 DOI: 10.3389/fmed.2021.676581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 11/22/2021] [Indexed: 01/08/2023] Open
Abstract
Objective: This meta-analysis aims to assess whether elevated De Ritis ratio is associated with poor prognosis in patients with coronavirus 2019 (COVID-19). Methods: A systematic literature search was performed using PubMed, Embase, and EuropePMC databases up until September 17, 2021. De Ritis ratio is also known as Aspartate aminotransferase/alanine transaminase (AST/ALT) ratio. The main outcome was poor prognosis, a composite of mortality, severity, the need for ICU care, and intubation. The effect measure was odds ratios (ORs) and mean differences. We generated sensitivity and specificity, negative and positive likelihood ratio (NLR and PLR), diagnostic odds ratio (DOR), and area under curve (AUC). Results: There were eight studies with 4,606 patients. De Ritis ratio was elevated in 44% of the patients. Patients with poor prognosis have higher De Ritis ratio [mean difference 0.41 (0.31, 0.50), p < 0.001; I 2: 81.0%] and subgroup analysis showed that non-survivors also have higher De Ritis Ratio [mean difference 0.47 (0.46, 0.48), p < 0.001; I 2: 0%]. Elevated De Ritis ratio was associated with poor prognosis [OR 3.28 (2.39, 4.52), p < 0.001; I 2: 35.8%]. It has a sensitivity of 55% (36-73), specificity of 71% (52-85), PLR 1.9, NLR.63, DOR of 3 (2-4), and AUC of.67 (0.63-0.71). The posterior probability of poor prognosis was 38% if De Ritis is elevated, while 17% if De Ritis is not elevated. Conclusion: Elevated De Ritis ratio is associated with poor prognosis in patients with COVID-19. Systematic Review Registration: PROSPERO ID: CRD42020216634.
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Affiliation(s)
- Raymond Pranata
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Ian Huang
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Emir Yonas
- Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
| | - Rachel Vania
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Faculty of Medicine, Division of Plastic, Reconstructive, and Aesthetic, Department of Surgery, Sanglah General Hospital, Udayana University, Jimbaran, Indonesia
| | - Antonia Anna Lukito
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Department of Cardiology and Vascular Medicine, Siloam Hospitals Lippo Village, Tangerang, Indonesia
| | - Sally Aman Nasution
- Faculty of Medicine, Division of Cardiology, Department of Internal Medicine, Universitas Indonesia/Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Bambang Budi Siswanto
- Faculty of Medicine, Department of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta, Indonesia
| | - Raden A. Tuty Kuswardhani
- Faculty of Medicine, Division of Geriatrics, Department of Internal Medicine, Sanglah Teaching Hospital, Udayana University, Denpasar, Indonesia
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Laiq S, Al Yaqoobi M, Al Saadi M, Rizvi S, Al Hajri Z, Al Azri S, Al Ramadhani K, Al Hinai Q. Fonsecaea associated cerebral phaeohyphomycosis in a post-COVID-19 patient: A first case report. CLINICAL INFECTION IN PRACTICE 2021; 13:100126. [PMID: 34901831 PMCID: PMC8647566 DOI: 10.1016/j.clinpr.2021.100126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Phaeohyphomycosis, previously known as chromoblastomycosis, is a chronic mycosis, usually affecting the skin. It is caused by dematiaceous fungi, which are a group of fungi that produce melanin in their cell walls. Cerebral phaeohyphomycosis occurs as a part of invasive presentation of the fungi, which usually affects immunocompromised patients, but may affect immunocompetent individuals as well. Cerebral infection in phaeohyphomycosis is associated with a poor prognosis regardless of the immune status of the patient. COVID-19 SARS-CoV-2 infection and/or medications used for its treatment may compromise the immune system, including in the post-COVID-19 period, resulting in invasive fungal infections, which have frequently been reported recently during the COVID-19 pandemic. We report a case of Fonsecaea associated cerebral phaeohyphomycosis in a recently diagnosed diabetic Omani lady, who presented to our hospital 6 weeks after recovery and discharge from hospitalization for moderate COVID-19 pneumonia.
