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Barus NRV, Tahapary DL, Kurniawan F, Sinto R, Wafa S, Wisnu W, Mansjoer A, Wijaya CN, Felix I, Tarigan TJE, Harbuwono DS, Soewondo P. Obesity Parameters as Predictor of Poor Outcomes in Hospitalized Patients with Confirmed Mild-to-Moderate COVID-19. Infect Dis Rep 2024; 16:894-905. [PMID: 39311212 PMCID: PMC11417886 DOI: 10.3390/idr16050071] [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: 07/01/2024] [Revised: 08/19/2024] [Accepted: 08/19/2024] [Indexed: 09/26/2024] Open
Abstract
(1) Background: This study aims to assess visceral fat values, waist circumference (WC), body mass index (BMI), and body fat percentage for their ability to predict poor outcomes during COVID-19 patients' hospitalization; (2) Methods: This study was a prospective cohort of mild-moderate COVID-19 patients hospitalized at Dr. Cipto Mangunkusumo National General Hospital from December 2020 to March 2021. This study includes hospitalized patients over 18 diagnosed with COVID-19 using RT-PCR. Patients who do not have chest radiography, waist circumference, a bioimpedance analyzer (BIA) error, or are unable to stand or mobilize during the examination are excluded from this study. Cox regression was used for multivariate analysis; (3) Results: The study included two hundred sixty-one patients. The median visceral fat value was 10 (equivalent to 100 cm2), the WC was 93.4 cm, the BMI was 26.1 kg/m2, and the body fat percentage was 31.5%. Based on multivariate Cox regression, WC was statistically significant as an independent factor influencing poor outcomes in COVID-19 patients (RR 1.037 [95% CI 1.011-1.064]) along with COVID-19 degree of severity (RR 3.063 [95% CI 1.537-6.104]) and comorbidities (RR 2.123 [95% CI 1.017-4.435]); (4) Conclusions: Waist circumference can influence poor outcomes in confirmed COVID-19 patients during hospitalization.
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Affiliation(s)
- Nadya R. V. Barus
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Dicky Levenus Tahapary
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
- Clinical Research Unit, Dr. Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Farid Kurniawan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Robert Sinto
- Division of Tropical Disease and Infection, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia;
| | - Syahidatul Wafa
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Wismandari Wisnu
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Arif Mansjoer
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia;
| | - Calysta Nadya Wijaya
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Immanuel Felix
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Tri Juli Edi Tarigan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Dante Saksono Harbuwono
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
| | - Pradana Soewondo
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta 10430, Indonesia; (F.K.); (S.W.); (W.W.); (T.J.E.T.); (D.S.H.); (P.S.)
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia; (C.N.W.); (I.F.)
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Santana A, Prestes GDS, da Silva MD, Girardi CS, Silva LDS, Moreira JCF, Gelain DP, Westphal GA, Kupek E, Walz R, Dal-Pizzol F, Ritter C. Identification of distinct phenotypes and improving prognosis using metabolic biomarkers in COVID-19 patients. CRITICAL CARE SCIENCE 2024; 36:e20240028en. [PMID: 39109758 PMCID: PMC11321718 DOI: 10.62675/2965-2774.20240028-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/09/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE To investigate the relationship between the levels of adipokines and other endocrine biomarkers and patient outcomes in hospitalized patients with COVID-19. METHODS In a prospective study that included 213 subjects with COVID-19 admitted to the intensive care unit, we measured the levels of cortisol, C-peptide, glucagon-like peptide-1, insulin, peptide YY, ghrelin, leptin, and resistin.; their contributions to patient clustering, disease severity, and predicting in-hospital mortality were analyzed. RESULTS Cortisol, resistin, leptin, insulin, and ghrelin levels significantly differed between severity groups, as defined by the World Health Organization severity scale. Additionally, lower ghrelin and higher cortisol levels were associated with mortality. Adding biomarkers to the clinical predictors of mortality significantly improved accuracy in determining prognosis. Phenotyping of subjects based on plasma biomarker levels yielded two different phenotypes that were associated with disease severity, but not mortality. CONCLUSION As a single biomarker, only cortisol was independently associated with mortality; however, metabolic biomarkers could improve mortality prediction when added to clinical parameters. Metabolic biomarker phenotypes were differentially distributed according to COVID-19 severity but were not associated with mortality.
