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Matu J, Griffiths A, Shannon OM, Jones A, Day R, Radley D, Feeley A, Mabbs L, Blackshaw J, Sattar N, Ells L. The association between excess weight and COVID-19 outcomes: An umbrella review. Obes Rev 2024:e13803. [PMID: 39096049 DOI: 10.1111/obr.13803] [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: 03/13/2023] [Revised: 03/14/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024]
Abstract
This umbrella review assessed the association between excess weight and COVID-19 outcomes. MEDLINE, PsycINFO, and CINAHL were systematically searched for reviews that assessed the association between excess weight and COVID-19 outcomes. A second-order meta-analysis was conducted on the available data for intensive care unit admission, invasive mechanical ventilation administration, disease severity, hospitalization, and mortality. The quality of included reviews was assessed using the AMSTAR-2 appraisal tool. In total, 52 systematic reviews were included, 49 of which included meta-analyses. The risk of severe outcomes (OR = 1.86; 95% CI: 1.70 to 2.05), intensive care unit admission (OR = 1.58; 95% CI: 1.45 to 1.72), invasive mechanical ventilation administration (OR = 1.70; 95% CI: 1.57 to 1.83), hospitalization (OR = 1.82; 95% CI: 1.61 to 2.05), and mortality (OR = 1.35; 95% CI: 1.24 to 1.48) following COVID-19 infection was significantly higher in individuals living with excess weight compared with those with a healthy weight. There was limited evidence available in the included reviews regarding the influence of moderating factors such as ethnicity, and the majority of included reviews were of poor quality. Obesity appears to represent an important modifiable pre-infection risk factor for severe COVID-19 outcomes, including death.
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Affiliation(s)
- Jamie Matu
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Alex Griffiths
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Jones
- Psychology, Liverpool John Moores University, Liverpool, UK
| | - Rhiannon Day
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Duncan Radley
- Obesity Institute, School of Sport, Leeds Beckett University, Leeds, UK
| | - Alison Feeley
- Office for Health Improvement and Disparities, London, UK
| | - Lisa Mabbs
- Office for Health Improvement and Disparities, London, UK
| | | | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Louisa Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
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Gutmann D, Dressler M, Eickmeier O, Herrmann E, Kirwil M, Schubert R, Zielen S, Zissler UM. Proinflammatory pattern in the lower airways of non-asthmatic obese adolescents. Cytokine 2024; 173:156452. [PMID: 38039695 DOI: 10.1016/j.cyto.2023.156452] [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: 08/18/2023] [Revised: 11/06/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Obesity is known to be a pro-inflammatory condition affecting multiple organs. Obesity as a systemic pro-inflammatory state, might be associated with bronchial inflammation in non-smoking adolescents with a BMI ≥ 30 kg/m2 without evidence of concomitant chronic diseases. MATERIALS AND METHODS We studied non-asthmatic obese patients (n = 20; median age 15.8 years; BMI 35.0 kg/m2) compared to age matched healthy control subjects (n = 20; median age 17.5 years; BMI 21.5 kg/m2). Induced sputum differential cell counts and sputum mRNA levels were assessed for all study subjects. Serum levels of CRP, IL-6, and IL-8 were measured. Further, IL-5, IL-6, IL-8, IL-13, IL-17, TNF-α, IFN-γ, and IP-10 protein levels were analyzed in induced sputum was. RESULTS Serum CRP levels, sputum inflammatory cell load and sputum eosinophils differed significantly between obese and non-obese subjects, for sputum neutrophils, a correlation was shown with BMI ≥ 30 kg/m2. Differences were also observed for sputum mRNA expression of IL6, IL8, IL13, IL17, IL23, and IFN-γ, as well as the transcription factors T-bet, GATA3, and FoxP3. CONCLUSIONS Increased bronchial inflammation, triggered by systemic or local inflammatory effects of obesity itself, may account for the higher rates of airway disease in obese adolescents.
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Affiliation(s)
- Desiree Gutmann
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Melanie Dressler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Olaf Eickmeier
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt, Germany
| | - Marta Kirwil
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Ralf Schubert
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt
| | - Ulrich M Zissler
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Center for Environmental Health (HMGU), Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.
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Awini E, Agyepong IA, Owiredu D, Gyimah L, Ashinyo ME, Yevoo LL, Aye SGEV, Abbas S, Cronin de Chavez A, Kane S, Mirzoev T, Danso-Appiah A. Burden of mental health problems among pregnant and postpartum women in sub-Saharan Africa: systematic review and meta-analysis protocol. BMJ Open 2023; 13:e069545. [PMID: 37286328 DOI: 10.1136/bmjopen-2022-069545] [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] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Pregnancy and postpartum-related mental health problems pose serious public health threat to the society, but worryingly, neglected in sub-Saharan Africa (SSA). This review will assess the burden and distribution of maternal mental health (MMH) problems in SSA, with the aim to inform the implementation of context sensitive interventions and policies. METHODS AND ANALYSIS All relevant databases, grey literature and non-database sources will be searched. PubMed, LILAC, CINAHL, SCOPUS and PsycINFO, Google Scholar, African Index Medicus, HINARI, African Journals Online and IMSEAR will be searched from inception to 31 May 2023, without language restriction. The reference lists of articles will be reviewed, and experts contacted for additional studies missed by our searches. Study selection, data extraction and risk of bias assessment will be done independently by at least two reviewers and any discrepancies will be resolved through discussion between the reviewers. Binary outcomes (prevalence and incidence) of MMH problems will be assessed using pooled proportions, OR or risk ratio and mean difference for continuous outcomes; all will be presented with their 95% CIs. Heterogeneity will be investigated graphically for overlapping CIs and statistically using the I2 statistic and where necessary subgroup analyses will be performed. Random-effects model meta-analysis will be conducted when heterogeneity is appreciable, otherwise fixed-effect model will be used. The overall level of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation. ETHICS AND DISSEMINATION Although no ethical clearance or exemption is needed for a systematic review, this review is part of a larger study on maternal mental health which has received ethical clearance from the Ethics Review Committee of the Ghana Health Service (GHS-ERC 012/03/20). Findings of this study will be disseminated through stakeholder forums, conferences and peer review publications. PROSPERO REGISTRATION NUMBER CRD42021269528.
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Affiliation(s)
- Elizabeth Awini
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
| | - Irene Akua Agyepong
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - David Owiredu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Leveana Gyimah
- Department of Psychiatry, Pantang Hospital, Accra, Ghana
- Faculty of Psychiatry, Ghana College of Physicians and Surgeons, Accra, Ghana
| | | | - Linda Lucy Yevoo
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
| | - Sorre Grace Emmanuelle Victoire Aye
- Research and Development Division, Dodowa Health Research Centre, Ghana Health Service, Dodowa, Ghana
- Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Shazra Abbas
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Anna Cronin de Chavez
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Sumit Kane
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
- Centre for Evidence Synthesis and Policy, University of Ghana, Legon, Accra, Ghana
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Nagy É, Cseh V, Barcs I, Ludwig E. The Impact of Comorbidities and Obesity on the Severity and Outcome of COVID-19 in Hospitalized Patients-A Retrospective Study in a Hungarian Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1372. [PMID: 36674133 PMCID: PMC9859007 DOI: 10.3390/ijerph20021372] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Patients with comorbidities and obesity are more likely to be hospitalized with coronavirus disease 2019 (COVID-19), to have a higher incidence of severe pneumonia and to also show higher mortality rates. Between 15 March 2020 and 31 December 2021, a retrospective, single-center, observational study was conducted among patients requiring hospitalization for COVID-19 infection. Our aim was to investigate the impact of comorbidities and lifestyle risk factors on mortality, the need for intensive care unit (ICU) admission and the severity of the disease among these patients. Our results demonstrated that comorbidities and obesity increased the risk for all investigated endpoints. Age over 65 years and male sex were identified as independent risk factors, and cardiovascular diseases, cancer, endocrine and metabolic diseases, chronic kidney disease and obesity were identified as significant risk factors. Obesity was found to be the most significant risk factor, associated with considerable odds of COVID-19 mortality and the need for ICU admission in the under-65 age group (aOR: 2.95; p < 0.001 and aOR: 3.49, p < 0.001). In our study, risk factors that increased mortality and morbidity among hospitalized patients were identified. Detailed information on such factors may support therapeutic decision making, the proper targeting of vaccination campaigns and the effective overall management of the COVID-19 epidemic, hence reducing the burden on the healthcare system.
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Affiliation(s)
- Éva Nagy
- Schools of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
- Bajcsy-Zsilinszky Hospital and Outpatient Clinic, 1106 Budapest, Hungary
| | - Viktória Cseh
- Bajcsy-Zsilinszky Hospital and Outpatient Clinic, 1106 Budapest, Hungary
| | - István Barcs
- Schools of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Endre Ludwig
- Bajcsy-Zsilinszky Hospital and Outpatient Clinic, 1106 Budapest, Hungary
- Department of Internal Medicine and Hematology, Division of Infectology, Semmelweis University, 1088 Budapest, Hungary
- National Institute of Hematology and Infectious Diseases, South Pest Central Hospital, 1097 Budapest, Hungary
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COVID-19: Reducing the risk via diet and lifestyle. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:1-16. [PMID: 36333177 PMCID: PMC9550279 DOI: 10.1016/j.joim.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/15/2022] [Indexed: 01/17/2023]
Abstract
This review shows that relatively simple changes to diet and lifestyle can significantly, and rapidly, reduce the risks associated with coronavirus disease 2019 (COVID-19) in terms of infection risk, severity of disease, and even disease-related mortality. A wide range of interventions including regular exercise, adequate sleep, plant-based diets, maintenance of healthy weight, dietary supplementation, and time in nature have each been shown to have beneficial effects for supporting more positive health outcomes with COVID-19, in addition to promoting better overall health. This paper brings together literature from these areas and presents the argument that non-pharmaceutical approaches should not be overlooked in our response to COVID-19. It is noted that, in several cases, interventions discussed result in risk reductions equivalent to, or even greater than, those associated with currently available vaccines. Where the balance of evidence suggests benefits, and the risk is minimal to none, it is suggested that communicating the power of individual actions to the public becomes morally imperative. Further, many lives could be saved, and many harms from the vaccine mandates avoided, if we were willing to embrace this lifestyle-centred approach in our efforts to deal with COVID-19.
