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Beurton A, Kooistra EJ, De Jong A, Schiffl H, Jourdain M, Garcia B, Vimpère D, Jaber S, Pickkers P, Papazian L. Specific and Non-specific Aspects and Future Challenges of ICU Care Among COVID-19 Patients with Obesity: A Narrative Review. Curr Obes Rep 2024; 13:545-563. [PMID: 38573465 DOI: 10.1007/s13679-024-00562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE OF REVIEW Since the end of 2019, the coronavirus disease 2019 (COVID-19) pandemic has infected nearly 800 million people and caused almost seven million deaths. Obesity was quickly identified as a risk factor for severe COVID-19, ICU admission, acute respiratory distress syndrome, organ support including mechanical ventilation and prolonged length of stay. The relationship among obesity; COVID-19; and respiratory, thrombotic, and renal complications upon admission to the ICU is unclear. RECENT FINDINGS The predominant effect of a hyperinflammatory status or a cytokine storm has been suggested in patients with obesity, but more recent studies have challenged this hypothesis. Numerous studies have also shown increased mortality among critically ill patients with obesity and COVID-19, casting doubt on the obesity paradox, with survival advantages with overweight and mild obesity being reported in other ICU syndromes. Finally, it is now clear that the increase in the global prevalence of overweight and obesity is a major public health issue that must be accompanied by a transformation of our ICUs, both in terms of equipment and human resources. Research must also focus more on these patients to improve their care. In this review, we focused on the central role of obesity in critically ill patients during this pandemic, highlighting its specificities during their stay in the ICU, identifying the lessons we have learned, and identifying areas for future research as well as the future challenges for ICU activity.
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Affiliation(s)
- Alexandra Beurton
- Department of Intensive Care, Hôpital Tenon, APHP, Paris, France.
- UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM, Sorbonne Université, Paris, France.
| | - Emma J Kooistra
- Department of Intensive Care Medicine, Radboud University Medical Center, 6500HB, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500HB, Nijmegen, The Netherlands
| | - Audrey De Jong
- Anesthesia and Critical Care Department, Saint Eloi Teaching Hospital, University Montpellier 1, Montpellier, France
- Phymed Exp INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Helmut Schiffl
- Division of Nephrology, Department of Internal Medicine IV, University Hospital LMU Munich, Munich, Germany
| | - Mercedes Jourdain
- CHU Lille, Univ-Lille, INSERM UMR 1190, ICU Department, F-59037, Lille, France
| | - Bruno Garcia
- CHU Lille, Univ-Lille, INSERM UMR 1190, ICU Department, F-59037, Lille, France
| | - Damien Vimpère
- Anesthesia and Critical Care Department, Hôpital Necker, APHP, Paris, France
| | - Samir Jaber
- Anesthesia and Critical Care Department, Saint Eloi Teaching Hospital, University Montpellier 1, Montpellier, France
- Phymed Exp INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Peter Pickkers
- Department of Intensive Care Medicine, Radboud University Medical Center, 6500HB, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500HB, Nijmegen, The Netherlands
| | - Laurent Papazian
- Intensive Care Unit, Centre Hospitalier de Bastia, Bastia, Corsica, France
- Aix-Marseille University, Marseille, France
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Grewal T, Nguyen MKL, Buechler C. Cholesterol and COVID-19-therapeutic opportunities at the host/virus interface during cell entry. Life Sci Alliance 2024; 7:e202302453. [PMID: 38388172 PMCID: PMC10883773 DOI: 10.26508/lsa.202302453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
The rapid development of vaccines to combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has been critical to reduce the severity of COVID-19. However, the continuous emergence of new SARS-CoV-2 subtypes highlights the need to develop additional approaches that oppose viral infections. Targeting host factors that support virus entry, replication, and propagation provide opportunities to lower SARS-CoV-2 infection rates and improve COVID-19 outcome. This includes cellular cholesterol, which is critical for viral spike proteins to capture the host machinery for SARS-CoV-2 cell entry. Once endocytosed, exit of SARS-CoV-2 from the late endosomal/lysosomal compartment occurs in a cholesterol-sensitive manner. In addition, effective release of new viral particles also requires cholesterol. Hence, cholesterol-lowering statins, proprotein convertase subtilisin/kexin type 9 antibodies, and ezetimibe have revealed potential to protect against COVID-19. In addition, pharmacological inhibition of cholesterol exiting late endosomes/lysosomes identified drug candidates, including antifungals, to block SARS-CoV-2 infection. This review describes the multiple roles of cholesterol at the cell surface and endolysosomes for SARS-CoV-2 entry and the potential of drugs targeting cholesterol homeostasis to reduce SARS-CoV-2 infectivity and COVID-19 disease severity.