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Affiliation(s)
- Simin Laiq
- Department of Histopathology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Mubarak Al Yaqoobi
- Department of Microbiology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Maimuna Al Saadi
- Department of Histopathology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Semee Rizvi
- Department of Microbiology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Zahra Al Hajri
- Department of Histopathology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Saleh Al Azri
- Department of Microbiology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Khalsa Al Ramadhani
- Department of Radiology, Directorate General of Khoula Hospital, Muscat, Oman
| | - Qasim Al Hinai
- Department of Neurosurgery, Directorate General of Khoula Hospital, Muscat, Oman
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Goyal A, Gupta Y, Kalaivani M, Praveen PA, Ambekar S, Tandon N. SARS-CoV-2 Seroprevalence in Individuals With Type 1 and Type 2 Diabetes Compared With Controls. Endocr Pract 2021; 28:191-198. [PMID: 34920109 PMCID: PMC8669945 DOI: 10.1016/j.eprac.2021.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/27/2021] [Accepted: 12/09/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Data for the association between diabetes and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) susceptibility are conflicting. We aimed to evaluate this association using an analytical cross-sectional study design. METHODS Study participants were recruited from endocrine clinics of our hospital and belonged to 3 groups: group 1 (type 1 diabetes mellitus [T1DM]), group 2 (type 2 diabetes mellitus [T2DM]), and group 3 (controls). All participants submitted blood samples for SARS-CoV-2 S1/S2 immunoglobulin G antibody test (LIAISON; DiaSorin) and were interviewed for a history of documented infection. RESULTS We evaluated a total of 643 participants (T1DM, 149; T2DM, 160; control, 334; mean age, 37.9 ± 11.5 years). A total of 324 (50.4%) participants were seropositive for SARS-CoV-2. The seropositivity rate was significantly higher in the T1DM (55.7% vs 44.9%, P = .028) and T2DM (56.9% vs 44.9%, P = .013) groups than in the control group. The antibody levels in seropositive participants with T1DM and T2DM were not significantly different from those in seropositive controls. On multivariable analysis, low education status (odds ratio [OR], 1.41 [95% CI, 1.03-1.94]; P = .035), diabetes (OR, 1.68 [95% CI, 1.20-2.34]; P = .002), and overweight/obesity (OR, 1.52 [95% CI, 1.10-2.10]; P = .012) showed a significant association with SARS-CoV-2 seropositivity. The association between diabetes and SARS-CoV-2 seropositivity was found to further increase in participants with coexisting overweight/obesity (adjusted OR, 2.63 [95% CI, 1.54-4.47]; P < .001). CONCLUSION SARS-CoV-2 seropositivity, assessed before the onset of the national vaccination program, was significantly higher in participants with T1DM and T2DM than in controls. The antibody response did not differ between seropositive participants with and without diabetes. These findings point toward an increased SARS-CoV-2 susceptibility for patients with diabetes, in general, without any differential effect of the diabetes type.
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Affiliation(s)
- Alpesh Goyal
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Yashdeep Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep A Praveen
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Samita Ambekar
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
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Zulfiqar AA, Massimbo DND, Hajjam M, Gény B, Talha S, Hajjam J, Ervé S, Hassani AHE, Andrès E. Glycemic Disorder Risk Remote Monitoring Program in the COVID-19 Very Elderly Patients: Preliminary Results. Front Physiol 2021; 12:749731. [PMID: 34777011 PMCID: PMC8579000 DOI: 10.3389/fphys.2021.749731] [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: 07/29/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. This was the basis for the “GER-e-TEC COVID study,” an experiment involving the use of the smart MyPrediTM e-platform to automatically detect the exacerbation of glycemic disorder risk in COVID-19 older diabetic patients. Methods: The MyPrediTM platform is connected to a medical analysis system that receives physiological data from medical sensors in real time and analyzes this data to generate (when necessary) alerts. An experiment was conducted between December 14th, 2020 and February 25th, 2021 to test this alert system. During this time, the platform was used on COVID-19 patients being monitored in an internal medicine COVID-19 unit at the University Hospital of Strasbourg. The alerts were compiled and analyzed in terms of sensitivity, specificity, positive and negative predictive values with respect to clinical data. Results: 10 older diabetic COVID-19 patients in total were monitored remotely, six of whom were male. The mean age of the patients was 84.1 years. The patients used the telemedicine solution for an average of 14.5 days. 142 alerts were emitted for the glycemic disorder risk indicating hyperglycemia, with an average of 20.3 alerts per patient and a standard deviation of 26.6. In our study, we did not note any hypoglycemia, so the system emitted any alerts. For the sensitivity of alerts emitted, the results were extremely satisfactory, and also in terms of positive and negative predictive values. In terms of survival analysis, the number of alerts and gender played no role in the length of the hospital stay, regardless of the reason for the hospitalization (COVID-19 management). Conclusion: This work is a pilot study with preliminary results. To date, relatively few projects and trials in diabetic patients have been run within the “telemedicine 2.0” setting, particularly using AI, ICT and the Web 2.0 in the era of COVID-19 disease.