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has brought severe challenges to global public health. Many studies have shown that obesity plays a vital role in the occurrence and development of COVID-19. Obesity exacerbates COVID-19, leading to increased intensive care unit hospitalization rate, high demand for invasive mechanical ventilation, and high mortality. The mechanisms of interaction between obesity and COVID-19 involve inflammation, immune response, changes in pulmonary dynamics, disruptions of receptor ligands, and dysfunction of endothelial cells. Therefore, for obese patients with COVID-19, the degree of obesity and related comorbidities should be evaluated. Treatment methods such as administration of anticoagulants and anti-inflammatory drugs like glucocorticoids and airway management should be actively initiated. We should also pay attention to long-term prognosis and vaccine immunity and actively address the physical and psychological problems caused by longterm staying-at-home during the pandemic. The present study summarized the research to investigate the role of obesity in the incidence and progression of COVID-19 and the psychosocial impact and treatment options for obese patients with COVID-19, to guide the understanding and management of the disease.
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Karampela I, Vallianou N, Magkos F, Apovian CM, Dalamaga M. Obesity, Hypovitaminosis D, and COVID-19: the Bermuda Triangle in Public Health. Curr Obes Rep 2022; 11:116-125. [PMID: 35391661 PMCID: PMC8989103 DOI: 10.1007/s13679-022-00471-3] [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] [Accepted: 03/02/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has challenged public health to a significant extent by markedly increasing morbidity and mortality. Evidence suggests that obesity and hypovitaminosis D constitute important risk factors for SARS-CoV-2 infection, severity of disease, and poor outcomes. Due to their high prevalence globally, obesity and hypovitaminosis D are considered pandemics. This review presents current epidemiologic and genetic data linking obesity, hypovitaminosis D, and COVID-19, highlighting the importance of the convergence of three pandemics and their impact on public health. We also briefly summarize potential mechanisms that could explain these links. RECENT FINDINGS Epidemiologic data have shown that obesity is an independent risk factor for COVID-19, severe disease and death, and genetic evidence has suggested a causal association between obesity-related traits and COVID-19 susceptibility and severity. Additionally, obesity is independently associated with hypovitaminosis D, which is highly prevalent in subjects with obesity. Hypovitaminosis D is independently associated with a higher risk for COVID-19, severity, hospitalization, infectious complications, acute respiratory distress syndrome, and poor outcomes. However, genome-wide association studies have not revealed any causal association between vitamin D levels and the risk for COVID-19, while there is no robust evidence for a beneficial role of vitamin D supplementation in the prevention and treatment of COVID-19. In the context of the ongoing COVID-19 pandemic, the epidemiologic impact of obesity and hypovitaminosis D is emphasized. Efforts to increase public awareness and reinforce preventive and therapeutic measures against obesity and hypovitaminosis D are strongly required.
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Affiliation(s)
- Irene Karampela
- grid.5216.00000 0001 2155 0800Second Department of Critical Care, Medical School, Attikon General University Hospital, National and Kapodistrian University of Athens, 1 Rimini St, 12462 Haidari, Greece
| | - Natalia Vallianou
- grid.414655.70000 0004 4670 4329Department of Internal Medicine and Endocrinology, Evangelismos General Hospital of Athens, 45-47 Ypsilantou St., 10676 Athens, Greece
| | - Faidon Magkos
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Caroline M. Apovian
- grid.62560.370000 0004 0378 8294Division of Endocrinology, Diabetes and Hypertension, Brigham and Womens Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA
| | - Maria Dalamaga
- grid.5216.00000 0001 2155 0800Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias St, 11527 Athens, Greece
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Singh R, Rathore SS, Khan H, Karale S, Chawla Y, Iqbal K, Bhurwal A, Tekin A, Jain N, Mehra I, Anand S, Reddy S, Sharma N, Sidhu GS, Panagopoulos A, Pattan V, Kashyap R, Bansal V. Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression. Front Endocrinol (Lausanne) 2022; 13:780872. [PMID: 35721716 PMCID: PMC9205425 DOI: 10.3389/fendo.2022.780872] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
Abstract
Background Obesity affects the course of critical illnesses. We aimed to estimate the association of obesity with the severity and mortality in coronavirus disease 2019 (COVID-19) patients. Data Sources A systematic search was conducted from the inception of the COVID-19 pandemic through to 13 October 2021, on databases including Medline (PubMed), Embase, Science Web, and Cochrane Central Controlled Trials Registry. Preprint servers such as BioRxiv, MedRxiv, ChemRxiv, and SSRN were also scanned. Study Selection and Data Extraction Full-length articles focusing on the association of obesity and outcome in COVID-19 patients were included. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used for study selection and data extraction. Our Population of interest were COVID-19 positive patients, obesity is our Intervention/Exposure point, Comparators are Non-obese vs obese patients The chief outcome of the study was the severity of the confirmed COVID-19 positive hospitalized patients in terms of admission to the intensive care unit (ICU) or the requirement of invasive mechanical ventilation/intubation with obesity. All-cause mortality in COVID-19 positive hospitalized patients with obesity was the secondary outcome of the study. Results In total, 3,140,413 patients from 167 studies were included in the study. Obesity was associated with an increased risk of severe disease (RR=1.52, 95% CI 1.41-1.63, p<0.001, I2 = 97%). Similarly, high mortality was observed in obese patients (RR=1.09, 95% CI 1.02-1.16, p=0.006, I2 = 97%). In multivariate meta-regression on severity, the covariate of the female gender, pulmonary disease, diabetes, older age, cardiovascular diseases, and hypertension was found to be significant and explained R2 = 40% of the between-study heterogeneity for severity. The aforementioned covariates were found to be significant for mortality as well, and these covariates collectively explained R2 = 50% of the between-study variability for mortality. Conclusions Our findings suggest that obesity is significantly associated with increased severity and higher mortality among COVID-19 patients. Therefore, the inclusion of obesity or its surrogate body mass index in prognostic scores and improvement of guidelines for patient care management is recommended.
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Affiliation(s)
- Romil Singh
- Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Sawai Singh Rathore
- Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India
| | - Hira Khan
- Department of Neurology, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Smruti Karale
- Department of Internal Medicine, Government Medical College-Kolhapur, Kolhapur, India
| | - Yogesh Chawla
- Department of Immunology, Mayo Clinic, Rochester, MN, United States
| | - Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Abhishek Bhurwal
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, United States
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Nirpeksh Jain
- Department of Emergency Medicine, Marshfield Clinic, Marshfield, WI, United States
| | - Ishita Mehra
- Department of Internal Medicine, North Alabama Medical Center, Florence, AL, United States
| | - Sohini Anand
- Department of Internal Medicine, Patliputra Medical College and Hospital, Dhanbad, India
| | - Sanjana Reddy
- Department of Internal Medicine, Gandhi Medical College, Secunderabad, India
| | - Nikhil Sharma
- Department of Nephrology, Mayo Clinic, Rochester, MI, United States
| | - Guneet Singh Sidhu
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MI, United States
| | | | - Vishwanath Pattan
- Department of Medicine, Division of Endocrinology and Metabolism, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Vikas Bansal
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MI, United States
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Yen YA, Wang CC, Sung WW, Fang KC, Huang SM, Lin CC, Tsai MC, Yang TW. Intragastric injection of botulinum toxin A for weight loss: A systematic review and meta-analysis of randomized controlled trials. J Gastroenterol Hepatol 2022; 37:983-992. [PMID: 35383416 DOI: 10.1111/jgh.15847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM Intragastric botulinum toxin A (BTA) injection is a potential treatment for weight reduction in obese patients. Current studies yielded conflicting results. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the efficacy of intragastric BTA injection for weight management. METHODS We searched several databases to identify RCTs evaluating intragastric BTA injections for obesity. We applied random-effects models for all meta-analyses due to heterogeneity in the included studies. The mean difference (MD) and 95% confidence interval (CI) were calculated for continuous outcomes. RESULTS A total of 6 RCTs including 192 subjects met the inclusion criteria and were included for the meta-analysis. Although the pooled data from six studies showed no difference in the absolute weight loss between intragastric BTA injection and control, subgroup analysis showed a significantly decreased absolute weight after a BTA injection dose ≥ 200 U (MD, -2.04 kg; 95% CI, -3.96 to -0.12) and after multiple injection regions in the stomach combined with diet control (MD, -4.44 kg; 95% CI, -6.54 to -2.33 kg) compared with the control. Regarding absolute weight loss, the impact of endoscopic ultrasound-guided injection and follow-up duration showed no difference. Intragastric BTA injection had a significant change in body mass index (MD, -1.25 kg/m2 ; 95% CI, -2.18 to -0.32 kg/m2 ) and prolonged gastric half-emptying time (MD, 11.37 min; 95% CI, -3.69 to 19.06 min). CONCLUSION Intragastric BTA injection is effective for obesity treatment, and adequate doses (≥ 200 U), multiple gastric injection regions, and combined diet control are crucial. However, given the small sample size and limited power, caution should be exercised.
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Affiliation(s)
- Yi-An Yen
- School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chi-Chih Wang
- School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wen-Wei Sung
- School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Kuan-Chieh Fang
- Division of Gastroenterology, Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shih-Ming Huang
- Division of Gastroenterology and Hepatology, Jen-Ai Hospital, Taichung, Taiwan
| | - Chun-Che Lin
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Chang Tsai
- School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tzu-Wei Yang
- School of Medicine and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Weight Management Center, Chung Shan Medical University Hospital, Taichung, Taiwan
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10
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Kristensen NM, Gribsholt SB, Andersen AL, Richelsen B, Bruun JM. Obesity augments the disease burden in COVID-19: Updated data from an umbrella review. Clin Obes 2022; 12:e12508. [PMID: 35137524 PMCID: PMC9111579 DOI: 10.1111/cob.12508] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/03/2021] [Accepted: 12/26/2021] [Indexed: 12/16/2022]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic calls for identification of risk factors, which may help to identify people at enhanced risk for severe disease outcomes to improve treatment and, if possible, establish prophylactic measures. This study aimed to determine whether individuals with obesity compared to individuals with normal weight have an increased risk for severe COVID-19. We conducted a systematic literature search of PubMed, Embase and Cochrane Library and critically reviewed the secondary literature using AMSTAR-2. We explored 27 studies. Findings indicate that individuals with obesity (body mass index ≥ 30 kg/m2 ), as compared to individuals without obesity, experience an increased risk for hospitalization (odds ratio [OR]: 1.40-2.45), admission to the intensive care unit (OR: 1.30-2.32), invasive mechanical ventilation (OR: 1.47-2.63), and the composite outcome 'severe outcome' (OR or risk ratio: 1.62-4.31). We found diverging results concerning death to COVID-19, but data trended towards increased mortality. Comparing individuals with obesity to individuals without obesity, findings suggested younger individuals (<60 years) experience a higher risk of severe disease compared to older individuals (≥60 years). Obesity augments the severity of COVID-19 including a tendency to increased mortality and, thus, contributes to an increased disease burden, especially among younger individuals.