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Affiliation(s)
- Thomas Grewal
- https://ror.org/0384j8v12 School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Mai Khanh Linh Nguyen
- https://ror.org/0384j8v12 School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Christa Buechler
- https://ror.org/01226dv09 Department of Internal Medicine I, Regensburg University Hospital, Regensburg, Germany
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Abdeen S, Abed Alah M, Al-Zaidan M, Mohamed Ibrahim MI, Abdulmajeed J, Al-Nuaimi AA, Al-Kuwari MG. Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study. Front Public Health 2024; 12:1384327. [PMID: 38660363 PMCID: PMC11039914 DOI: 10.3389/fpubh.2024.1384327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Background Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar. Methods A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects. Results Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose. Conclusion The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.
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Affiliation(s)
- Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Manal Al-Zaidan
- Department of Pharmacy and Therapeutics Supply, Primary Health Care Corporation, Doha, Qatar
| | | | - Jazeel Abdulmajeed
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Asma Ali Al-Nuaimi
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Mohamed Ghaith Al-Kuwari
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
- Collège of Medicine, Qatar University, Doha, Qatar
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Yu EA, Stone M, Bravo MD, Grebe E, Bruhn RL, Lanteri MC, Townsend M, Kamel H, Jones JM, Busch MP, Custer B. Associations of Temporal Cardiometabolic Patterns and Incident SARS-CoV-2 Infection Among U.S. Blood Donors With Serologic Evidence of Vaccination. AJPM FOCUS 2024; 3:100186. [PMID: 38304025 PMCID: PMC10832374 DOI: 10.1016/j.focus.2024.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Introduction Cardiometabolic diseases are associated with greater COVID-19 severity; however, the influences of cardiometabolic health on SARS-CoV-2 infections after vaccination remain unclear. Our objective was to investigate the associations between temporal blood pressure and total cholesterol patterns and incident SARS-CoV-2 infections among those with serologic evidence of vaccination. Methods In this prospective cohort of blood donors, blood samples were collected in 2020-2021 and assayed for binding antibodies of SARS-CoV-2 nucleocapsid protein antibody seropositivity. We categorized participants into intraindividual pattern subgroups of blood pressure and total cholesterol (persistently, intermittently, or not elevated [systolic blood pressure <130 mmHg, diastolic blood pressure <80 mmHg, total cholesterol <200 mg/dL]) across the study time points. Results Among 13,930 donors with 39,736 donations representing 1,127,071 person-days, there were 221 incident SARS-CoV-2 infections among those with serologic evidence of vaccination (1.6%). Intermittent hypertension was associated with greater SARS-CoV-2 infections among those with serologic evidence of vaccination risk (adjusted incidence rate ratio=2.07; 95% CI=1.44, 2.96; p<0.01) than among participants with consistent normotension on the basis of a multivariable Poisson regression. Among men, intermittently elevated total cholesterol (adjusted incidence rate ratio=1.90; 95% CI=1.32, 2.74; p<0.01) and higher BMI at baseline (adjusted hazard ratio=1.44; 95% CI=1.07, 1.93; p=0.01; per 10 units) were associated with greater SARS-CoV-2 infections among those with serologic evidence of vaccination probability; these associations were null among women (both p>0.05). Conclusions Our findings underscore that the benefits of cardiometabolic health, particularly blood pressure, include a lower risk of SARS-CoV-2 infection after vaccination.