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Affiliation(s)
- Andressa Santana
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
| | - Gabriele da Silveira Prestes
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
| | - Marinara Dagostin da Silva
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
| | - Carolina Saibro Girardi
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Lucas dos Santos Silva
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - José Cláudio Fonseca Moreira
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Daniel Pens Gelain
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | | | - Emil Kupek
- Public Health DepartmentUniversidade Federal de Santa CatarinaFlorianópolisSCBrazilPublic Health Department, Universidade Federal de Santa Catarina - Florianópolis (SC), Brazil.
| | - Roger Walz
- Department of Clinical MedicineHospital UniversitárioUniversidade Federal de Santa CatarinaFlorianópolisSCBrazilCenter for Applied Neuroscience, Department of Clinical Medicine, Hospital Universitário, Universidade Federal de Santa Catarina - Florianópolis (SC), Brazil.
| | - Felipe Dal-Pizzol
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
- Intensive Care UnitHospital São JoséCriciúmaSCBrazilIntensive Care Unit, Hospital São José - Criciúma (SC), Brazil.
| | - Cristiane Ritter
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
- Intensive Care UnitHospital São JoséCriciúmaSCBrazilIntensive Care Unit, Hospital São José - Criciúma (SC), Brazil.
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Nour TY, Altintaş KH. Effect of the COVID-19 pandemic on obesity and it is risk factors: a systematic review. BMC Public Health 2023; 23:1018. [PMID: 37254139 DOI: 10.1186/s12889-023-15833-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/06/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) is a contagious disease caused by the severe acute new coronavirus called SARS-CoV-2. Devastating social, economic, and health service utilisation-related activities. Increased burden and lifestyle changes due to confinement. OBJECTIVE This study aimed to investigate and determine the determinants of obesity during the coronavirus disease (COVID-19) pandemic from 2019 to 2023. METHODS Observational studies published between December 2019 and January 2023 were thoroughly searched using a PRISMA flow chart. PubMed, Google Scholar, Web of Science, HINARI, Scopus, and Embase databases were used. Two reviewers independently identified and critically evaluated the relevant literature. Studies that reported weight gain or involved BMI measurements of 25 kg/m2 or BMI z-scores for children during the COVID-19 lockdown were selected for inclusion. The Newcastle-Ottawa Scale (NOS) was used as a quality assessment instrument in nonrandomised studies to evaluate study quality. All the contributing determinants of weight increase were identified, gathered, and synthesised. RESULTS This systematic review identified 40 studies with a total population of 5,681,813 from 22 countries, of which 74.6% were male. The sample size from included articles ranged from 37 to 5,315,435. Of the 40 selected articles, 24 focused on adults, five on adolescents, three on children, and eight on children and adolescents. Physical inactivity, sedentary behaviour, bad eating habits, behavioural lifestyle, excessive stress, depression, anxiety, behavioural risk factors, sex, and ethnic minorities were associated with obesity during the COVID-19 pandemic lockdown. CONCLUSION During the COVID-19 pandemic, physical inactivity, sedentary lifestyle, and poor eating patterns were the most common risk factors for obesity. Additionally, unhealthy eating habits, excessive behavioural stress, depression, anxiety, low mood, age, gender, and ethnic minorities have been identified as risk factors for obesity during the COVID-19 pandemic.