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Affiliation(s)
- Nickolai M. Kristensen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
| | - Sigrid B. Gribsholt
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
| | - Anton L. Andersen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
| | - Bjørn Richelsen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Department of Endocrinology and Internal MedicineAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Jens M. Bruun
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
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Association of epicardial adipose tissue with the severity and adverse clinical outcomes of COVID-19: A meta-analysis. Int J Infect Dis 2022; 120:33-40. [PMID: 35421580 PMCID: PMC8996473 DOI: 10.1016/j.ijid.2022.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Epicardial adipose tissue (EAT) has been proposed to be an independent predictor of visceral adiposity. EAT measures are associated with coronary artery disease, diabetes, and chronic obstructive pulmonary disease, which are risk factors for COVID-19 poor prognosis. Whether EAT measures are related to COVID-19 severity and prognosis is controversial. Methods We searched 6 databases for studies until January 7, 2022. The pooled effects are presented as the standard mean difference (SMD) or weighted mean difference with 95% confidence intervals (CIs). The primary end point was COVID-19 severity. Adverse clinical outcomes were also assessed. Results A total of 13 studies with 2482 patients with COVID-19 were identified. All patients had positive reverse transcriptase-polymerase chain reaction results. All quantitative EAT measures were based on computed tomography. Patients in the severe group had higher EAT measures compared with the nonsevere group (SMD = 0.74, 95% CI: 0.29–1.18, P = 0.001). Patients with hospitalization requirement, requiring invasive mechanical ventilation, admitted to intensive care unit, or with combined adverse outcomes had higher EAT measures compared to their controls (all P < 0.001). Conclusions EAT measures were associated with the severity and adverse clinical outcomes of COVID-19. EAT measures might help in prognostic risk stratification of patients with COVID-19.
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12
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Obesity and Leptin Resistance in the Regulation of the Type I Interferon Early Response and the Increased Risk for Severe COVID-19. Nutrients 2022; 14:nu14071388. [PMID: 35406000 PMCID: PMC9002648 DOI: 10.3390/nu14071388] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity, and obesity-associated conditions such as hypertension, chronic kidney disease, type 2 diabetes, and cardiovascular disease, are important risk factors for severe Coronavirus disease-2019 (COVID-19). The common denominator is metaflammation, a portmanteau of metabolism and inflammation, which is characterized by chronically elevated levels of leptin and pro-inflammatory cytokines. These induce the “Suppressor Of Cytokine Signaling 1 and 3” (SOCS1/3), which deactivates the leptin receptor and also other SOCS1/3 sensitive cytokine receptors in immune cells, impairing the type I and III interferon early responses. By also upregulating SOCS1/3, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 adds a significant boost to this. The ensuing consequence is a delayed but over-reactive immune response, characterized by high-grade inflammation (e.g., cytokine storm), endothelial damage, and hypercoagulation, thus leading to severe COVID-19. Superimposing an acute disturbance, such as a SARS-CoV-2 infection, on metaflammation severely tests resilience. In the long run, metaflammation causes the “typical western” conditions associated with metabolic syndrome. Severe COVID-19 and other serious infectious diseases can be added to the list of its short-term consequences. Therefore, preventive measures should include not only vaccination and the well-established actions intended to avoid infection, but also dietary and lifestyle interventions aimed at improving body composition and preventing or reversing metaflammation.
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13
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Hewitt RM, Pattinson R, Daniel R, Carrier J, Sanders O, Bundy C. Online survey comparing coping responses to SARS-CoV-2 by people with and without existing health conditions in the UK. BMJ Open 2022; 12:e051575. [PMID: 35144948 PMCID: PMC8845092 DOI: 10.1136/bmjopen-2021-051575] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the impact of SARS-CoV-2 on self-reported mood, coping and health behaviours of people living with existing health conditions in the UK to understand how to improve coping responses to the threat of SARS-CoV-2. DESIGN Quantitative design using a cross-sectional survey. SETTING Online survey in the UK. PARTICIPANTS UK adults (18+ years) were eligible to participate. A total of 9110 people participated. Of these, 4377 (48%) reported at least one existing health condition, 874 (10%) reported having two or more existing conditions, and 715 (8%) reported having an existing mental health condition. PRIMARY AND SECONDARY OUTCOME MEASURES Multivariable linear regression and sequential multiple mediation analysis were used to estimate differences in average scores for active and avoidant coping response scores due to pre-existing health conditions, and to investigate the extent to which these differences are explained by differences in perceptions, beliefs, concerns and mood. RESULTS People with pre-existing physical (+1.11 higher; 95% CI 0.88 to 1.34) and especially mental health conditions (3.06 higher; 95% CI 2.65 to 3.48) reported poorer health and used more avoidant coping compared with healthy participants. Under some strong untestable assumptions, we estimate that experiencing low mood or concern related to SARS-CoV-2 mostly explained the relationship between existing health conditions and avoidant coping. CONCLUSION Psychological support and interventions including behaviour change are required to mitigate the psychological burden of the SARS-CoV-2 pandemic and increase autonomy in people with and without pre-existing conditions during this highly uncertain time. Psychologists are well placed to support clinicians and people with existing health conditions to minimise the psychological impact of SARS-CoV-2, in order to alleviate the subsequent strain on healthcare services.
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Affiliation(s)
| | | | - Rhian Daniel
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Judith Carrier
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Oliver Sanders
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Christine Bundy
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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14
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Moradpour G, Amini M, Moeinvaziri N, Hosseini SV, Rajabi S, Clark CCT, Hosseini B, Vafa L, Haghighat N. Bariatric Surgery and COVID-19: What We Have Learned from the Pandemic in Iran: a Retrospective Observational Cohort Study. Obes Surg 2022; 32:18-25. [PMID: 34716898 PMCID: PMC8556836 DOI: 10.1007/s11695-021-05761-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/10/2021] [Accepted: 10/18/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Little is known about the symptoms of coronavirus disease 2019 (COVID-19) on patients with morbid obesity following bariatric surgery (BS) in Iran. Thus, we sought to investigate the symptoms and effect of COVID-19 in patients with morbid obesity following, or candidates for, BS in Iran. MATERIALS AND METHODS In this retrospective observational cohort study, we enrolled 236 morbid obese patients following (surgical group) or candidates (nonsurgical group) for bariatric surgery. Demographics, probable COVID-19 incidence, acute and persistent COVID-19 symptoms, and clinical outcome parameters of bariatric patients and candidates for BS were compared. The incidence of probable COVID-19 was assessed including the clinical definition of probable case, according to World Health Organization criteria. RESULTS The incidence of probable COVID-19 among surgical and nonsurgical groups was significantly different (20.6% vs 26.08%, respectively, p = 0.046). The probable case of surgical patients had a shorter length of symptoms and hospitalization duration, and a lower proportion of admission in ICUs and hospitals with respect to nonsurgical patients (p < 0.001). Surgical patients had a greater prevalence of persistent symptoms including anorexia, food intolerance, and anosmia-hyposmia than nonsurgical patients. Moreover, surgical patients with probable COVID-19 had a significantly higher proportion of diabetic patients than surgical patients without probable COVID-19 (20% vs 9.3%). CONCLUSION These findings highlight the need to evaluate the persistent symptoms of COVID-19 and the importance of nutritional support for at least several weeks after COVID-19 symptom onset. Moreover, it seems that COVID-19 incidence in post-bariatric surgery patients could reduce the effectiveness of bariatric surgery in the resolution of diabetes.
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Affiliation(s)
- Gholamreza Moradpour
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Amini
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Moeinvaziri
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Vahid Hosseini
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shirin Rajabi
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Babak Hosseini
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Vafa
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Haghighat
- laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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15
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Brasil S, Renck AC, Taccone FS, Fontoura Solla DJ, Tomazini BM, Wayhs SY, Fonseca S, Bassi E, Lucena B, De Carvalho Nogueira R, Paiva W, Teixeira MJ, Frade Costa EM, Sá Malbouisson LM. Obesity and its implications on cerebral circulation and intracranial compliance in severe COVID-19. Obes Sci Pract 2021; 7:751-759. [PMID: 34226849 PMCID: PMC8242615 DOI: 10.1002/osp4.534] [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: 03/08/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 12/16/2022] Open
Abstract
Objective Multiple factors have been identified as causes of intracranial compliance impairment (ICCI) among patients with obesity. On the other hand, obesity has been linked with worst outcomes in COVID-19. Thus, the hypothesis of severe acute respiratory syndrome (SARS) conducing to cerebral hemodynamic disorders (CHD) able to worsen ICCI and play an additional role on prognosis determination for COVID-19 among obese patients becomes suitable. Methods 50 cases of SARS by COVID-19 were evaluated, for the presence of ICCI and cerebrovascular circulatory disturbances in correspondence with whether unfavorable outcomes (death or impossibility for mechanical ventilation weaning [MVW]) within 7 days after evaluation. The objective was to observe whether obese patients (BMI ≥ 30) disclosed worse outcomes and tests results compared with lean subjects with same clinical background. Results 23 (46%) patients among 50 had obesity. ICCI was verified in 18 (78%) obese, whereas in 13 (48%) of 27 non-obese (p = 0,029). CHD were not significantly different between groups, despite being high prevalent in both. 69% unfavorable outcomes were observed among obese and 44% for lean subjects (p = 0,075). Conclusion In the present study, intracranial compliance impairment was significantly more observed among obese subjects and may have contributed for SARS COVID-19 worsen prognosis.
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16
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Li C, Islam N, Gutierrez JP, Lacey B, Moolenaar RL, Richter P. Diabetes, obesity, hypertension and risk of severe COVID-19: a protocol for systematic review and meta-analysis. BMJ Open 2021; 11:e051711. [PMID: 34836901 PMCID: PMC8628113 DOI: 10.1136/bmjopen-2021-051711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Previous evidence from several countries, including China, Italy, Mexico, UK and the USA, indicates that among patients with confirmed COVID-19 who were hospitalised, diabetes, obesity and hypertension might be important risk factors for severe clinical outcomes. Several preliminary systematic reviews and meta-analyses have been conducted on one or more of these non-communicable diseases, but the findings have not been definitive, and recent evidence has become available from many more populations. Thus, we aim to conduct a systematic review and meta-analysis of observational studies to assess the relationship of diabetes, obesity and hypertension with severe clinical outcomes in patients with COVID-19. METHOD AND ANALYSIS We will search 16 major databases (MEDLINE, Embase, Global Health, CAB Abstracts, PsycINFO, CINAHL, Academic Research Complete, Africa Wide Information, Scopus, PubMed Central, ProQuest Central, WHO Virtual Health Library, Homeland Security COVID-19 collection, SciFinder, Clinical Trials and Cochrane Library) for articles published between December 2019 and December 2020. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2016 guidelines for the design and reporting the results. We will include observational studies that assess the associations of pre-existing diabetes, obesity and hypertension in patients with COVID-19 with risk of severe clinical outcomes such as intensive care unit admission, receiving mechanical ventilation or death. Stata V.16.1 and R-Studio V.1.4.1103 statistical software will be used for statistical analysis. Meta-analysis will be used to estimate the pooled risks and to assess potential heterogeneities in risks. ETHICS AND DISSEMINATION The study was reviewed for human subjects concerns by the US CDC Center for Global Health and determined to not represent human subjects research because it uses data from published studies. We plan to publish results in a peer-reviewed journal and present at national and international conferences. PROSPERO REGISTRATION NUMBER CRD42021204371.
