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Wilk P, Stranges S, Cuschieri S. Does sex modify the effect of pre-pandemic body mass index on the risk of Long COVID? Evidence from the longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe. Int J Obes (Lond) 2024; 48:821-829. [PMID: 38287094 DOI: 10.1038/s41366-024-01477-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Research on Long COVID risk factors is ongoing. High body mass index (BMI) may increase Long COVID risk, yet no evidence has been established regarding sex differences in the relationship between BMI and the risk of Long COVID. Investigating the nature of this relationship was the main objective of this study. METHODS A population-based prospective study involving a sample of respondents aged 50 years and older (n = 4004) from 27 European countries that participated in the 2020 and 2021 Survey of Health, Ageing and Retirement in Europe's (SHARE) Corona Surveys and in Waves 7 and 8 of the main SHARE survey. Logistic regression models were estimated to produce unadjusted and adjusted estimates of the sex differences in the relationship between BMI and Long COVID. RESULTS Linear relationship for females, with probability of Long COVID increasing with BMI (68% at BMI = 18, 93% at BMI = 45). Non-linear relationship for males, with probability of Long COVID of 27% at BMI = 18, 68% at BMI = 33, and 40% at BMI = 45. Relationships remained significant after adjusting for known Long COVID risk factors (age and COVID-19 hospitalization), presence of chronic diseases, and respondents' place of residence. CONCLUSION Sex differences appear to play an important role in the relationship between BMI and risk of Long COVID. Overall, females were more likely to have Long COVID, regardless of their BMI. Males at the higher end of the BMI spectrum had a lower risk of Long COVID as opposed to their female counterparts. Sex-specific research is recommended for better understanding of Long COVID risk factors.
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Affiliation(s)
- Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Sarah Cuschieri
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
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Chen S, Song P, Wang Y, Wang Z, Xue J, Jiang Y, Zhou Y, Zhao J, Tang L. CircMAPK9 promotes adipogenesis through modulating hsa-miR-1322/FTO axis in obesity. iScience 2023; 26:107756. [PMID: 37692283 PMCID: PMC10492215 DOI: 10.1016/j.isci.2023.107756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/21/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
Circular RNA (circRNA) is a special category of non-coding RNA that has garnered increasing attention in the exploration of lipid metabolism. However, the functional regulation mechanisms of circRNAs in obesity diseases remain unclear. By whole transcriptome sequencing, a total of 164 circular RNAs were found to exhibit differential expression between lean and obese individuals. RT-qPCR was used to detect significant expression of circMAPK9 in obese individuals, and it was closely related to BMI. Western blot, triglyceride detection, and Oil Red O staining were employed to investigate the role of circMAPK9/hsa-miR-1322/FTO in adipogenesis. In adipocytes, the connection between hsa-miR-1322 and circMAPK9 was verified using fluorescence in situ hybridization, luciferase reporter assay, and RNA immunoprecipitation. It was found that circMAPK9 competed for binding hsa-miR-1322 in the cytoplasm, weakening the inhibitory effect on FTO and promoting adipogenesis. Our study revealed the regulatory mechanism and important role of circMAPK9 in the process of adipogenesis.