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Affiliation(s)
- Tahir Yousuf Nour
- Department of Public Health, School of Public Health, Jigjiga University, Jigjiga, Ethiopia.
| | - Kerim Hakan Altintaş
- Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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4
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Geitgey DK, Lee M, Cottrill KA, Jaffe M, Pilcher W, Bhasin S, Randall J, Ross AJ, Salemi M, Castillo-Castrejon M, Kilgore MB, Brown AC, Boss JM, Johnston R, Fitzpatrick AM, Kemp ML, English R, Weaver E, Bagchi P, Walsh R, Scharer CD, Bhasin M, Chandler JD, Haynes KA, Wellberg EA, Henry CJ. The 'omics of obesity in B-cell acute lymphoblastic leukemia. J Natl Cancer Inst Monogr 2023; 2023:12-29. [PMID: 37139973 PMCID: PMC10157791 DOI: 10.1093/jncimonographs/lgad014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
The obesity pandemic currently affects more than 70 million Americans and more than 650 million individuals worldwide. In addition to increasing susceptibility to pathogenic infections (eg, SARS-CoV-2), obesity promotes the development of many cancer subtypes and increases mortality rates in most cases. We and others have demonstrated that, in the context of B-cell acute lymphoblastic leukemia (B-ALL), adipocytes promote multidrug chemoresistance. Furthermore, others have demonstrated that B-ALL cells exposed to the adipocyte secretome alter their metabolic states to circumvent chemotherapy-mediated cytotoxicity. To better understand how adipocytes impact the function of human B-ALL cells, we used a multi-omic RNA-sequencing (single-cell and bulk transcriptomic) and mass spectroscopy (metabolomic and proteomic) approaches to define adipocyte-induced changes in normal and malignant B cells. These analyses revealed that the adipocyte secretome directly modulates programs in human B-ALL cells associated with metabolism, protection from oxidative stress, increased survival, B-cell development, and drivers of chemoresistance. Single-cell RNA sequencing analysis of mice on low- and high-fat diets revealed that obesity suppresses an immunologically active B-cell subpopulation and that the loss of this transcriptomic signature in patients with B-ALL is associated with poor survival outcomes. Analyses of sera and plasma samples from healthy donors and those with B-ALL revealed that obesity is associated with higher circulating levels of immunoglobulin-associated proteins, which support observations in obese mice of altered immunological homeostasis. In all, our multi-omics approach increases our understanding of pathways that may promote chemoresistance in human B-ALL and highlight a novel B-cell-specific signature in patients associated with survival outcomes.
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Affiliation(s)
- Delaney K Geitgey
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Miyoung Lee
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Kirsten A Cottrill
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Maya Jaffe
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - William Pilcher
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Swati Bhasin
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Jessica Randall
- Emory Integrated Computational Core, Emory University, Atlanta, GA, USA
| | - Anthony J Ross
- Riley Children’s Health, Indiana University Health, Indianapolis, IN, USA
| | - Michelle Salemi
- Proteomics Core Facility, University of California Davis Genome Center, Davis, 95616, CA
| | - Marisol Castillo-Castrejon
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew B Kilgore
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Ayjha C Brown
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Jeremy M Boss
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Rich Johnston
- Emory Integrated Computational Core, Emory University, Atlanta, GA, USA
| | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Melissa L Kemp
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Emory Integrated Proteomics Core, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Eric Weaver
- Shimadzu Scientific Instruments, Columbia, MD, USA
| | - Pritha Bagchi
- Emory Integrated Proteomics Core, Emory University School of Medicine, Atlanta, GA, USA
| | - Ryan Walsh
- Shimadzu Scientific Instruments, Columbia, MD, USA
| | - Christopher D Scharer
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Manoj Bhasin
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Joshua D Chandler
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Karmella A Haynes
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Elizabeth A Wellberg