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Affiliation(s)
- Elaine A. Yu
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | | | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Roberta L. Bruhn
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | - Marion C. Lanteri
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
- Creative Testing Solutions, Tempe, Arizona
| | | | | | | | - Michael P. Busch
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
- Vitalant, Scottsdale, Arizona
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
- Vitalant, Scottsdale, Arizona
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Yoon SS, Lim Y, Jeong S, Han HW. Association of weight changes with SARS-CoV-2 infection and severe COVID-19 outcomes: A nationwide retrospective cohort study. J Infect Public Health 2023; 16:1918-1924. [PMID: 37871359 DOI: 10.1016/j.jiph.2023.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Obesity is a risk factor for COVID-19. However, it is unknown whether weight changes can alter this risk. We investigated the association of weight changes with SARS-CoV-2 infection and acute severe COVID-19 outcomes occurring within two months of the infection. METHODS We used 6.3 million nationwide cohort. The body weight was classified as follows: (1) underweight, body mass index (BMI) < 18.5 kg/m2; (2) normal, BMI 18.5-22.9 kg/m2; (3) overweight, BMI 23-24.9 kg/m2; (4) obese, BMI≥ 25 kg/m2. Weight changes were defined by comparing the classification of body weight during the health screening period I and II. The outcomes were SARS-CoV-2 infection and severe COVID-19 outcomes within two months after the infection. The association was evaluated using multivariable-adjusted logistic regression. The following covariates were adjusted: age, sex, household income, cigarette smoking, alcohol consumption, physical activity, hypertension, diabetes mellitus, dyslipidemia, Charlson comorbidity index score, and dose of all COVID-19 vaccinations prior to SARS-CoV-2 infection. RESULTS Of the 2119,460 study participants, 184,204 were infected with SARS-CoV-2. Weight gain showed a higher risk of SARS-CoV-2 infection in underweight to normal and normal to overweight groups. Conversely, weight loss showed a lower risk of SARS-CoV-2 infection in normal to underweight, overweight to underweight, overweight to normal, obese to normal, and obese to overweight groups. In addition, weight gain revealed a higher risk of severe COVID-19 outcomes, whereas weight loss showed a lower risk of severe COVID-19 outcomes. CONCLUSION This study found that weight loss and gain are associated with a lower and higher risk of both SARS-CoV-2 infection and severe COVID-19 outcomes, respectively. Healthy weight management may be beneficial against the risk of COVID-19.
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Affiliation(s)
- Sung Soo Yoon
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea; Institute of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea
| | - Yohwan Lim
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea; Institute of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea.
| | - Hyun Wook Han
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea; Institute of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea.
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Alghamdi A, Wani K, Alnaami AM, Al-Daghri NM. Dose Intervals and Time since Final Dose on Changes in Metabolic Indices after COVID-19 Vaccination. Vaccines (Basel) 2023; 11:1746. [PMID: 38140151 PMCID: PMC10748310 DOI: 10.3390/vaccines11121746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
The rapid development and implementation of COVID-19 vaccines merit understanding its effects on metabolic indices. This retrospective longitudinal study investigated the influence of first-to-second-dose intervals and time since the final dose on the metabolic indices of individuals receiving COVID-19 vaccinations. A total of 318 Saudi subjects (59.7% females) aged 12-60 years received COVID-19 vaccines via the national vaccination program. We collected the anthropometric data and fasting blood samples at specific time points before vaccination and after the final vaccination dose, and biochemical metabolic indices, including glucose and lipid profile, were measured. We also collected the dates of vaccination and COVID-19 history during the study period. The participants were stratified into groups based on first-to-second-dose intervals and time since the final dose to compare pre-and post-vaccination changes in metabolic indices between the groups. Logistic regression analysis revealed no differences in pre- to post-vaccination metabolic status between groups based on first-to-second-dose intervals in either adolescents or adults. However, shorter intervals (≤6 months) between the final dose and follow-up were associated with a decrease in total cardiometabolic components, especially triglyceride levels (OR = 0.39, 95% CI: (0.22-0.68), p < 0.001) than longer intervals (>6 months) in adults. In conclusion, time duration since final dose was associated with pre- to post-vaccination changes in metabolic indices, especially triglyceride levels, indicating that post-vaccination improvements wane over time. Further research is needed to validate the observed relationship, as it may contribute to optimizing vaccine effectiveness and safety in the future.