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Affiliation(s)
- Shuai Chen
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Peng Song
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Yu Wang
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Zeng Wang
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Jiaming Xue
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Yicheng Jiang
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Yan Zhou
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Jie Zhao
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
| | - Liming Tang
- Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou City, Jiangsu Province, China
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Mohammed HAEM, Hassan MH, Abdalla H, Mahmoud MA, Maher A, Malak M, Tag-Adeen M, Izzaldin MR, Adel S, Ali WE, Abo-Rahma A, Abd Elnabi MGM, Abdalla IAM, Morsy MFM, Sayed MAFM, Abdelaal UM. Body Mass Index as a Major Prognostic Contributing Factor in COVID-19: A Multicentral Egyptian Study. Infect Drug Resist 2023; 16:5985-6004. [PMID: 37705514 PMCID: PMC10496921 DOI: 10.2147/idr.s426440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/19/2023] [Indexed: 09/15/2023] Open
Abstract
Background Extreme body mass index (BMI) is an influential pathophysiological risk factor for serious illnesses following lower respiratory tract infection. The purpose of the current study was to examine how the BMI of Coronavirus disease-19 (COVID-19) patients affects their prognosis. Methods Two hundred patients with COVID-19 admitted to Al-Azhar, Qena, Aswan, and Sohag University hospitals in Egypt were included and categorized into four groups according to their BMI. The diagnosis was made according to a real-time reverse transcription-polymerase chain reaction (rRT-PCR) positive result for the SARS-CoV-2 nucleic acid in swabs from upper respiratory tract. A detailed history, clinical examination, and outcomes (disease severity and complications, hospital stay, ICU admission, mortality) were recorded for all patients. SPSS version 24 software was used for data analysis. Results Average age of participants (19-90 years old), 92 (46%) males and 108 females (54%). ICU admission was significantly higher among underweight patients (75%) and obese patients (78.6%). The majority of underweight (62.5%) and obese (57.1%) patients had critical disease. Invasive mechanical ventilation (MV) is frequently used in underweight (50%) and obese patients (42.9%) patients. Adult respiratory distress syndrome (ARDS), cardiac, neurological, and hematological complications, and incidence of myalgia and bed sores were most frequent among obese and overweight patients. Acute kidney injury was significantly higher among underweight patients (37.5%) and obese patients (28.6%) than among other classes (p=0.004). Frequency of endocrine complications was significantly higher in underweight patients than that in other classes (p=0.01). The majority of underweight (75%) and obese patients (50%) deteriorated and died, whereas the majority of normal-weight patients (90.3%) and overweight patients (75.8%) improved and were discharged (p< 0.001). Conclusion Body mass index is a major contributing factor to the outcome of patients with COVID-19, and patients with extreme of body mass index were associated with the worst prognosis.
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Affiliation(s)
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, 83523, Egypt
| | - Hytham Abdalla
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
| | - Marwa Ahmed Mahmoud
- Department of Medical Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amira Maher
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Malak
- Department of Internal Medicine, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohammed Tag-Adeen
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Faculty of Medicine, South Valley University, Qena, 83523, Egypt
| | - Mohamed Ramadan Izzaldin
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
| | - Sara Adel
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
| | - Wael Esmat Ali
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
| | - Alyaa Abo-Rahma
- Department of Public Health and Community Medicine, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
| | | | | | - Mohamed Fakhry Mohamed Morsy
- Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
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Zisis SN, Durieux JC, Mouchati C, Perez JA, McComsey GA. The Protective Effect of Coronavirus Disease 2019 (COVID-19) Vaccination on Postacute Sequelae of COVID-19: A Multicenter Study From a Large National Health Research Network. Open Forum Infect Dis 2022; 9:ofac228. [PMID: 35818362 PMCID: PMC9129153 DOI: 10.1093/ofid/ofac228] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) vaccines have been proven to decrease the severity of acute-phase infection; however, little is known about their effect on postacute sequelae of COVID-19 (PASC). Methods Patients with confirmed COVID-19 diagnosis and minimum age of 18 years with 3-month follow-up postdiagnosis between 21 September 2020 and 14 December 2021 were identified from the TriNetX Research Network platform. The primary outcomes consisted of new-onset or persistent symptoms, new-onset diagnoses, and death and were compared between vaccine and no-vaccine groups. Results At baseline, 1 578 719 patients with confirmed COVID-19 were identified and 1.6% (n = 25 225) completed vaccination. After matching, there were no differences (P > .05) in demographics or preexisting comorbidities. At 28 days following COVID-19 diagnosis, the incidence of hypertension was 13.52 per 1000, diabetes was 5.98 per 1000, thyroid disease was 3.80 per 1000, heart disease was 15.41 per 1000, and mental disorders was 14.77 per 1000 in the vaccine cohort. At 90 days following COVID-19 diagnosis, the relative risk of hypertension was 0.33 (95% confidence interval [CI], .26-.42), diabetes was 0.28 (95% CI, .20-.38), heart disease was 0.35 (95% CI, .29-.44), and death was 0.21 (95% CI, .16-.27). Differences in both 28- and 90-day risk between the vaccine and no-vaccine cohorts were observed for each outcome, and there was enough evidence (P < .05) to suggest that these differences were attributed to the vaccine. Conclusions Our data suggest that COVID-19 vaccine is protective against PASC symptoms, new onset of health conditions, and mortality.