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Curtis J Henry
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
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5
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de Nooijer AH, Kooistra EJ, Grondman I, Janssen NAF, Joosten LAB, van de Veerdonk FL, Kox M, Pickkers P, Netea MG. Adipocytokine plasma concentrations reflect influence of inflammation but not body mass index (BMI) on clinical outcomes of COVID-19 patients: A prospective observational study from the Netherlands. Clin Obes 2023; 13:e12568. [PMID: 36426776 DOI: 10.1111/cob.12568] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/21/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022]
Abstract
Obesity is recognized as a risk factor for adverse outcome in COVID-19, but the molecular mechanisms underlying this relationship remain unknown. Adipose tissue functions as an endocrine organ by secreting multiple pro-inflammatory and anti-inflammatory factors, known as adipocytokines, which could be involved in COVID-19 severity. We explored the role of adipocytokines in COVID-19 and its association with BMI, clinical outcome, and inflammation. This is an observational study in 195 hospitalized COVID-19 patients. Serial plasma concentrations of the adipocytokines leptin, adiponectin, resistin, and various inflammatory cytokines were assessed. Adipocytokines were compared between patients with normal weight (BMI: 18.5-24.9 kg/m2 ), overweight (BMI: 25.0-29.9 kg/m2 ), and obesity (BMI ≥ 30 kg/m2 ), between patients admitted to the ICU and to non-ICU clinical wards, and between survivors and non-survivors. Patients with overweight and obesity displayed higher leptin concentrations and lower adiponectin concentrations throughout hospital admission (p < .001), whereas resistin concentrations were not different from patients with normal weight (p = .12). Resistin concentrations correlated with inflammatory markers and were persistently higher in ICU patients and non-survivors compared to non-ICU patients and survivors, respectively (both p < .001), whereas no such relationships were found for the other adipocytokines. In conclusion, leptin and adiponectin are associated with BMI, but not with clinical outcomes and inflammation in COVID-19 patients. In contrast, resistin is not associated with BMI, but high concentrations are associated with worse clinical outcomes and more pronounced inflammation. Therefore, it is unlikely that BMI-related adipocytokines or differences in the inflammatory response underlie obesity as a risk factor for severe COVID-19.
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Affiliation(s)
- Aline H de Nooijer
- Department of Internal Medicine, Radboud University Medical Center, The Netherlands
- Department of Intensive Care Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Emma J Kooistra
- Department of Intensive Care Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Inge Grondman
- Department of Internal Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nico A F Janssen
- Department of Internal Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- Núcleo de Pesquisa da Faculdade da Polícia Militar (FPM) do Estado de Goiás, Brazil
| | - Frank L van de Veerdonk
- Department of Internal Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthijs Kox
- Department of Intensive Care Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Pickkers
- Department of Intensive Care Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine, Radboud University Medical Center, The Netherlands
- Radboud University Medical Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Immunology and Metabolism, Life & Medical Sciences Institute, University of Bonn, Germany
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6
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De la Cruz-Cano E, Jiménez-González CDC, Díaz-Gandarilla JA, López-Victorio CJ, Escobar-Ramírez A, Uribe-López SA, Huerta-García E, Ayala-Sumuano JT, Morales-García V, Gútierrez-López L, González-Garrido JA. Comorbidities and laboratory parameters associated with SARS-CoV-2 infection severity in patients from the southeast of Mexico: a cross-sectional study. F1000Res 2022; 11:10. [PMID: 35464048 PMCID: PMC9005987 DOI: 10.12688/f1000research.74023.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 01/08/2023] Open
Abstract
Background. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is the etiological agent of the coronavirus disease 2019 (COVID-19) pandemic. Among the risk factors associated with the severity of this disease is the presence of several metabolic disorders.