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Affiliation(s)
- Chaoyang Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nazrul Islam
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Juan Pablo Gutierrez
- Center for Policy, Population and Health Research, School of Medicine, National Autonomous University of Mexico, CDMX, Mexico
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ronald L Moolenaar
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patricia Richter
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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17
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Manolis AS, Manolis AA, Manolis TA, Apostolaki NE, Melita H. COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship. Obes Res Clin Pract 2021; 15:523-535. [PMID: 34799284 PMCID: PMC8563353 DOI: 10.1016/j.orcp.2021.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 10/10/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023]
Abstract
During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings are consistent, the higher the body mass index (BMI) the worse the outcomes. Ectopic (visceral) obesity also promotes proinflammatory, prothrombotic, and vasoconstrictive states, thus enhancing the deleterious effects of COVID-19 disease. Less, albeit robust, evidence also exists for a higher risk of COVID-19 infection incurred with underweight. Thus, the relationship of COVID-19 and BMI has a J-curve pattern, where patients with both overweight/obesity and underweight are more susceptible to the ailments of COVID-19. The pathophysiology underlying this link is multifactorial, mostly relating to the inflammatory state characterizing obesity, the impaired immune response to infectious agents coupled with increased viral load, the overexpression in adipose tissue of the receptors and proteases for viral entry, an increased sympathetic activity, limited cardiorespiratory reserve, a prothrombotic milieu, and the associated comorbidities. All these issues are herein reviewed, the results of large studies and meta-analyses are tabulated and the pathogenetic mechanisms and the BMI relationship with COVID-19 are pictorially illustrated.
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18
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Schaller MA, Sharma Y, Dupee Z, Nguyen D, Urueña J, Smolchek R, Loeb JC, Machuca TN, Lednicky JA, Odde DJ, Campbell RF, Sawyer WG, Mehrad B. Ex vivo SARS-CoV-2 infection of human lung reveals heterogeneous host defense and therapeutic responses. JCI Insight 2021; 6:e148003. [PMID: 34357881 PMCID: PMC8492301 DOI: 10.1172/jci.insight.148003] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022] Open
Abstract
Cell lines are the mainstay in understanding the biology of COVID-19 infection but do not recapitulate many of the complexities of human infection. The use of human lung tissue is one solution for the study of such novel respiratory pathogens. We hypothesized that a cryopreserved bank of human lung tissue would allow for the ex vivo study of the interindividual heterogeneity of host response to SARS-CoV-2, thus providing a bridge between studies with cell lines and studies in animal models. We generated a cryobank of tissues from 21 donors, many of whom had clinical risk factors for severe COVID-19. Cryopreserved tissues preserved 90% cell viability and contained heterogenous populations of metabolically active epithelial, endothelial, and immune cell subsets of the human lung. Samples were readily infected with HCoV-OC43 and SARS-CoV-2 and demonstrated comparable susceptibility to infection. In contrast, we observed a marked donor-dependent heterogeneity in the expression of IL6, CXCL8, and IFNB1 in response to SARS-CoV-2. Treatment of tissues with dexamethasone and the experimental drug N-hydroxycytidine suppressed viral growth in all samples, whereas chloroquine and remdesivir had no detectable effect. Metformin and sirolimus, molecules with predicted but unproven antiviral activity, each suppressed viral replication in tissues from a subset of donors. In summary, we developed a system for the ex vivo study of human SARS-CoV-2 infection using primary human lung tissue from a library of donor tissues. This model may be useful for drug screening and for understanding basic mechanisms of COVID-19 pathogenesis.
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Affiliation(s)
- Matthew A. Schaller
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine
| | - Yamini Sharma
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine
| | - Zadia Dupee
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine
| | - Duy Nguyen
- Department of Mechanical and Aerospace Engineering, Herbert Wertheim College of Engineering
| | - Juan Urueña
- Department of Mechanical and Aerospace Engineering, Herbert Wertheim College of Engineering
| | - Ryan Smolchek
- Department of Mechanical and Aerospace Engineering, Herbert Wertheim College of Engineering
| | - Julia C. Loeb
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute; and
| | - Tiago N. Machuca
- Division of Cardiothoracic Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute; and
| | - David J. Odde
- Department of Biomedical Engineering, College of Science and Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert F. Campbell
- Department of Drug Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - W. Gregory Sawyer
- Department of Mechanical and Aerospace Engineering, Herbert Wertheim College of Engineering
| | - Borna Mehrad
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine
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19
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Sattar N, Valabhji J. Obesity as a Risk Factor for Severe COVID-19: Summary of the Best Evidence and Implications for Health Care. Curr Obes Rep 2021; 10:282-289. [PMID: 34374955 PMCID: PMC8353061 DOI: 10.1007/s13679-021-00448-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW To collate the best evidence from several strands-epidemiological, genetic, comparison with historical data and mechanistic information-and ask whether obesity is an important causal and potentially modifiable risk factor for severe COVID-19 outcomes. RECENT FINDINGS Several hundred studies provide powerful evidence that body mass index (BMI) is a strong linear risk factor for severe COVID-19 outcomes, with recent studies suggesting ~5-10% higher risk for COVID-19 hospitalisation per every kg/m2 higher BMI. Genetic data concur with hazard ratios increasing by 14% per every kg/m2 higher BMI. BMI to COVID-19 links differ markedly from prior BMI-infection associations and are further supported as likely causal by multiple biologically plausible pathways. Excess adiposity appears to be an important, modifiable risk factor for adverse COVID-19 outcomes across all ethnicities. The pandemic is also worsening obesity levels. It is imperative that medical systems worldwide meet this challenge by upscaling investments in obesity prevention and treatments.
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Affiliation(s)
- Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
| | - Jonathan Valabhji
- NHS England & Improvement, London, UK
- Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
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20
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Messiah SE, Xie L, Mathew MS, Delclos GL, Kohl HW, Kahn JS. Results of COVID-19 Surveillance in a Large United States Pediatric Healthcare System over One Year. CHILDREN-BASEL 2021; 8:children8090752. [PMID: 34572184 PMCID: PMC8468442 DOI: 10.3390/children8090752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/21/2022]
Abstract
Background: The lack of SARS-CoV-2 antigen surveillance testing in the pediatric population has inhibited accurate infection and hospitalization prevalence estimates. We aim to report the estimated prevalence of and risk factors for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission across the three United States (US) waves in one of the largest pediatric healthcare systems in the nation. Methods: Retrospective electronic health record (EHR) review of all COVID-19 surveillance data among children aged 0–19 years seeking healthcare at one pediatric healthcare system that serves predominantly Medicaid-dependent families from 1 March 2020 to 31 March 2021. COVID-19 infection status (Y/N), hospital admission (Y/N), and ICU admission (Y/N) are the main outcomes. Results: Of 22,377 children aged ≤ 19 years tested for SARS-CoV-2 infection from March 2020–March 2021, 3126 were positive (14.0%), and out of those positive, 53.7% were hospitalized and 2.9% were admitted to the ICU. Compared to Wave 1 (1 March 2020–31 May 2020), the risk of a positive test increased from 16% (RR 1.16, 95% CI, 1.07–1.26) in Wave 2 (1 June 2020–31 October 2020) to 33% (RR 1.33, 95% CI, 1.23–1.44) in Wave 3 (1 November 2020–31 March 2021). Similarly, compared to Wave 1, the risk for hospitalization increased 86% (RR 1.86, 95% CI, 1.86–2.06) in Wave 2 and 89% in Wave 3 (RR 1.89, 95% CI, 1.70–2.08), and the risk for ICU admission increased from 10% in Wave 2 (RR 1.10, 95% CI, 0.39–3.01) to 310% in Wave 3 (RR 3.10, 95% CI, 1.21–7.80). Children with asthma, depressive disorders, type 1 or 2 diabetes, and anemia were more likely to be hospitalized while children with diabetes, obesity, cardiac malformations, and hypertension were more likely to be admitted to the ICU versus children without these conditions. Conclusions: Children were cumulatively impacted by the COVID-19 pandemic through the three US waves with more than a third hospitalized in Wave 3. Children with underlying health conditions were particularly at risk for severe illness and should be monitored for any long-term impacts.
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Affiliation(s)
- Sarah E. Messiah
- University of Texas Health Science Center at Houston, School of Public Health, Dallas Campus, Dallas, TX 75390, USA; (L.X.); (M.S.M.)
- Center for Pediatric Population Health, UTHealth School of Public Health at Houston and Children’s Health System of Texas, Dallas, TX 75390, USA
- Correspondence: or ; Tel.: +1-972-546-2919
| | - Luyu Xie
- University of Texas Health Science Center at Houston, School of Public Health, Dallas Campus, Dallas, TX 75390, USA; (L.X.); (M.S.M.)
- Center for Pediatric Population Health, UTHealth School of Public Health at Houston and Children’s Health System of Texas, Dallas, TX 75390, USA
| | - Matthew S. Mathew
- University of Texas Health Science Center at Houston, School of Public Health, Dallas Campus, Dallas, TX 75390, USA; (L.X.); (M.S.M.)