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Affiliation(s)
- Sokratis N Zisis
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jared C Durieux
- Clinical Research Center, University Hospitals Health System, Cleveland, Ohio, USA
| | - Christian Mouchati
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jamie A Perez
- Clinical Research Center, University Hospitals Health System, Cleveland, Ohio, USA
| | - Grace A McComsey
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Clinical Research Center, University Hospitals Health System, Cleveland, Ohio, USA
- Department of Pediatrics and Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Lu X, Cui Z, Ma X, Pan F, Li L, Wang J, Sun P, Li H, Yang L, Liang B. The association of obesity with the progression and outcome of COVID-19: The insight from an artificial-intelligence-based imaging quantitative analysis on computed tomography. Diabetes Metab Res Rev 2022; 38:e3519. [PMID: 35062046 PMCID: PMC9015278 DOI: 10.1002/dmrr.3519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
AIMS To explore the association of obesity with the progression and outcome of coronavirus disease 2019 (COVID-19) at the acute period and 5-month follow-up from the perspectives of computed tomography (CT) imaging with artificial intelligence (AI)-based quantitative evaluation, which may help to predict the risk of obese COVID-19 patients progressing to severe and critical disease. MATERIALS AND METHODS This retrospective cohort enrolled 213 hospitalized COVID-19 patients. Patients were classified into three groups according to their body mass index (BMI): normal weight (from 18.5 to <24 kg/m2 ), overweight (from 24 to <28 kg/m2 ) and obesity (≥28 kg/m2 ). RESULTS Compared with normal-weight patients, patients with higher BMI were associated with more lung involvements in lung CT examination (lung lesions volume [cm3 ], normal weight vs. overweight vs. obesity; 175.5[34.0-414.9] vs. 261.7[73.3-576.2] vs. 395.8[101.6-1135.6]; p = 0.002), and were more inclined to deterioration at the acute period. At the 5-month follow-up, the lung residual lesion was more serious (residual total lung lesions volume [cm3 ], normal weight vs. overweight vs. obesity; 4.8[0.0-27.4] vs. 10.7[0.0-55.5] vs. 30.1[9.5-91.1]; p = 0.015), and the absorption rates were lower for higher BMI patients (absorption rates of total lung lesions volume [%], normal weight vs. overweight vs. obesity; 99.6[94.0-100.0] vs. 98.9[85.2-100.0] vs. 88.5[66.5-95.2]; p = 0.013). The clinical-plus-AI parameter model was superior to the clinical-only parameter model in the prediction of disease deterioration (areas under the ROC curve, 0.884 vs. 0.794, p < 0.05). CONCLUSIONS Obesity was associated with severe pneumonia lesions on CT and adverse clinical outcomes. The AI-based model with combinational use of clinical and CT parameters had incremental prognostic value over the clinical parameters alone.
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Affiliation(s)
- Xiaoting Lu
- Department of RadiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Zhenhai Cui
- Department of EndocrinologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic DisordersWuhanChina
| | - Xiang Ma
- Department of RadiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Feng Pan
- Department of RadiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Lingli Li
- Department of RadiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Jiazheng Wang
- Clinical & Technical SolutionsPhilips HealthcareWuhanChina
| | - Peng Sun
- Clinical & Technical SolutionsPhilips HealthcareWuhanChina
| | - Huiqing Li
- Department of EndocrinologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic DisordersWuhanChina
| | - Lian Yang
- Department of RadiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Bo Liang
- Department of RadiologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
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Azevedo RB, Wandermurem DC, Libório FC, Machado MK, Ushijima NM, Narde RS, Pecly IMD, Muxfeldt ES. Impact of Metabolic Risk Factors on COVID-19 Clinical Outcomes: An Extensive Review. Curr Cardiol Rev 2022; 18:e090522204452. [PMID: 35579126 PMCID: PMC9893150 DOI: 10.2174/1573403x18666220509154236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/11/2022] [Accepted: 02/24/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cardiovascular (CV) risk factors, particularly cardiometabolic, seem to be associated with heightened severity and increased morbimortality in patients infected with the novel Coronavirus disease-2019 (COVID-19). METHODS A thorough scoping review was conducted to elucidate and summarize the latest evidence for the effects of adverse cardiac metabolic profiles on the severity, morbidity, and prognosis of COVID-19 infection. RESULTS The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is complex, being characterized by viral-induced immune dysregulation and hypercytokinemia, particularly in patients with critical disease, evolving with profound endothelial dysfunction, systemic inflammation, and prothrombotic state. Moreover, cardiovascular comorbidities such as diabetes are the most prevalent amongst individuals requiring hospitalization, raising concerns towards the clinical evolution and prognosis of these patients. The chronic proinflammatory state observed in patients with cardiovascular risk factors may contribute to the immune dysregulation mediated by SARS-CoV-2, favoring more adverse clinical outcomes and increased severity. Cardiometabolism is defined as a combination of interrelated risk factors and metabolic dysfunctions such as dyslipidemia, insulin resistance, impaired glucose tolerance, and central adiposity, which increase the likelihood of vascular events, being imperative to specifically analyze its clinical association with COVID-19 outcomes. CONCLUSION DM and obesity appears to be important risk factors for severe COVID-19. The chronic proinflammatory state observed in patients with excess visceral adipose tissue (VAT) possibly augments COVID-19 immune hyperactivity leading to more adverse clinical outcomes in these patients.