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Affiliation(s)
- Amani Alghamdi
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Kaiser Wani
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdullah M. Alnaami
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nasser M. Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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Zhang J, Wen J, Wan X, Luo P. The causal relationship between air pollution, obesity, and COVID-19 risk: a large-scale genetic correlation study. Front Endocrinol (Lausanne) 2023; 14:1221442. [PMID: 37867515 PMCID: PMC10585274 DOI: 10.3389/fendo.2023.1221442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/10/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Observational evidence reported that air pollution is a significant risk element for numerous health problems, such as obesity and coronavirus disease 2019 (COVID-19), but their causal relationship is currently unknown. Our objective was to probe the causal relationship between air pollution, obesity, and COVID-19 and to explore whether obesity mediates this association. Methods We obtained instrumental variables strongly correlated to air pollutants [PM2.5, nitrogen dioxide (NO2) and nitrogen oxides (NOx)], 9 obesity-related traits (abdominal subcutaneous adipose tissue volume, waist-to-hip ratio, body mass index, hip circumference, waist circumference, obesity class 1-3, visceral adipose tissue volume), and COVID-19 phenotypes (susceptibility, hospitalization, severity) from public genome-wide association studies. We used clinical and genetic data from different public biological databases and performed analysis by two-sample and two-step Mendelian randomization. Results PM2.5 genetically correlated with 5 obesity-related traits, which obesity class 1 was most affected (beta = 0.38, 95% CI = 0.11 - 0.65, p = 6.31E-3). NO2 genetically correlated with 3 obesity-related traits, which obesity class 1 was also most affected (beta = 0.33, 95% CI = 0.055 - 0.61, p = 1.90E-2). NOx genetically correlated with 7 obesity-related traits, which obesity class 3 was most affected (beta = 1.16, 95% CI = 0.42-1.90, p = 2.10E-3). Almost all the obesity-related traits genetically increased the risks for COVID-19 phenotypes. Among them, body mass index, waist circumference, hip circumference, waist-to-hip ratio, and obesity class 1 and 2 mediated the effects of air pollutants on COVID-19 risks (p < 0.05). However, no direct causal relationship was observed between air pollution and COVID-19. Conclusion Our study suggested that exposure to heavy air pollutants causally increased risks for obesity. Besides, obesity causally increased the risks for COVID-19 phenotypes. Attention needs to be paid to weight status for the population who suffer from heavy air pollution, as they are more likely to be susceptible and vulnerable to COVID-19.
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Affiliation(s)
- Jingwei Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wen
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xin Wan
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Warpechowski J, Leszczyńska P, Juchnicka D, Olichwier A, Szczerbiński Ł, Krętowski AJ. Assessment of the Immune Response in Patients with Insulin Resistance, Obesity, and Diabetes to COVID-19 Vaccination. Vaccines (Basel) 2023; 11:1203. [PMID: 37515018 PMCID: PMC10383449 DOI: 10.3390/vaccines11071203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
The SARS-CoV-19 pandemic overwhelmed multiple healthcare systems across the world. Patients with underlying medical conditions such as obesity or diabetes were particularly vulnerable, had more severe symptoms, and were more frequently hospitalized. To date, there have been many studies on the severity of SARS-CoV-2 in patients with metabolic disorders, but data on the efficiency of vaccines against COVID-19 are still limited. This paper aims to provide a comprehensive overview of the effectiveness of COVID-19 vaccines in individuals with diabetes, insulin resistance, and obesity. A comparison is made between the immune response after vaccination in patients with and without metabolic comorbidities. Additionally, an attempt is made to highlight the mechanisms of immune stimulation affected by SARS-CoV-2 vaccines and how metabolic comorbidities modulate these mechanisms. The focus is on the most common COVID-19 vaccines, which include mRNA vaccines such as Pfizer-BioNTech and Moderna, as well as viral vector vaccines such as AstraZeneca and Johnson & Johnson. Furthermore, an effort is made to clarify how the functional differences between these vaccines may impact the response in individuals with metabolic disorders, drawing from available experimental data. This review summarizes the current knowledge regarding the post-vaccination response to COVID-19 in the context of metabolic comorbidities such as diabetes, insulin resistance, and obesity.