- Center for Pediatric Population Health, UTHealth School of Public Health at Houston and Children’s Health System of Texas, Dallas, TX 75390, USA
| | - George L. Delclos
- University of Texas Health Science Center at Houston, School of Public Health, Houston Campus, Houston, TX 77225, USA;
| | - Harold W. Kohl
- University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin, TX, USA;
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX 78712, USA
| | - Jeffrey S. Kahn
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
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21
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Treskova-Schwarzbach M, Haas L, Reda S, Pilic A, Borodova A, Karimi K, Koch J, Nygren T, Scholz S, Schönfeld V, Vygen-Bonnet S, Wichmann O, Harder T. Pre-existing health conditions and severe COVID-19 outcomes: an umbrella review approach and meta-analysis of global evidence. BMC Med 2021; 19:212. [PMID: 34446016 PMCID: PMC8390115 DOI: 10.1186/s12916-021-02058-6] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/08/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study applies an umbrella review approach to summarise the global evidence on the risk of severe COVID-19 outcomes in patients with pre-existing health conditions. METHODS Systematic reviews (SRs) were identified in PubMed, Embase/Medline and seven pre-print servers until December 11, 2020. Due to the absence of age-adjusted risk effects stratified by geographical regions, a re-analysis of the evidence was conducted. Primary studies were extracted from SRs and evaluated for inclusion in the re-analysis. Studies were included if they reported risk estimates (odds ratio (OR), hazard ratio (HR), relative risk (RR)) for hospitalisation, intensive care unit admission, intubation or death. Estimated associations were extracted from the primary studies for reported pre-existing conditions. Meta-analyses were performed stratified for each outcome by regions of the World Health Organization. The evidence certainty was assessed using GRADE. Registration number CRD42020215846. RESULTS In total, 160 primary studies from 120 SRs contributed 464 estimates for 42 pre-existing conditions. Most studies were conducted in North America, European, and Western Pacific regions. Evidence from Africa, South/Latin America, and the Eastern Mediterranean region was scarce. No evidence was available from the South-East Asia region. Diabetes (HR range 1.2-2.0 (CI range 1.1-2.8)), obesity (OR range 1.5-1.75 (CI range 1.1-2.3)), heart failure (HR range 1.3-3.3 (CI range 0.9-8.2)), COPD (HR range 1.12-2.2 (CI range 1.1-3.2)) and dementia (HR range 1.4-7.7 (CI range 1.2-39.6)) were associated with fatal COVID-19 in different regions, although the estimates varied. Evidence from Europe and North America showed that liver cirrhosis (OR range 3.2-5.9 (CI range 0.9-27.7)) and active cancer (OR range 1.6-4.7 (CI range 0.5-14.9)) were also associated with increased risk of death. Association between HIV and undesirable COVID-19 outcomes showed regional heterogeneity, with an increased risk of death in Africa (HR 1.7 (CI 1.3-2.2)). GRADE certainty was moderate to high for most associations. CONCLUSION Risk of undesirable COVID-19 health outcomes is consistently increased in certain patient subgroups across geographical regions, showing high variability in others. The results can be used to inform COVID-19 vaccine prioritisation or other intervention strategies.
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Affiliation(s)
| | - Laura Haas
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sarah Reda
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Antonia Pilic
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Anna Borodova
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Kasra Karimi
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Judith Koch
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Teresa Nygren
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Stefan Scholz
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Viktoria Schönfeld
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sabine Vygen-Bonnet
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Ole Wichmann
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Thomas Harder
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
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22
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Mulugeta W, Desalegn H, Solomon S. Impact of the COVID-19 pandemic lockdown on weight status and factors associated with weight gain among adults in Massachusetts. Clin Obes 2021; 11:e12453. [PMID: 33855789 PMCID: PMC8250379 DOI: 10.1111/cob.12453] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/06/2021] [Accepted: 03/18/2021] [Indexed: 12/20/2022]
Abstract
The study aims to examine the impact of the coronavirus disease-2019 (COVID-19) pandemic lockdown on weight, overweight and obesity, and identify factors associated with weight gain. At a safety net health system in Massachusetts, 11 534 adults were retrospectively followed within 3 months of the COVID-19 lockdown. Chi-square and 95% confidence intervals (CI) were reported for categorical and continues variables, respectively. Multivariate analyses were performed to identify factors associated with weight gain (≥0.01 kg and 5%). During the lockdown period, greater proportion of women gained weight compared to men (46.1% vs 40.6%, P < .01). The obesity rate after the lockdown increased among women (40.7%-41.7, P < .01) but decreased among men (39.6%-38.6, P < .01) compared to before the lockdown. Post-lockdown obesity rates increased among Haitian (51.2%-55.0%, P < .01) and Hispanic women (50.7%-51.8%, P < .01). More than 5% weight gain was associated with 18 to 39 vs ≥60 years of age (OR = 1.45, 95% CI = 1.07, 1.97), food and housing insecurity (OR = 1.44, 95% CI = 1.05, 1.97) and tobacco use (OR = 1.38, 95% CI = 1.07, 1.78) among men; and 18 to 39 vs ≥60 years of age (OR = 1.55, 95% CI = 1.25, 1.91), Hispanics (OR = 1.25, 95% CI = 1.01, 1.54), Brazilians (OR = 1.22, 95% CI = 1.03, 1.45), and tobacco use (OR = 1.36, 95% CI = 1.10, 1.69) among women. During the COVID-19 lockdown, significant proportion of participants gained weight, but subgroup variations existed. Our study can inform healthcare professionals about the impact of the lockdown on unhealthy weight gain and identify vulnerable populations. Strategies are needed to combat unhealthy weight gain during and beyond the pandemic.
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Affiliation(s)
- Wudeneh Mulugeta
- Harvard Medical SchoolDepartment of Medicine, Cambridge Health AllianceRevereMassachusettsUSA
| | - Hailemicheal Desalegn
- Department of Internal MedicineSt. Paul's Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Samrawit Solomon
- Department of Public HealthSt. Paul's Hospital Millennium Medical CollegeAddis AbabaEthiopia
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23
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Yamada G, Hayakawa K, Matsunaga N, Terada M, Suzuki S, Asai Y, Ohtsu H, Toyoda A, Kitajima K, Tsuzuki S, Saito S, Ohmagari N. Predicting respiratory failure for COVID-19 patients in Japan: a simple clinical score for evaluating the need for hospitalisation. Epidemiol Infect 2021; 149:e175. [PMID: 36043382 PMCID: PMC8365048 DOI: 10.1017/s0950268821001837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Predicting the need for hospitalisation of patients with coronavirus disease 2019 (COVID-19) is important for preventing healthcare disruptions. This observational study aimed to use the COVID-19 Registry Japan (COVIREGI-JP) to develop a simple scoring system to predict respiratory failure due to COVID-19 using only underlying diseases and symptoms. A total of 6873 patients with COVID-19 admitted to Japanese medical institutions between 1 June 2020 and 2 December 2020 were included and divided into derivation and validation cohorts according to the date of admission. We used multivariable logistic regression analysis to create a simple risk score model, with respiratory failure as the outcome for young (18-39 years), middle-aged (40-64 years) and older (≥65 years) groups, using sex, age, body mass index, medical history and symptoms. The models selected for each age group were quite different. Areas under the receiver operating characteristic curves for the simple risk score model were 0.87, 0.79 and 0.80 for young, middle-aged and elderly derivation cohorts, and 0.81, 0.80 and 0.67 in the validation cohorts. Calibration of the model was good. The simple scoring system may be useful in the appropriate allocation of medical resources during the COVID-19 pandemic.
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Affiliation(s)
- Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Author for correspondence: Gen Yamada, E-mail:
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Setsuko Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Ohtsu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ako Toyoda
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Kitajima
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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24
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A Clinical Monitoring Program of COVID-19 Outpatients: A Prospective Cohort Study. ACTA ACUST UNITED AC 2021; 2021:6644570. [PMID: 34336065 PMCID: PMC8292082 DOI: 10.1155/2021/6644570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/05/2021] [Indexed: 01/08/2023]
Abstract
Purpose Coronavirus disease 2019 (COVID-19) has been associated with a high rate of mortality and morbidity. While a high portion of COVID-19 patients have mild symptoms, a limited number of clinical trials have evaluated the clinical course of this large group of patients. This study was designed to investigate the demographics and clinical characteristics and comorbidity of nonhospitalized COVID-19 patients. Methods This prospective, observational cohort study was performed on nonhospitalized adult patients (≥18 years) with COVID-19. Pharmacotherapy service was responsible for patients' assessment for up to 1 month. Demographic characteristics, the onset of symptoms, severity, duration, laboratory data, and hospitalization rate were evaluated by a pharmacist-based monitoring program. Results From 323 patients who had been referred to the emergency department, 105 individuals were recruited between April 26 and August 2, 2020. Most of the patients were female (66.7%) with a mean age of 39.39 years (SD: ± 15.82). The mean time of the symptom onset was 5.6 days (SD: ±1.79). The majority of patients suffered from fatigue (78.1%), sore throat (67.6%), cough (60%), and myalgia (55.2%). C-reactive protein, white blood cell, lymphocyte, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and hemoglobin levels were recovered significantly during the first two weeks (P < 0.001). Hydroxychloroquine, naproxen, diphenhydramine, azithromycin, and vitamin D3 were the most common medications administered (98%, 96%, 94%, 68%, and 57%, respectively). Forty patients were not symptom-free after the one-month follow-up, and 8 patients (7.6%) were required to revisit without the need for hospitalization. Anosmia (18.1%) and fatigue (17.1%) were the most common persisted symptoms. There were no significant differences between symptom-free and symptomatic patients. Conclusion Mild COVID-19 patients had a wide variety of symptoms and could be symptomatic even one month after the onset of symptoms. The pharmacist-based monitoring system can contribute beneficially to patients through the evaluation of symptoms, reduction of unnecessary visits, and provision of updated information to patients concerning the status of their illness.
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Bailly S, Fabre O, Legrand R, Pantagis L, Mendelson M, Terrail R, Tamisier R, Astrup A, Clément K, Pépin JL. The Impact of the COVID-19 Lockdown on Weight Loss and Body Composition in Subjects with Overweight and Obesity Participating in a Nationwide Weight-Loss Program: Impact of a Remote Consultation Follow-Up-The CO-RNPC Study. Nutrients 2021; 13:nu13072152. [PMID: 34201490 PMCID: PMC8308256 DOI: 10.3390/nu13072152] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on weight loss and body composition modifications in subjects participating in a weight loss program and to evaluate the impact of remote consultations on participants’ adherence to the weight loss program. The CO-RNPC study was a prospective multicentre cohort study including participants undergoing a two to six months program. The rate of weight loss in kg/week was computed before (15 days), during (99 days) and after LD (15 days). In the 1550 completing participants, body weight decreased from 87.1 kg [IQR 77.0; 100.2] to 82.3 kg [72.1; 94.3] resulting in a difference of −4.79 kg [−4.48; −5.10] (p < 0.01), with a corresponding reduction in waist circumference by 4 cm ([0; 9], p < 0.01). The median weight loss was 4.4 kg [0.5; 9.4] in those who used remote consultations, and 1.4 kg [0.8; 5.7] in the no remote consultation group (p < 0.01). In this large prospective cohort, we observed that the rate of weight loss was reduced during LD. This reduction was counterbalanced in participants involved in a remote consultation follow-up with a dose-effect response based on the number of remote consultations.