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Affiliation(s)
- Rafael B. Azevedo
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Débora C.R. Wandermurem
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Flávia C.F. Libório
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Maíra K. Machado
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Natália M. Ushijima
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Ramon S. Narde
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Inah Maria D. Pecly
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
| | - Elizabeth S. Muxfeldt
- Medicine Course, IDOMED - Universidade Estácio de Sá - Campus Presidente Vargas, Rio de Janeiro, Brazil
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Tantisattamo E, Imhof C, Jager KJ, Hilbrands LB, Guidotti R, Islam M, Katicic D, Konings C, Molenaar FM, Nistor I, Noordzij M, Rodríguez Ferrero ML, Verhoeven MAM, de Vries APJ, Kalantar-Zadeh K, Gansevoort RT, Vart P. OUP accepted manuscript. Clin Kidney J 2022; 15:1348-1360. [PMID: 35747092 PMCID: PMC8992331 DOI: 10.1093/ckj/sfac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background In the general population with coronavirus disease 2019 (COVID-19), obesity is associated with an increased risk of mortality. Given the typically observed obesity paradox among patients on kidney function replacement therapy (KFRT), especially dialysis patients, we examined the association of obesity with mortality among dialysis patients or living with a kidney transplant with COVID-19. Methods Data from the European Renal Association COVID-19 Database (ERACODA) were used. KFRT patients diagnosed with COVID-19 between 1 February 2020 and 31 January 2021 were included. The association of Quetelet's body mass index (BMI) (kg/m2), divided into: <18.5 (lean), 18.5–24.9 (normal weight), 25–29.9 (overweight), 30–34.9 (obese I) and ≥35 (obese II/III), with 3-month mortality was investigated using Cox proportional-hazards regression analyses. Results In 3160 patients on KFRT (mean age: 65 years, male: 61%), 99 patients were lean, 1151 normal weight (reference), 1160 overweight, 525 obese I and 225 obese II/III. During follow-up of 3 months, 28, 20, 21, 23 and 27% of patients died in these categories, respectively. In the fully adjusted model, the hazard ratios (HRs) for 3-month mortality were 1.65 [95% confidence interval (CI): 1.10, 2.47], 1 (ref.), 1.07 (95% CI: 0.89, 1.28), 1.17 (95% CI: 0.93, 1.46) and 1.71 (95% CI: 1.27, 2.30), respectively. Results were similar among dialysis patients (N = 2343) and among those living with a kidney transplant (N = 817) (Pinteraction = 0.99), but differed by sex (Pinteraction = 0.019). In males, the HRs for the association of aforementioned BMI categories with 3-month mortality were 2.07 (95% CI: 1.22, 3.52), 1 (ref.), 0.97 (95% CI: 0.78. 1.21), 0.99 (95% CI: 0.74, 1.33) and 1.22 (95% CI: 0.78, 1.91), respectively, and in females corresponding HRs were 1.34 (95% CI: 0.70, 2.57), 1 (ref.), 1.31 (95% CI: 0.94, 1.85), 1.54 (95% CI: 1.05, 2.26) and 2.49 (95% CI: 1.62, 3.84), respectively. Conclusion In KFRT patients with COVID-19, on dialysis or a kidney transplant, obesity is associated with an increased risk of mortality at 3 months. This is in contrast to the obesity paradox generally observed in dialysis patients. Additional studies are required to corroborate the sex difference in the association of obesity with mortality.