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Affiliation(s)
- Abrar-Ahmad Zulfiqar
- Service de Médecine Interne, Diabète et Maladies Métaboliques de la Clinique Médicale B, Hôpitaux Universitaires de Strasbourg et Equipe EA 3072 "Mitochondrie, Stress Oxydant et Protection Musculaire," Faculté de Médecine-Université de Strasbourg, Strasbourg, France
| | | | | | - Bernard Gény
- Faculté de Médecine-Université de Strasbourg, Service de Physiologie et d'Explorations Fonctionnelles, Hôpitaux Universitaires de Strasbourg et Equipe EA 3072 "Mitochondrie, Stress Oxydant et Protection Musculaire," Strasbourg, France
| | - Samy Talha
- Faculté de Médecine-Université de Strasbourg, Service de Physiologie et d'Explorations Fonctionnelles, Hôpitaux Universitaires de Strasbourg et Equipe EA 3072 "Mitochondrie, Stress Oxydant et Protection Musculaire," Strasbourg, France
| | - Jawad Hajjam
- Centre d'Expertise des TIC pour l'Autonomie (CenTich) et Mutualité Française Anjou-Mayenne (MFAM)-Angers, Angers, France
| | - Sylvie Ervé
- Centre d'Expertise des TIC pour l'Autonomie (CenTich) et Mutualité Française Anjou-Mayenne (MFAM)-Angers, Angers, France
| | - Amir Hajjam El Hassani
- Laboratoire IRTES-SeT, Université de Technologie de Belfort-Montbéliard (UTBM), Belfort, France
| | - Emmanuel Andrès
- Service de Médecine Interne, Diabète et Maladies Métaboliques de la Clinique Médicale B, Hôpitaux Universitaires de Strasbourg et Equipe EA 3072 "Mitochondrie, Stress Oxydant et Protection Musculaire," Faculté de Médecine-Université de Strasbourg, Strasbourg, France.,Faculté de Médecine-Université de Strasbourg, Service de Physiologie et d'Explorations Fonctionnelles, Hôpitaux Universitaires de Strasbourg et Equipe EA 3072 "Mitochondrie, Stress Oxydant et Protection Musculaire," Strasbourg, France
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Martha JW. COVID-19 and Cardiovascular Complications: An Updated Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7235] [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
COVID-19 has become a global pandemic. Patients with pre-existing comorbidities such as hypertension, diabetes, and cardiovascular disease (CVD) are associated with greater severity and higher mortality. COVID-19 can cause cardiovascular complications, including myocardial injury, myocarditis, heart failure, acute coronary syndrome, and coagulation abnormalities. Possible pathophysiology and molecular pathways driving these disease processes are cytokine release syndrome, RAAS system dysregulation, plaque destabilization and coagulation disorders Myocarditis is one concern among persons who received mRNA-Based COVID-19 vaccines. There are several cardiovascular complications that are possibly caused by COVID-19 treatments, such as QT interval prolongation, arrhythmia, and hypotension. Due to increasingly recognized CVD damage in COVID-19, we need to understand about COVID-19 related to cardiovascular complications and treatment strategies.