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Affiliation(s)
- Sébastien Bailly
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
- Correspondence:
| | - Odile Fabre
- Groupe Éthique et Santé. Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.); (L.P.)
| | - Rémy Legrand
- Groupe Éthique et Santé. Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.); (L.P.)
| | - Laurent Pantagis
- Groupe Éthique et Santé. Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.); (L.P.)
| | - Monique Mendelson
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
| | - Robin Terrail
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
| | - Renaud Tamisier
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1165 Copenhagen, Denmark;
| | - Karine Clément
- Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 75013 Paris, France;
- Nutrition and Obesities: Systemic Approaches (NutriOmics) Research Unit, Sorbonne Université, INSERM, 75013 Paris, France
| | - Jean-Louis Pépin
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
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26
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Kompaniyets L, Agathis NT, Nelson JM, Preston LE, Ko JY, Belay B, Pennington AF, Danielson ML, DeSisto CL, Chevinsky JR, Schieber LZ, Yusuf H, Baggs J, Mac Kenzie WR, Wong KK, Boehmer TK, Gundlapalli AV, Goodman AB. Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children. JAMA Netw Open 2021; 4:e2111182. [PMID: 34097050 PMCID: PMC8185607 DOI: 10.1001/jamanetworkopen.2021.11182] [Citation(s) in RCA: 224] [Impact Index Per Article: 74.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPORTANCE Information on underlying conditions and severe COVID-19 illness among children is limited. OBJECTIVE To examine the risk of severe COVID-19 illness among children associated with underlying medical conditions and medical complexity. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included patients aged 18 years and younger with International Statistical Classification of Diseases, Tenth Revision, Clinical Modification code U07.1 (COVID-19) or B97.29 (other coronavirus) during an emergency department or inpatient encounter from March 2020 through January 2021. Data were collected from the Premier Healthcare Database Special COVID-19 Release, which included data from more than 800 US hospitals. Multivariable generalized linear models, controlling for patient and hospital characteristics, were used to estimate adjusted risk of severe COVID-19 illness associated with underlying medical conditions and medical complexity. EXPOSURES Underlying medical conditions and medical complexity (ie, presence of complex or noncomplex chronic disease). MAIN OUTCOMES AND MEASURES Hospitalization and severe illness when hospitalized (ie, combined outcome of intensive care unit admission, invasive mechanical ventilation, or death). RESULTS Among 43 465 patients with COVID-19 aged 18 years or younger, the median (interquartile range) age was 12 (4-16) years, 22 943 (52.8%) were female patients, and 12 491 (28.7%) had underlying medical conditions. The most common diagnosed conditions were asthma (4416 [10.2%]), neurodevelopmental disorders (1690 [3.9%]), anxiety and fear-related disorders (1374 [3.2%]), depressive disorders (1209 [2.8%]), and obesity (1071 [2.5%]). The strongest risk factors for hospitalization were type 1 diabetes (adjusted risk ratio [aRR], 4.60; 95% CI, 3.91-5.42) and obesity (aRR, 3.07; 95% CI, 2.66-3.54), and the strongest risk factors for severe COVID-19 illness were type 1 diabetes (aRR, 2.38; 95% CI, 2.06-2.76) and cardiac and circulatory congenital anomalies (aRR, 1.72; 95% CI, 1.48-1.99). Prematurity was a risk factor for severe COVID-19 illness among children younger than 2 years (aRR, 1.83; 95% CI, 1.47-2.29). Chronic and complex chronic disease were risk factors for hospitalization, with aRRs of 2.91 (95% CI, 2.63-3.23) and 7.86 (95% CI, 6.91-8.95), respectively, as well as for severe COVID-19 illness, with aRRs of 1.95 (95% CI, 1.69-2.26) and 2.86 (95% CI, 2.47-3.32), respectively. CONCLUSIONS AND RELEVANCE This cross-sectional study found a higher risk of severe COVID-19 illness among children with medical complexity and certain underlying conditions, such as type 1 diabetes, cardiac and circulatory congenital anomalies, and obesity. Health care practitioners could consider the potential need for close observation and cautious clinical management of children with these conditions and COVID-19.
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Affiliation(s)
- Lyudmyla Kompaniyets
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nickolas T. Agathis
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M. Nelson
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Leigh Ellyn Preston
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jean Y. Ko
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Brook Belay
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Audrey F. Pennington
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Melissa L. Danielson
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carla L. DeSisto
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer R. Chevinsky
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lyna Z. Schieber
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hussain Yusuf
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James Baggs
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William R. Mac Kenzie
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Karen K. Wong
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Tegan K. Boehmer
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
| | - Adi V. Gundlapalli
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alyson B. Goodman
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, Georgia
- US Public Health Service Commissioned Corps, Rockville, Maryland
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Ali AM, Kunugi H. Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era. Int J Endocrinol 2021; 2021:5563960. [PMID: 34113379 PMCID: PMC8152925 DOI: 10.1155/2021/5563960] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/22/2021] [Accepted: 04/30/2021] [Indexed: 01/08/2023] Open
Abstract
Although the numbers of aged populations have risen considerably in the last few decades, the current coronavirus disease 2019 (COVID-19) has revealed an extensive vulnerability among these populations. Sarcopenia is an age-related disorder that increases hospitalization, dependencies, and mortality in older adults. It starts to develop in midlife or even earlier as a result of unbalanced diet/poor nutrition and low levels of physical activity, in addition to chronic disorders such as obesity and diabetes mellitus. Given that social isolation is adopted as the most protective measure against COVID-19, the level of physical activity and the intake of adequate diet have considerably declined, especially among older adults-denoting an increased possibility for developing sarcopenia. Research also shows a higher vulnerability of sarcopenic people to COVID-19 as well as the development of wasting disorders such as sarcopenia and cachexia in a considerable proportion of symptomatic and recovering COVID-19 patients. Muscular wasting in COVID-19 is associated with poor prognosis. Accordingly, early detection and proper management of sarcopenia and wasting conditions in older adults and COVID-19 patients may minimize morbidity and mortality during the current COVID-19 crisis. This review explored different aspects of screening for sarcopenia, stressing their relevance to the detection of altered muscular structure and performance in patients with COVID-19. Current guidelines recommend prior evaluation of muscle strength by simple measures such as grip strength to identify individuals with proven weakness who then would be screened for muscle mass loss. The latter is best measured by MRI and CT. However, due to the high cost and radiation risk entailed by these techniques, other simpler and cheaper techniques such as DXA and ultrasound are given preference. Muscle loss in COVID-19 patients was measured during the acute phase by CT scanning of the pectoralis muscle simultaneously during a routine check for lung fibrosis, which seems to be an efficient evaluation of sarcopenia among those patients with no additional cost. In recovering patients, muscle strength and physical performance have been evaluated by electromyography and traditional tests such as the six-minute walk test. Effective preventive and therapeutic interventions are necessary in order to prevent muscle loss and associated physical decline in COVID-19 patients.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Hiroshi Kunugi
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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28
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Qaisieh R, Al-Tamimi M, El-Hammuri N, Shalabi M, Kilani MM, Taha H, Al-Muhtaseb A, Alfarrajin I, Abu Shaqra M, Hamdan A. Comparative study of Clinical, Laboratory, and Imaging Features of COVID-19. JMIR Public Health Surveill 2021; 7:e28005. [PMID: 34081600 PMCID: PMC8457339 DOI: 10.2196/28005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 12/31/2022] Open
Abstract
Background The clinical, laboratory, and imaging features of COVID-19 disease are variable. Multiple factors can affect the disease progression and outcome. Objective This study aimed to analyze the clinical, laboratory, and imaging features of COVID-19 in Jordan. Methods Clinical, laboratory, and imaging data were collected for 557 confirmed COVID-19 patients admitted to Prince Hamzah Hospital (PHH), Jordan. Analysis was performed using appropriate statistical tests with SPSS version 24. Results Of the 557 COVID-19 polymerase chain reaction (PCR)-positive cases admitted to PHH, the mean age was 34.4 years (SD 18.95 years; range 5 weeks to 87 years), 86.0% (479/557) were male, 41% (29/70) were blood group A+, and 57.1% (93/163) were overweight or obese. Significant past medical history was documented in 25.9% (144/557), significant surgical history in 12.6% (70/557), current smoking in 14.9% (83/557), and pregnancy in 0.5% (3/557). The mean duration of hospitalization was 16.4 (SD 9.3; range 5 to 70) days; 52.6% (293/557) were asymptomatic, and 12.9% (72/557) had more than 5 symptoms, with generalized malaise and dry cough the most common symptoms. Only 2.5% (14/557) had a respiratory rate over 25 breaths/minute, and 1.8% (10/557) had an oxygen saturation below 85%. Laboratory investigations showed a wide range of abnormalities, with lymphocytosis and elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and D-dimer the most common abnormalities. Ground glass opacity was the most common imaging finding. Men had a significantly higher frequency of symptoms, incidence of smoking, reduced hemoglobin, increased monocyte %, elevated creatinine levels, and intensive care unit admissions compared with women (P<.05). Hospitalization duration was associated with increased age, male gender, symptom score, history of smoking, elevated systolic blood pressure, elevated respiratory rate, and elevated monocyte %, CRP, ESR, creatinine, and D-dimer (P<.05). Conclusions Most COVID-19 cases admitted to PHH were asymptomatic. Variabilities in symptoms, signs, laboratory results, and imaging findings should be noted. Increased age, male gender, smoking history, and elevated inflammatory markers were significantly associated with longer duration of hospitalization.
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Affiliation(s)
- Rami Qaisieh
- Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, JO
| | - Mohammad Al-Tamimi
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Damascus Highway, Zarqa, JO
| | - Naser El-Hammuri
- Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, JO
| | - Marwan Shalabi
- Department of Pediatrics and Neonatology, Faculty of Medicine, Hashemite University, Zarqa, JO
| | - Muna M Kilani
- Department of Pediatrics and Neonatology, Faculty of Medicine, Hashemite University, Zarqa, JO
| | - Hana Taha
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Damascus Highway, Zarqa, JO.,Global Health Development- Eastern Mediterranean Public health Network, Amman, JO.,Department of Neuroscience, caring science and society, Karolinska Institute,, Stockholm, SE
| | - Abdallah Al-Muhtaseb
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Damascus Highway, Zarqa, JO
| | - Ibrahim Alfarrajin
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Damascus Highway, Zarqa, JO
| | - Marwan Abu Shaqra
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Damascus Highway, Zarqa, JO
| | - Almothana Hamdan
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Damascus Highway, Zarqa, JO
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29
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Caussy C. Obésité et infection par la COVID-19 : une liaison dangereuse. MÉDECINE DES MALADIES MÉTABOLIQUES 2021. [PMCID: PMC7881725 DOI: 10.1016/j.mmm.2021.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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30
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Alsuwaidi AR, Al Hosani FI, Al Memari S, Narchi H, Abdel Wareth L, Kamal H, Al Ketbi M, Al Baloushi D, Elfateh A, Khudair A, Al Mazrouei S, AlHumaidan HS, Alghaithi N, Afsh K, Al Kaabi N, Altrabulsi B, Jones M, Shaban S, Sheek-Hussein M, Zoubeidi T. Seroprevalence of COVID-19 infection in the Emirate of Abu Dhabi, United Arab Emirates: a population-based cross-sectional study. Int J Epidemiol 2021; 50:1077-1090. [PMID: 33893483 PMCID: PMC8135550 DOI: 10.1093/ije/dyab077] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 01/08/2023] Open
Abstract
Background The United Arab Emirates (UAE) was the first country in the Middle East to report severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Serosurveys are essential to understanding the extent of virus transmission. This cross-sectional study aims to assess the seroprevalence of SARS-CoV-2 infection in the Emirate of Abu Dhabi. Methods Between 19 July and 14 August 2020, 4487 households were selected using a random sample stratified by region and citizenship of the head of household (UAE citizen or non-citizen). A cluster sample of 40 labour camps was selected. Data on socio-demographic characteristics, risk factors and symptoms compatible with coronavirus disease 2019 (COVID-19) were collected. Each participant was first tested by Roche Elecsys® Anti-SARS-CoV-2 assay, followed, when reactive, by the LIAISON® SARS-CoV-2 S1/S2 IgG assay. Results Among 8831 individuals from households, seroprevalence was 10·4% [95% confidence intervals (CIs) 9·5–11·4], with higher seroprevalence in Abu Dhabi and Al Ain regions compared with those in Al Dhafra. In households, we found no sex difference and UAE citizens had lower seroprevalence compared with those of other nationalities. Among 4855 workers residing in labour camps, seroprevalence was 68·6% (95% CI 61·7–74·7), with higher seroprevalence among workers from Southeast Asia. In households, individuals with higher body mass indexes demonstrated higher seroprevalences than individuals with normal weight. Anosmia and ageusia were strongly associated with seropositivity. Conclusions The majority of household populations in the Emirate of Abu Dhabi remained unexposed to SARS-CoV-2. In labour camps, SARS-CoV-2 transmission was high. Effective public health measures should be maintained.