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Affiliation(s)
| | | | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rebecca Guidotti
- Institute of Nephrology, City Hospital Waid and Triemli, Zurich, Switzerland
| | - Mahmud Islam
- Zonguldak Ataturk state hospital, Zonguldak, Turkey
| | - Dajana Katicic
- Croatian Society of Nephrology, Dialysis and Transplantation, Croatia
| | | | | | - Ionut Nistor
- Faculty of Medicine, University of Medicine and Pharmacy, Grigore T.Popa, Iași, Romania
| | - Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Han Y. Artificial intelligence CT helps evaluate the severity of COVID-19 patients: A retrospective study. World J Emerg Med 2022; 13:91-97. [DOI: 10.5847/wjem.j.1920-8642.2022.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/02/2021] [Indexed: 01/08/2023] Open
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Gryczyńska W, Litvinov N, Bitew B, Bartosz Z, Kośmider W, Bogdański P, Skrypnik D. Excess Body Mass-A Factor Leading to the Deterioration of COVID-19 and Its Complications-A Narrative Review. Viruses 2021; 13:v13122427. [PMID: 34960696 PMCID: PMC8708912 DOI: 10.3390/v13122427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/30/2021] [Indexed: 01/08/2023] Open
Abstract
Currently, the world is facing two serious pandemics: obesity and COVID-19. It is well-established that the prevalence of obesity has risen dramatically, causing a deterioration in the health quality of the population and increasing susceptibility for the unfavourable course of acute infections. It has been observed that excess body mass significantly influences the COVID-19 outcome. The aim of this review is to present the latest scientific reports on the impact of excess body mass on the course and complications of COVID-19. The Web of Science, PubMed, and Google Scholar databases were searched. Only studies reporting patients stated to be COVID-19 positive based on the results of a nasopharyngeal swab and the ribonucleic acid test were included. It is shown that thromboembolic and ischemic complications, namely stroke, disseminated intravascular coagulation, severe hyperglycaemia, and leukoencephalopathy are more likely to appear in COVID-19 positive patients with obesity compared to non-obese subjects. COVID-19 complications such as cardiomyopathy, dysrhythmias, endothelial dysfunction, acute kidney injury, dyslipidaemia, lung lesions and acute respiratory distress syndrome have a worse outcome among obese patients.
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Affiliation(s)
- Weronika Gryczyńska
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.G.); (N.L.); (B.B.); (Z.B.); (W.K.)
| | - Nikita Litvinov
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.G.); (N.L.); (B.B.); (Z.B.); (W.K.)
| | - Bezawit Bitew
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.G.); (N.L.); (B.B.); (Z.B.); (W.K.)
- Ethiopian Medical Students’ Association, Zambia Street, Addis Ababa P.O. Box 9302, Ethiopia
| | - Zuzanna Bartosz
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.G.); (N.L.); (B.B.); (Z.B.); (W.K.)
| | - Weronika Kośmider
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.G.); (N.L.); (B.B.); (Z.B.); (W.K.)
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland;
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland;
- Correspondence:
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Aminian A, Bena J, Pantalone KM, Burguera B. Association of obesity with postacute sequelae of COVID-19. Diabetes Obes Metab 2021; 23:2183-2188. [PMID: 34060194 PMCID: PMC8239834 DOI: 10.1111/dom.14454] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/15/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022]
Abstract
Obesity is a major risk factor for the development of severe coronavirus disease 2019 (COVID-19) infection and mortality. However, it is not known whether patients with obesity are at a greater risk of developing postacute sequelae of COVID-19 (PASC). In a median follow-up time of 8 months and counting from 30 days following a positive viral test of 2839 patients who did not require intensive care unit admission and survived the acute phase of COVID-19, 1230 (43%) patients required medical diagnostic tests, 1255 (44%) patients underwent hospital admission, and 29 (1%) patients died. Compared with patients with a normal body mass index (BMI), the risk of hospital admission was 28% and 30% higher in patients with moderate and severe obesity, respectively. The need for diagnostic tests to assess different medical problems, compared with patients with normal BMI, was 25% and 39% higher in patients with moderate and severe obesity, respectively. The findings of this study suggest that moderate and severe obesity (BMI ≥ 35 kg/m2 ) are associated with a greater risk of PASC.