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Abed Alah M, Abdeen S, Kehyayan V, Bougmiza I. Impact of COVID-19 related home confinement measures on the lifestyle, body weight, and perceived glycemic control of diabetics. Metabol Open 2021; 12:100144. [PMID: 34734171 PMCID: PMC8553630 DOI: 10.1016/j.metop.2021.100144] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Background People with Diabetes Mellitus are at high risk of encountering COVID-19 infection and are more vulnerable to the negative repercussions of this infection. In this study we aimed to explore the impact of COVID-19 related home confinement measures on physical activity, dietary habits, body weight and perceived glycemic control of adults with type 2 Diabetes Mellitus (T2DM) in Qatar. Methods A cross sectional web-based survey was conducted between January and February 2021 targeting adults ≥18 years with T2DM. Results Over 40% of the participants reported unhealthy dietary changes. We found a significant increase in the sitting/reclining, and screen times. One third of the participants reported weight gain, while one fifth reported poorer glycemic control since the start of home confinement measures. We found that reporting at least one unhealthy dietary change (p < 0.001) and being a female (p = 0.002) were significantly associated with reporting greater weight gain. Participants who reported five unhealthy dietary behaviours were more than seven times more likely to perceive poorer glycemic control during home confinement measures compared to those who did not report any unhealthy changes (OR: 7.27, 95%CI 1.60–33.5, p = 0.011). Conclusion Adults with T2DM experienced adverse lifestyle changes during COVID-19 related home confinement measures. Further research is needed to investigate the persistence of such changes in the post pandemic era. One third of the participants reported weight gain. Participants reported a significant increase in each of the sitting/reclining and screen times. The perceived glycemic control varied among the participants.
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Affiliation(s)
- Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
- Corresponding author.
| | - Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | | | - Iheb Bougmiza
- Community Medicine Department, Primary Health Care Corporation (PHCC), Doha, Qatar
- Community Medicine Department, College of Medicine, Sousse University, Tunisia
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Zein AFMZ, Sulistiyana CS, Raffaelo WM, Pranata R. Ivermectin and mortality in patients with COVID-19: A systematic review, meta-analysis, and meta-regression of randomized controlled trials. Diabetes Metab Syndr 2021; 15:102186. [PMID: 34237554 PMCID: PMC8236126 DOI: 10.1016/j.dsx.2021.102186] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 01/08/2023]
Abstract
AIMS This systematic review and meta-analysis aims to investigate the effect of ivermectin on mortality in patients with COVID-19. METHODS A comprehensive systematic literature search was performed using PubMed, Scopus, Embase, and Clinicaltrials.gov from the inception of databases up until April 9, 2021. The intervention group was ivermectin and the control group was standard of care or placebo. The primary outcome was mortality reported as risk ratio (RR). RESULTS There were 9 RCTs comprising of 1788 patients included in this meta-analysis. Ivermectin was associated with decreased mortality (RR 0.39 [95% 0.20-0.74], p = 0.004; I2: 58.2%, p = 0.051). Subgroup analysis in patients with severe COVID-19 showed borderline statistical significance towards mortality reduction (RR 0.42 [95% 0.18-1.00], p = 0.052; I2: 68.3, p = 0.013). The benefit of ivermectin and mortality was reduced by hypertension (RR 1.08 [95% CI 1.03-1.13], p = 0.001); but was not influenced by age (p = 0.657), sex (p = 0.466), diabetes (p = 0.429). Sensitivity analysis using fixed-effect model showed that ivermectin decreased mortality in general (RR 0.43 [95% CI 0.29-0.62], p < 0.001) and severe COVID-19 subgroup (RR 0.48 [95% CI 0.32-0.72], p < 0.001). CONCLUSIONS Ivermectin was associated with decreased mortality in COVID-19 with a low certainty of evidence. Further adequately powered double-blinded placebo-controlled RCTs are required for definite conclusion.
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Affiliation(s)
- Ahmad Fariz Malvi Zamzam Zein
- Department of Internal Medicine, Faculty of Medicine, Universitas Swadaya Gunung Jati, Department of Internal Medicine, Waled General Hospital, Cirebon, Indonesia.
| | - Catur Setiya Sulistiyana
- Department of Medical Education, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia.
| | | | - Raymond Pranata
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
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