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Affiliation(s)
- Ahmed R Alsuwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | - Hassib Narchi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Laila Abdel Wareth
- National Reference Laboratory, Abu Dhabi, United Arab Emirates.,Pathology & Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Hazem Kamal
- Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates
| | - Mai Al Ketbi
- Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Durra Al Baloushi
- Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Abubaker Elfateh
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Ahmed Khudair
- Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates
| | | | - Hiba Saud AlHumaidan
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Noura Alghaithi
- Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Khalil Afsh
- Al Dhafra Hospitals, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Nawal Al Kaabi
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Basel Altrabulsi
- National Reference Laboratory, Abu Dhabi, United Arab Emirates.,Pathology & Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Matthew Jones
- National Reference Laboratory, Abu Dhabi, United Arab Emirates
| | - Sami Shaban
- Department of Medical Education, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Taoufik Zoubeidi
- Department of Analytics in the Digital Era, College of Business and Economics, United Arab Emirates University, Al Ain, United Arab Emirates
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31
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Herle M, Smith AD, Bu F, Steptoe A, Fancourt D. Trajectories of eating behavior during COVID-19 lockdown: Longitudinal analyses of 22,374 adults. Clin Nutr ESPEN 2021; 42:158-165. [PMID: 33745572 PMCID: PMC7871880 DOI: 10.1016/j.clnesp.2021.01.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS The COVID-19 pandemic has led to the implementation of stay-at-home and lockdown measures. It is currently unknown if the experience of lockdown leads to long term changes in individual's eating behaviors. The objectives of this study were: i) to derive longitudinal trajectories of change in eating during UK lockdown, and ii) to identify risk factors associated with eating behavior trajectories. METHOD Data from 22,374 UK adults from the UCL COVID-19 Social study (a panel study collecting weekly data during the pandemic) were analyzed from 28th March to 29th May 2020. Latent Class Growth Analysis was used to derive trajectories of change in eating. These were then associated with prior socio-economic, health-related and psychological factors using multinomial regression models. RESULTS Analyses suggested five trajectories, with the majority (64%) showing no change in eating. In contrast, one trajectory was marked by persistently eating more, whereas another by persistently eating less. Overall, participants with greater depressive symptoms were more likely to report any change in eating. Loneliness was linked to persistently eating more (OR = 1.07), whereas being single or divorced, as well as stressful life events, were associated with consistently eating less (OR = 1.69). Overall, higher education status was linked to lower odds of changing eating behavior (OR = 0.54-0.77). Secondary exploratory analyses suggest that participants self-reported to have overweight were more commonly categorised into the group consistently eating more, whereas participants with underweigh persistently ate less. CONCLUSION In this study, we found that one third of the sample report changes in quantities eaten throughout the first UK lockdown period. Findings highlight the importance of adjusting public health programs to support eating behaviors in future lockdowns both in this and potential future pandemics. This is particularly important as part of on-going preventive efforts to prevent nutrition-related chronic diseases.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - Andrea D Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Feifei Bu
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK.
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Predictors of Worse Prognosis in Young and Middle-Aged Adults Hospitalized with COVID-19 Pneumonia: A Multi-Center Italian Study (COVID-UNDER50). J Clin Med 2021; 10:jcm10061218. [PMID: 33804084 PMCID: PMC7999047 DOI: 10.3390/jcm10061218] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity as well as metabolic and cardiovascular comorbidities are established, significant predictors of worse prognosis in the overall COVID-19 population, but limited information is available on their roles in young and middle-aged adults (aged ≤ 50 years). The main objectives of the present Italian multi-center study were to describe clinical characteristics and role of selected prognostic predictors in a large cohort of young and middle-aged hospitalized patients. Nine pulmonology units, across north and center of Italy, were involved in this retrospective study. Comorbidities were classified according to their known or potential association with COVID-19. A total of 263 subjects were included. The prevalence of obesity was 25.9%, mechanical ventilation (MV) was needed in 27.7%, and 28 in-hospital deaths occurred (10.6%). Obesity and older age were the only independent, significant predictors for MV. Comorbidities, such as hypertension, diabetes, asthma, and increased D-dimer levels were significantly associated with higher mortality risk, regardless of age, body mass index, and MV. Obesity in young and middle-aged adults is a strong predictor of a more complicated COVID-19, without, however, evidence of a significant effect on in-hospital mortality. Selected comorbidities, including hypertension, diabetes and asthma, significantly impact survival even in a younger population, suggesting the need for prompt recognition of these conditions.
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Földi M, Farkas N, Kiss S, Dembrovszky F, Szakács Z, Balaskó M, Erőss B, Hegyi P, Szentesi A. Visceral Adiposity Elevates the Risk of Critical Condition in COVID-19: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2021; 29:521-528. [PMID: 33263191 PMCID: PMC7753720 DOI: 10.1002/oby.23096] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE A higher BMI has become acknowledged as one of the important risk factors for developing critical condition in coronavirus disease 2019 (COVID-19). In addition to BMI, body composition, and particularly visceral adiposity, might be an even more accurate measure to stratify patients. Therefore, the aim of this study was to evaluate the association between the distributions of computed-tomography-quantified fat mass and critical condition of patients with COVID-19. METHODS A systematic search was conducted in five databases for studies published until November 17, 2020. In the meta-analysis, pooled mean difference (standardized mean difference [SMD]) of visceral fat area (VFA; in square centimeters) was calculated between patients in the intensive care unit and those in general ward and between patients with the requirement for invasive mechanical ventilation (IMV) and those without the IMV requirement. RESULTS The quantitative synthesis revealed that patients requiring intensive care had higher VFA values (SMD = 0.46, 95% CI: 0.20-0.71, P < 0.001) compared with patients on the general ward. Similarly, patients requiring IMV had higher VFA values (SMD = 0.38, 95% CI: 0.05-0.71, P = 0.026) compared with patients without the IMV requirement. CONCLUSIONS VFA values were found to be significantly higher in patients with critical condition. Therefore, abdominal adiposity seems to be a risk factor in COVID-19, and patients with central obesity might need special attention.
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Affiliation(s)
- Mária Földi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
| | - Nelli Farkas
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Institute of BioanalysisMedical SchoolUniversity of PécsPécsHungary
| | - Szabolcs Kiss
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
| | - Fanni Dembrovszky
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Zsolt Szakács
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Márta Balaskó
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Bálint Erőss
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Péter Hegyi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
| | - Andrea Szentesi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
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Mulugeta W, Hoque L. Impact of the COVID-19 lockdown on weight status and associated factors for obesity among children in Massachusetts. OBESITY MEDICINE 2021; 22:100325. [PMID: 36567747 PMCID: PMC9764432 DOI: 10.1016/j.obmed.2021.100325] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/27/2022]
Abstract
This study aims to evaluate the impact of the COVID-19 lockdown on weight status, obesity and overweight among US children and identify associated factors. METHODS At a large safety net health system in Massachusetts, anthropometric measurements of 701 children were analyzed before and after the COVID-19 lockdown. Chi-square and paired t-test were computed for categorical and continuous variables, respectively. Multivariate analyses were performed to identify factors associated with obesity and overweight. RESULTS Post-lockdown, the overall mean body mass index (BMI) increased from 21.07 to 21.57 kg/m2 (p < .001). The overall obesity (23.2%-27.4%, p < .001) and overweight (41.1%-44.5%, p < .001) burdens increased after the lockdown period. Obesity (40.5%-46.9%, p < .001) was highest among Spanish speakers. The youngest age group (2-5 years) had the greatest obesity rate increase by 26% (19.7%-24.8%, p < .001). Obesity was associated with younger age (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.91, 1.00), higher baseline BMI (OR = 1.19, 95% CI = 1.15, 1.23) and Spanish speaking children (OR = 2.19, 95% CI = 1.10, 4.33). CONCLUSIONS BMI, obesity and overweight increased among children during the COVID-19 lockdown, disproportionately affecting disadvantaged subpopulations. Strategies are needed to counteract the impact of the COVID-19 lockdown on unhealthy weight gain and childhood obesity.
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Key Words
- AOR, adjusted odds ratio
- BMI, body mass index
- Body mass index
- CHA, Cambridge Health Alliance
- CI, confidence intervals
- COVID-19
- COVID-19, corona virus disease 2019
- Children
- EMR, electronic medical records
- ICD, International Statistical Classification of Diseases and Related Health Problems
- Kg, kilogram
- M, meter squared
- Obesity
- Overweight
- PA, physical activity
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Affiliation(s)
- Wudeneh Mulugeta
- Department of Medicine, Cambridge Health Alliance, Revere, MA, 02151, USA,Harvard Medical School, Boston, MA, 02115, USA,Corresponding author. Harvard Medical School Department of Medicine, Cambridge Health Alliance 454 Broadway, Revere, MA, 02151, USA
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35
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De Groot CJ, Poitou Bernert C, Coupaye M, Clement K, Paschou SA, Charmandari E, Kanaka-Gantenbein C, Wabitsch M, Buddingh EP, Nieuwenhuijsen B, Marina L, Johannsson G, Van Den Akker ELT. Clinical management of patients with genetic obesity during COVID-19 pandemic: position paper of the ESE Growth & Genetic Obesity COVID-19 Study Group and Rare Endo-ERN main thematic group on Growth and Obesity. Endocrine 2021; 71:653-662. [PMID: 33512658 PMCID: PMC7845285 DOI: 10.1007/s12020-021-02619-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022]
Abstract
This article aims to provide guidance on prevention and treatment of COVID-19 in patients with genetic obesity. Key principals of the management of patients with genetic obesity during COVID-19 pandemic for patients that have contracted COVID-19 are to be aware of: possible adrenal insufficiency (e.g., POMC deficiency, PWS); a more severe course in patients with concomitant immunodeficiency (e.g., LEP and LEPR deficiency), although defective leptin signalling could also be protective against the pro-inflammatory phenotype of COVID-19; disease severity being masked by insufficient awareness of symptoms in syndromic obesity patients with intellectual deficit (in particular PWS); to adjust medication dose to increased body size, preferably use dosing in m2; the high risk of malnutrition in patients with Sars-Cov2 infection, even in case of obesity. Key principals of the obesity management during the pandemic are to strive for optimal obesity management and a healthy lifestyle within the possibilities of the regulations to prevent weight (re)gain and to address anxiety within consultations, since prevalence of anxiety for COVID-19 is underestimated.