For this reason, the aim of this research was
to identify the comorbidities and laboratory parameters among COVID-19 patients admitted to the intensive care unit (ICU), comparing the patients who required invasive mechanical ventilation (IMV) with those who did not require IMV, in order to determine the clinical characteristics associated with the COVID-19 severity. Methods. We carried out a cross-sectional study among 152 patients who were admitted to the ICU from April 1
st to July 31
st, 2021, in whom the comorbidities and laboratory parameters associated with the SARS-CoV-2 infection severity were identified. The data of these patients was grouped into two main groups: “patients who required IMV” and “patients who did not require IMV”. The nonparametric Mann–Whitney U test for continuous data and the
χ2 test for categorical data were used to compare the variables between both groups. Results. Of the
152 COVID-19 patients who were admitted to the ICU, 66 required IMV and 86 did not require IMV. Regarding the comorbidities found in these patients, a higher prevalence of type 2 diabetes mellitus (T2DM), hypertension and obesity was observed among patients who required IMV vs. those who did not require IMV (
p<0.05). Concerning laboratory parameters, only glucose, Interleukin 6 (IL-6), lactate dehydrogenase (LDH) and C-reactive protein (CRP) were significantly higher among patients who required IMV than in those who did not require IMV (
p<0.05). Conclusion. This study performed in a Mexican population indicates that comorbidities such as: T2DM, hypertension and obesity, as well as elevated levels of glucose, IL-6, LDH and CRP are associated with the COVID-19 severity.
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Affiliation(s)
- Eduardo De la Cruz-Cano
- División Académica de Ciencias Básicas. CICTAT. Laboratorio de Bioquímica y Biología Molecular., Universidad Juárez Autónoma de Tabasco, Cunduacán,, Tabasco., 86690, Mexico.,Laboratorio de Análisis Clínicos., Secretaría de Salud, Hospital General de Comalcalco., Comalcalco., Tabasco, 86300, Mexico
| | - Cristina Del C Jiménez-González
- División Académica Multidisciplinaria de Comalcalco. Laboratorio de Análisis Clínicos., Universidad Juárez Autónoma de Tabasco., Comalcalco., Tabasco., 86650, Mexico
| | - José A Díaz-Gandarilla
- División Académica Multidisciplinaria de Comalcalco. Laboratorio de Análisis Clínicos., Universidad Juárez Autónoma de Tabasco., Comalcalco., Tabasco., 86650, Mexico
| | - Carlos J López-Victorio
- División Académica de Ciencias Básicas. CICTAT. Laboratorio de Bioquímica y Biología Molecular., Universidad Juárez Autónoma de Tabasco, Cunduacán,, Tabasco., 86690, Mexico
| | - Adelma Escobar-Ramírez
- División Académica de Ciencias Básicas. CICTAT. Laboratorio de Bioquímica y Biología Molecular., Universidad Juárez Autónoma de Tabasco, Cunduacán,, Tabasco., 86690, Mexico
| | - Sheila A Uribe-López
- División Académica Multidisciplinaria de Jalpa de Méndez. Laboratorio de Inmunología y Microbiología Molecular., Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, 86205, Mexico
| | - Elizabeth Huerta-García
- División Académica Multidisciplinaria de Jalpa de Méndez. Laboratorio de Inmunología y Microbiología Molecular., Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, 86205, Mexico
| | | | - Vicente Morales-García
- División Académica Multidisciplinaria de Comalcalco. Laboratorio de Análisis Clínicos., Universidad Juárez Autónoma de Tabasco., Comalcalco., Tabasco., 86650, Mexico
| | - Liliana Gútierrez-López
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina., Instituto Politécnico Nacional., Ciudad de México, Ciudad de México, 11340, Mexico
| | - José A González-Garrido
- División Académica de Ciencias Básicas. CICTAT. Laboratorio de Bioquímica y Biología Molecular., Universidad Juárez Autónoma de Tabasco, Cunduacán,, Tabasco., 86690, Mexico
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7
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Izquierdo AG, Carreira MC, Boughanem H, Moreno-Navarrete JM, Nicoletti CF, Oliver P, de Luis D, Nonino CB, Portillo MP, Martinez-Olmos MA, Fernandez-Real JM, Tinahones FJ, Martinez JA, Macias-González M, Casanueva FF, Crujeiras AB. Adipose tissue and blood leukocytes ACE2 DNA methylation in obesity and after weight loss. Eur J Clin Invest 2022; 52:e13685. [PMID: 34582564 DOI: 10.1111/eci.13685] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Obesity was consistently associated with a poor prognosis in patients with COVID-19. Epigenetic mechanisms were proposed as the link between obesity and comorbidities risk. AIM To evaluate the methylation levels of angiotensin-converting enzyme 2 (ACE2) gene, the main entry receptor of SARS-CoV-2, in different depots of adipose tissue (AT) and leukocytes (PBMCs) in obesity and after weight loss therapy based on a very-low-calorie ketogenic diet (VLCKD), a balanced hypocaloric diet (HCD) or bariatric surgery (BS). MATERIALS AND METHODS DNA methylation levels of ACE2 were extracted from our data sets generated by the hybridization of subcutaneous (SAT) (n = 32) or visceral (VAT; n = 32) adipose tissue, and PBMCs (n = 34) samples in Infinium HumanMethylation450 BeadChips. Data were compared based on the degree of obesity and after 4-6 months of weight loss either by following a nutritional or surgical treatment and correlated with ACE2 transcript levels. RESULTS As compared with normal weight, VAT from patients with obesity showed higher ACE2 methylation levels. These differences were mirrored in PBMCs but not in SAT. The observed obesity-associated methylation of ACE2 was reversed after VLCKD and HCD but not after BS. Among the studied CpG sites, cg16734967 and cg21598868, located at the promoter, were the most affected and correlated with BMI. The observed DNA methylation pattern was inversely correlated with ACE2 expression. CONCLUSION Obesity-related VAT shows hypermethylation and downregulation of the ACE2 gene that is mirrored in PBMCs and is restored after nutritional weight reduction therapy. The results warrant the necessity to further evaluate its implication for COVID-19 pathogenesis.