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Affiliation(s)
- Jędrzej Warpechowski
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Paula Leszczyńska
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Dominika Juchnicka
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Adam Olichwier
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Łukasz Szczerbiński
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
- Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, 75 Ames Street, Cambridge, MA 02142, USA
| | - Adam Jacek Krętowski
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
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Fu C, Lin N, Zhu J, Ye Q. Association between Overweight/Obesity and the Safety and Efficacy of COVID-19 Vaccination: A Systematic Review. Vaccines (Basel) 2023; 11:vaccines11050996. [PMID: 37243100 DOI: 10.3390/vaccines11050996] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE The objective of this study was to appraise the interrelation between overweight/obesity and the safety and efficacy of COVID-19 vaccination by synthesizing the currently available evidence. METHODS A systematic review of published studies on the safety and efficacy of the COVID-19 vaccine in people who were overweight or obese was conducted. Databases including Embase, Medline Epub (Ovid), PsychInfo (Ovid), Web of Science, PubMed, CINAHL, and Google Scholar were searched to identify relevant studies. The databases of the Centers for Disease Control (CDC) and World Health Organization (WHO) were also searched for relevant unpublished and gray literature. RESULTS Fifteen studies were included in the review. All the included studies used observational study designs; there were ten cohort studies and five cross-sectional studies. The sample size of these studies ranged from 21 to 9,171,524. Thirteen studies reported using BNT162b2 (Pfizer-BioNTech, USA), four reported using ChAdOx-nCov19 (AstraZeneca, U.K), two were reported using CoronaVac (Sinovac, China), and two were reported using mRNA1273 (Moderna, USA). The efficacy and safety of COVID-19 vaccines have been extensively studied in individuals with overweight/obesity. Most studies have shown that the humoral response decreases with increasing BMI. The available evidence does not conclusively indicate that these vaccines are generally safe in this population. CONCLUSION While the efficacy of the COVID-19 vaccine may be less than ideal in people who are overweight or obese, it does not mean that obese people should not be vaccinated, as the vaccine can still provide some protection. There is a lack of evidence for conclusions to be drawn about the safety of the vaccine in the population. This study calls on health professionals, policymakers, caregivers, and all other stakeholders to focus on monitoring the possible adverse effects of injections in overweight/obese people.
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Affiliation(s)
- Cangcang Fu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Nan Lin
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Jihua Zhu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Qing Ye
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
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10
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Fan X, Han J, Zhao E, Fang J, Wang D, Cheng Y, Shi Y, Wang Z, Yao Z, Lu P, Liu T, Li Q, Poulsen KL, Yuan Z, Song Y, Zhao J. The effects of obesity and metabolic abnormalities on severe COVID-19-related outcomes after vaccination: A population-based study. Cell Metab 2023; 35:585-600.e5. [PMID: 36931274 PMCID: PMC9974355 DOI: 10.1016/j.cmet.2023.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/01/2022] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
Breakthrough SARS-CoV-2 infections of vaccinated individuals are being reported globally, resulting in an increased risk of hospitalization and death among such patients. Therefore, it is crucial to identify the modifiable risk factors that may affect the protective efficacy of vaccine use against the development of severe COVID-19 and thus to initiate early medical interventions. Here, in population-based studies using the UK Biobank database and the 2021 National Health Interview Survey (NHIS), we analyzed 20,362 participants aged 50 years or older and 2,588 aged 18 years or older from both databases who tested positive for SARS-COV-2, of whom 33.1% and 67.7% received one or more doses of vaccine, respectively. In the UK Biobank, participants are followed from the vaccination date until October 18, 2021. We found that obesity and metabolic abnormalities (namely, hyperglycemia, hyperlipidemia, and hypertension) were modifiable factors for severe COVID-19 in vaccinated patients (all p < 0.05). When metabolic abnormalities were present, regardless of obesity, the risk of severe COVID-19 was higher than that of metabolically normal individuals (all p < 0.05). Moreover, pharmacological interventions targeting such abnormalities (namely, antihypertensive [adjusted hazard ratio (aHR) 0.64, 95% CI 0.48-0.86; p = 0.003], glucose-lowering [aHR 0.55, 95% CI 0.36-0.83; p = 0.004], and lipid-lowering treatments [aHR 0.50, 95% CI 0.37-0.68; p < 0.001]) were significantly associated with a reduced risk for this outcome. These results show that more proactive health management of patients with obesity and metabolic abnormalities is critical to reduce the incidence of severe COVID-19 after vaccination.
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Affiliation(s)
- Xiude Fan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Junming Han
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Enfa Zhao
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230022, China
| | - Jiansong Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Dawei Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Yiping Cheng
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Yingzhou Shi
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Zhen Wang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Zhenyu Yao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Peng Lu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Tianbao Liu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Qihang Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China
| | - Kyle L Poulsen
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China.
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital, Shandong University, Jinan, Shandong 250021, China; Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China; Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong 250021, China.