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Affiliation(s)
- Cornelis Jan De Groot
- Pediatric Endocrinology and Obesity Center CGG Erasmus MC, Rotterdam and Willem Alexander Children's Hospital, LUMC, Leiden, the Netherlands.
| | - Christine Poitou Bernert
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (PRADORT, Prader-Willi Syndrome and other rare obesities), Nutrition Department, Pitié-Salpêtrière hospital, Paris, France
- Sorbonne Université/INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Paris, France
| | - Muriel Coupaye
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (PRADORT, Prader-Willi Syndrome and other rare obesities), Nutrition Department, Pitié-Salpêtrière and Louis-Mourier hospitals, Paris, France
| | - Karine Clement
- Sorbonne Université/INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Paris, France
- Assistance Publique-Hopitaux de Paris, Nutrition Department, Pitie-Salpetriere Hospital, Paris, France
| | - Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Charmandari
- Pediatric and Adolescent Endocrinology, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
- Division of Endocrinology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | | | | | - Ljiljana Marina
- Assistant Professor Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gudmundur Johannsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Department of Endocrinology, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden
| | - E L T Van Den Akker
- Pediatric Endocrinology and Obesity Center CGG, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
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36
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Poly TN, Islam MM, Yang HC, Lin MC, Jian WS, Hsu MH, Jack Li YC. Obesity and Mortality Among Patients Diagnosed With COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:620044. [PMID: 33634150 PMCID: PMC7901910 DOI: 10.3389/fmed.2021.620044] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/06/2021] [Indexed: 12/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has already raised serious concern globally as the number of confirmed or suspected cases have increased rapidly. Epidemiological studies reported that obesity is associated with a higher rate of mortality in patients with COVID-19. Yet, to our knowledge, there is no comprehensive systematic review and meta-analysis to assess the effects of obesity and mortality among patients with COVID-19. We, therefore, aimed to evaluate the effect of obesity, associated comorbidities, and other factors on the risk of death due to COVID-19. We did a systematic search on PubMed, EMBASE, Google Scholar, Web of Science, and Scopus between January 1, 2020, and August 30, 2020. We followed Cochrane Guidelines to find relevant articles, and two reviewers extracted data from retrieved articles. Disagreement during those stages was resolved by discussion with the main investigator. The random-effects model was used to calculate effect sizes. We included 17 articles with a total of 543,399 patients. Obesity was significantly associated with an increased risk of mortality among patients with COVID-19 (RRadjust: 1.42 (95%CI: 1.24-1.63, p < 0.001). The pooled risk ratio for class I, class II, and class III obesity were 1.27 (95%CI: 1.05-1.54, p = 0.01), 1.56 (95%CI: 1.11-2.19, p < 0.01), and 1.92 (95%CI: 1.50-2.47, p < 0.001), respectively). In subgroup analysis, the pooled risk ratio for the patients with stroke, CPOD, CKD, and diabetes were 1.80 (95%CI: 0.89-3.64, p = 0.10), 1.57 (95%CI: 1.57-1.91, p < 0.001), 1.34 (95%CI: 1.18-1.52, p < 0.001), and 1.19 (1.07-1.32, p = 0.001), respectively. However, patients with obesity who were more than 65 years had a higher risk of mortality (RR: 2.54; 95%CI: 1.62-3.67, p < 0.001). Our study showed that obesity was associated with an increased risk of death from COVID-19, particularly in patients aged more than 65 years. Physicians should aware of these risk factors when dealing with patients with COVID-19 and take early treatment intervention to reduce the mortality of COVID-19 patients.
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Affiliation(s)
- Tahmina Nasrin Poly
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Md. Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsuan Chia Yang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ming Chin Lin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Professional Master Program in Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institution, Taipei Medical University, Taipei, Taiwan
| | - Wen-Shan Jian
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - Min-Huei Hsu
- Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Jack Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Dermatology, Wan Fang Hospital, Taipei, Taiwan
- TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei, Taiwan
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Abdollahi A, Kamali Sarvestani H, Rafat Z, Ghaderkhani S, Mahmoudi-Aliabadi M, Jafarzadeh B, Mehrtash V. The association between the level of serum 25(OH) vitamin D, obesity, and underlying diseases with the risk of developing COVID-19 infection: A case-control study of hospitalized patients in Tehran, Iran. J Med Virol 2020; 93:2359-2364. [PMID: 33314166 DOI: 10.1002/jmv.26726] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVES: The outbreak of COVID-19 has created a global public health crisis. Little is known about the predisposing factors of this infection. The aim of this study was to explore an association between the serum vitamin D level, obesity, and underlying health conditions, as well as the vulnerability to COVID-19 in the Iranian population. METHODS We conducted a case-control study of 201 patients with coronavirus infection and 201 controls. Cases and controls were matched for age and gender. The study was carried out for 2 months (February 2020-April 2020) at Imam Khomeini Hospital Complex, Tehran, Iran. Serum 25(OH) vitamin D was measured using the enzyme-linked immunosorbent assay method. Information containing age, gender, clinical symptoms, body mass index, computed tomography scan findings, and underlying health conditions related to each participant were elicited from health records. RESULTS A significant negative correlation (p = .02) was observed between the serum vitamin D level and developing coronavirus infection. Also, the results showed that the COVID-19 cases were more likely to be overweight than the controls (p = .023). Diabetes mellitus, hypertension, and respiratory infections were found in 20.89%, 9.65%, and 6.96% of cases, respectively. These underlying health conditions were not significantly different between cases and controls (p = .81). CONCLUSIONS Vitamin D deficiency and obesity are two main predisposing factors associated with the vulnerability to coronavirus infection in the Iranian population.
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Affiliation(s)
- Alireza Abdollahi
- Department of Pathology, Imam Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasti Kamali Sarvestani
- Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rafat
- Department of Medical Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Ghaderkhani
- Department of Infectious Diseases and Tropical Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maedeh Mahmoudi-Aliabadi
- Department of Laboratory, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Jafarzadeh
- Department of Pathology, Imam Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Mehrtash
- Department of Pathology, Imam Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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38
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Földi M, Farkas N, Kiss S, Dembrovszky F, Szakács Z, Balaskó M, Erőss B, Hegyi P, Szentesi A. Reply to a Letter to the Editor "Is there an exposure-effect relationship between body mass index and invasive mechanical ventilation, severity, and death in patients with COVID-19? Evidence from an updated meta-analysis". Obes Rev 2020; 21:e13159. [PMID: 33067858 DOI: 10.1111/obr.13159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Mária Földi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Szabolcs Kiss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Márta Balaskó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Centre for Translational Medicine, Department of Medicine, University of Szeged, Szeged, Hungary
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39
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Zhang Y, Han H, Tian Y, Dong J, Yu Y, Kang Y, Xing L, Lian R, Zhang R, Xie D. Impact of cancer on mortality and severity of corona virus disease 2019: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e23005. [PMID: 33126383 PMCID: PMC7598814 DOI: 10.1097/md.0000000000023005] [Citation(s) in RCA: 4] [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] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cancer patients are in a state of systemic immunosuppression and are considered a highly vulnerable population in the Corona Virus Disease 2019 (COVID-19) epidemic. However, the relationship between cancer and the severity and mortality of patients with COVID-19 remains unclear. This study aims to evaluate whether cancer patients with COVID-19 may be at an increased risk of severe illness and mortality. METHODS We will perform comprehensive searches in PubMed, EMBASE.com, Web of Science, and the Cochrane Central Register of Controlled Trials to identify studies providing prevalence of cancer between patients with severe and non-severe illness or between non-survivors and survivors. We will use the Newcastle-Ottawa quality assessment scale to assess the quality of included studies. We will conduct pairwise meta-analyses to compute the odds ratio and 95% confidence interval using the Mantel Haenszel method with the random-effects model. The statistical heterogeneity will be assessed using the I statistic. Subgroup analyses, sensitivity analyses, and meta-regression analyses will be performed to explore the sources of heterogeneity. RESULTS The results of this study will be published in a peer-reviewed journal. CONCLUSION Our meta-analysis will systematically evaluate the association between cancer and the severity and mortality of patients with COVID-19. This study will provide evidence to help determine whether cancer patients should be provided with special precautions and advised to use stronger personal protection. INPLASY REGISTRATION NUMBER INPLASY202090093.
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Affiliation(s)
- Yi Zhang
- Department of Geriatric Respiratory Medicine, Lanzhou University First Hospital
| | - Hao Han
- Department of Critical Care Medicine, The Second Provincial People's Hospital of Gansu
| | - Yunling Tian
- Department of Endocrinology, Lanzhou University First Hospital
| | - Jing Dong
- Department of Geriatric Respiratory Medicine, Lanzhou University First Hospital
| | - Yage Yu
- Department of Geriatric Respiratory Medicine, Lanzhou University First Hospital
| | - Yingying Kang
- School of Basic Medical Sciences, Lanzhou University
| | - Lina Xing
- School of Basic Medical Sciences, Lanzhou University
| | - Rongna Lian
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Ruinian Zhang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Dairong Xie
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
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Yoshioka T, Funada S, Luo Y. The inherent problems with the generalizability of the CALL score: towards reliable clinical prediction models for COVID-19. Clin Infect Dis 2020; 73:e2818. [PMID: 33064127 PMCID: PMC7665360 DOI: 10.1093/cid/ciaa1564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima city, Fukushima, Japan.,Department of Healthcare Epidemiology, Kyoto University School of Public Health in the Graduate School of Medicine, Kyoto city, Kyoto, Japan
| | - Satoshi Funada
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto city, Kyoto, Japan.,Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/ School of Public Health, Kyoto city, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/ School of Public Health, Kyoto city, Kyoto, Japan
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