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Affiliation(s)
- Andrea G Izquierdo
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS), Santiago de Compostela, Spain.,Endocrine Division, Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain
| | - Marcos C Carreira
- Endocrine Division, Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Molecular Endocrinology Group, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain
| | - Hatim Boughanem
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, University of Malaga (IBIMA), Malaga, Spain
| | - Jose M Moreno-Navarrete
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdIBGi) and Universitat de Girona, Girona, Spain
| | - Carolina F Nicoletti
- Department of Internal Medicine, Laboratory of Nutrigenomic Studies, Ribeirao Preto Medical School (FMRP) University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Paula Oliver
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Nutrigenomics and Obesity Group, University of the Balearic Islands and Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Daniel de Luis
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Department of Endocrinology and Investigation, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Carla B Nonino
- Department of Internal Medicine, Laboratory of Nutrigenomic Studies, Ribeirao Preto Medical School (FMRP) University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Maria P Portillo
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Nutrition and Obesity Group, Department of Nutrition and Food Science, Lucio Lascaray Research Institute and Bioaraba Health Research Institute, University of the Basque Country (UPV/EHU), Vitoria, Spain
| | - Miguel A Martinez-Olmos
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS), Santiago de Compostela, Spain.,Endocrine Division, Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain
| | - Jose M Fernandez-Real
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdIBGi) and Universitat de Girona, Girona, Spain
| | - Francisco J Tinahones
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, University of Malaga (IBIMA), Malaga, Spain
| | - J Alfredo Martinez
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Department of Nutrition, Food Science and Physiology, Centre for Nutrition Research, Navarra Institute for Health Research, University of Navarra (UNAV) and IdiSNA, Pamplona, Spain.,Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Manuel Macias-González
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, University of Malaga (IBIMA), Malaga, Spain
| | - Felipe F Casanueva
- Endocrine Division, Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain.,Molecular Endocrinology Group, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain
| | - Ana B Crujeiras
- Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS), Santiago de Compostela, Spain.,Endocrine Division, Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS) and Santiago de Compostela University (USC), Santiago de Compostela, Spain.,CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Madrid, Spain
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8
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Bil J, Możeńska O. The vicious cycle: a history of obesity and COVID-19. BMC Cardiovasc Disord 2021; 21:332. [PMID: 34229605 PMCID: PMC8258476 DOI: 10.1186/s12872-021-02134-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/23/2021] [Indexed: 12/11/2022] Open
Abstract
Recently, we face a surge in the fast-forward Coronavirus Disease 2019 (COVID-19) pandemic with nearly 170 million confirmed cases and almost 3.5 million confirmed deaths at the end of May 2021. Obesity, also known as the pandemic of the 21st century, has been evolving as an adverse prognostic marker. Obesity is associated with a higher risk of being SARS-CoV-2-positive (46%), as well as hospitalization (113%) and death (48%) due to COVID-19. It is especially true for subjects with morbid obesity. Also, observational studies suggest that in the case of COVID-19, no favorable “obesity paradox” is observed. Therefore, it is postulated to introduce a new entity, i.e., coronavirus disease-related cardiometabolic syndrome (CIRCS). In theory, it applies to all stages of COVID-19, i.e., prevention, acute proceedings (from COVID-19 diagnosis to resolution or three months), and long-term outcomes. Consequently, lifestyle changes, glycemic control, and regulation of the renin-angiotensin-aldosterone pathway have crucial implications for preventing and managing subjects with COVID-19. Finally, it is crucial to use cardioprotective drugs such as angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers and statins. Nevertheless, there is the need to conduct prospective studies and registries better to evaluate the issue of obesity in COVID-19 patients.