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Affiliation(s)
- Ali Aminian
- Bariatric and Metabolic InstituteCleveland ClinicClevelandOhioUSA
| | - James Bena
- Department of Quantitative Health SciencesLerner Research Institute, Cleveland ClinicClevelandOhioUSA
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Huang H, Bukhari K, Peng CC, Hung D, Shih M, Chang RH, Lin S, Munir KM, Tu Y. The J-shaped relationship between body mass index and mortality in patients with COVID-19: A dose-response meta-analysis. Diabetes Obes Metab 2021; 23:1701-1709. [PMID: 33764660 PMCID: PMC8250762 DOI: 10.1111/dom.14382] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/15/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Huei‐Kai Huang
- Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
- Department of Medical Research, Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualienTaiwan
- Department of Family Medicine, Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualienTaiwan
| | - Khulood Bukhari
- Department of MedicineUniversity of Maryland Medical Centre Midtown CampusBaltimoreMarylandUSA
| | - Carol Chiung‐Hui Peng
- Department of Internal MedicineUniversity of Maryland Medical Centre Midtown CampusBaltimoreMarylandUSA
| | - Duan‐Pei Hung
- Department of Family Medicine, Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualienTaiwan
| | - Ming‐Chieh Shih
- Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
| | - Rachel Huai‐En Chang
- The Johns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Shu‐Man Lin
- Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualienTaiwan
| | - Kashif M. Munir
- Division of Endocrinology, Diabetes and NutritionUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Yu‐Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
- Department of Dentistry, National Taiwan University Hospital and School of DentistryNational Taiwan UniversityTaipeiTaiwan
- Research Centre of Big Data and Meta‐analysis, Wan Fang HospitalTaipei Medical UniversityTaipeiTaiwan
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Gardiner J, Oben J, Sutcliffe A. Obesity as a driver of international differences in COVID-19 death rates. Diabetes Obes Metab 2021; 23:1463-1470. [PMID: 33620765 PMCID: PMC8013490 DOI: 10.1111/dom.14357] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 12/19/2022]
Abstract
AIM To determine what proportion of the inter-country variation in death rates can be explained in terms of obesity rates and other known risk factors for coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS COVID-19 death rates from 30 industrialized countries were analysed using linear regression models. Covariates modelled population density, the age structure of the population, obesity, population health, per capita gross domestic product (GDP), ethnic diversity, national temperature and the delay in the government imposing virus control measures. RESULTS The multivariable regression model explained 63% of the inter-country variation in COVID-19 death rates. The initial model was optimized using stepwise selection. In descending order of absolute size of model coefficient, the covariates in the optimized model were the obesity rate, the hypertension rate, population density, life expectancy, the percentage of the population aged older than 65 years, the percentage of the population aged younger than 15 years, the diabetes rate, the delay in imposing national COVID-19 control measures, per capita GDP and mean temperature (with a negative coefficient indicating an association between higher national temperatures and lower death rates). CONCLUSIONS A large proportion of the inter-country variation in COVID-19 death rates can be explained by differences in obesity rates, population health, population densities, age demographics, delays in imposing national virus control measures, per capita GDP and climate. Some of the unexplained variation is probably attributable to inter-country differences in the definition of a COVID-19 death and in the completeness of the recording of COVID-19 deaths.
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Affiliation(s)
- Julian Gardiner
- University College London Great Ormond Street Institute of Child HealthLondonUK
- Department of EducationUniversity of OxfordOxfordUK
| | - Jude Oben
- University College London Institute for Liver and Digestive HealthRoyal Free HospitalLondonUK
- Department of Gastroenterology and HepatologyGuy's and St Thomas' HospitalLondonUK
| | - Alastair Sutcliffe
- University College London Great Ormond Street Institute of Child HealthLondonUK
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Sahin S, Sezer H, Cicek E, Yagız Ozogul Y, Yildirim M, Icli TB, Polat Korkmaz O, Durcan E, Sulu C, Somay K, Bekdemir B, Borekci S, Yazici D, Deyneli O, Ergonul O, Tabak F, Dikmen Y, Ozkaya HM, Gonen MS, Damci T, Ilkova H, Yumuk VD. The Role of Obesity in Predicting the Clinical Outcomes of COVID-19. Obes Facts 2021; 14:481-489. [PMID: 34352797 PMCID: PMC8450845 DOI: 10.1159/000517180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. METHODS We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. RESULTS There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). CONCLUSION COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.
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Affiliation(s)
- Serdar Sahin
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Havva Sezer
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ebru Cicek
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Yeliz Yagız Ozogul
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Murat Yildirim
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Tevhide Betul Icli
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Ozge Polat Korkmaz
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Emre Durcan
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Cem Sulu
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Kayra Somay
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Bahar Bekdemir
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sermin Borekci
- Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Dilek Yazici
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Oguzhan Deyneli
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Onder Ergonul
- Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Yalim Dikmen
- Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Hande Mefkure Ozkaya
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Mustafa Sait Gonen
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Taner Damci
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Hasan Ilkova
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Volkan Demirhan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- *Volkan Demirhan Yumuk,
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