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Affiliation(s)
- Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Woloska Street 137, 02-507, Warsaw, Poland.
| | - Olga Możeńska
- Department of Internal Medicine, Hypertension and Angiology, Independent Public Central Clinical Hospital, Medical University of Warsaw, Warsaw, Poland
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9
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Bhaskaran K. New insights into the association between body-mass index and severe COVID-19. Lancet Diabetes Endocrinol 2021; 9:322-323. [PMID: 33932336 PMCID: PMC8081399 DOI: 10.1016/s2213-8587(21)00109-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Krishnan Bhaskaran
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
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10
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Alyammahi SK, Abdin SM, Alhamad DW, Elgendy SM, Altell AT, Omar HA. The dynamic association between COVID-19 and chronic disorders: An updated insight into prevalence, mechanisms and therapeutic modalities. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2021; 87:104647. [PMID: 33264669 PMCID: PMC7700729 DOI: 10.1016/j.meegid.2020.104647] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/26/2020] [Indexed: 02/06/2023]
Abstract
The devastating pandemic of coronavirus disease 2019 (COVID-19) has caused thousands of deaths and left millions of restless patients suffering from its complications. Increasing data indicate that the disease presents in a severe form in patients with pre-existing chronic conditions like cardiovascular diseases, diabetes, respiratory system diseases, and renal diseases. This denotes that these patients are more susceptible to COVID-19 and have higher mortality rates compared to patients with no comorbid conditions. Several factors can explain the heightened susceptibility and fatal presentation of COVID-19 in these patients, for example, the enhanced expression of the angiotensin-converting enzyme-2 (ACE2) in specific organs, cytokine storm, and drug interactions contribute to the increased morbidity and mortality. Adding to the findings that individuals with pre-existing conditions may be more susceptible to COVID-19, it has also been shown that COVID-19 can induce chronic diseases in previously healthy patients. Therefore, understanding the interlinked relationship between COVID-19 and chronic diseases helps in optimizing the management of susceptible patients. This review comprehensively described the molecular mechanisms that contribute to worse COVID-19 prognosis in patients with pre-existing comorbidities such as diabetes, cardiovascular diseases, respiratory diseases, gastrointestinal and renal diseases, blood disorders, autoimmune diseases, and finally, obesity. It also focused on how COVID-19 could, in some cases, lead to chronic conditions as a result of long-term multi-organ damage. Lastly, this work carefully discussed the tailored management plans for each specific patient population, aiming to achieve the best therapeutic outcome with minimum complications.
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Affiliation(s)
- Shatha K Alyammahi
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Shifaa M Abdin
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Dima W Alhamad
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Sara M Elgendy
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Amani T Altell
- School of Public Health and Health Sciences, University of Massachusetts, Amherst 01002, United States of America
| | - Hany A Omar
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates.
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