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11
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Alkazmi L, Al-Kuraishy HM, Al-Gareeb AI, Alexiou A, Papadakis M, Saad HM, Batiha GES. The potential role of scavenger receptor B type I (SR-BI) in SARS-CoV-2 infection. Immun Inflamm Dis 2023; 11:e786. [PMID: 37102664 PMCID: PMC10103078 DOI: 10.1002/iid3.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 04/28/2023] Open
Abstract
Scavenger receptor type B I (SR-BI), the major receptor for high-density lipoprotein (HDL) mediates the delivery of cholesterol ester and cholesterol from HDL to the cell membrane. SR-BI is implicated as a receptor for entry of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). SR-BI is colocalized with the angiotensin-converting enzyme 2 (ACE2) increasing the binding and affinity of SARS-CoV-2 to ACE2 with subsequent viral internalization. SR-BI regulates lymphocyte proliferation and the release of pro-inflammatory cytokines from activated macrophages and lymphocytes. SR-BI is reduced during COVID-19 due to consumption by SARS-CoV-2 infection. COVID-19-associated inflammatory changes and high angiotensin II (AngII) might be possible causes of repression of SR-BI in SARS-CoV-2 infection. In conclusion, the downregulation of SR-BI in COVID-19 could be due to direct invasion by SARS-CoV-2 or through upregulation of pro-inflammatory cytokines, inflammatory signaling pathways, and high circulating AngII. Reduction of SR-BI in COVID-19 look like ACE2 may provoke COVID-19 severity through exaggeration of the immune response. Further studies are invoked to clarify the potential role of SR-BI in the pathogenesis of COVID-19 that could be protective rather than detrimental.
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Affiliation(s)
- Luay Alkazmi
- Biology Department, Faculty of Applied Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia
- AFNP Med, Wien, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
| | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Matrouh, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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12
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Shams E, Kamalumpundi V, Cheng L, Taiwo A, Shibli-Rahhal A, Dokun AO, Correia ML. Association between RAAS Antagonism and COVID-19-related Mortality in Patients with Overweight/Obesity-related Hypertension: A Retrospective Cohort Study. Arq Bras Cardiol 2023; 120:e20220277. [PMID: 37098985 PMCID: PMC10263421 DOI: 10.36660/abc.20220277] [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: 04/11/2022] [Revised: 11/05/2022] [Accepted: 12/14/2022] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitors (ACEI) increase the expression of ACE2, which is a receptor for entry of SARS-CoV-2 into cells. Though evidence suggests that ARB/ACEI are safe among the general population with COVID-19, their safety in patients with overweight/obesity-related hypertension deserves further evaluation. OBJECTIVE We assessed the association between ARB/ACEI use and COVID-19 severity in patients with overweight/obesity-related hypertension. METHODS This study included 439 adult patients with overweight/obesity (body mass index ≥ 25 kg/m2) and hypertension, diagnosed with COVID-19 and admitted to University of Iowa Hospitals and Clinic from March 1 to December 7, 2020. Mortality and severity of COVID-19 were evaluated based on length of stay in hospital, intensive care unit admission, use of supplemental oxygen, mechanical ventilation, and vasopressors. Multivariable logistic regression was used to examine the associations of ARB/ACEI use with mortality and other markers of COVID-19 severity, with a two-sided alpha set at 0.05. RESULTS Exposure to ARB (n = 91) and ACEI (n = 149) before hospitalization was significantly associated with lower mortality (odds ratio [OR] = 0.362, 95% confidence interval [CI] 0.149 to 0.880, p = 0.025) and a shorter length of stay (95% CI -0.217 to -0.025, p = 0.015). Additionally, patients using ARB/ACEI showed a non-significant trend toward lower intensive care unit admission (OR = 0.727, 95% CI 0.485 to 1.090, p = 0.123), use of supplemental oxygen (OR = 0.929, 95% CI 0.608 to 1.421, p = 0.734), mechanical ventilation (OR = 0.728, 95% CI 0.457 to 1.161, p = 0.182), and vasopressors (OR = 0.677, 95% CI 0.430 to 1.067, p = 0.093). CONCLUSION Results suggest that hospitalized patients with COVID-19 and overweight/obesity-related hypertension who were prescribed ARB/ACEI before admission to the hospital exhibit lower mortality and less severe COVID-19 than those who were not taking ARB/ACEI. The results also suggest that exposure to ARB/ACEI may protect patients with overweight/obesity-related hypertension from severe COVID-19 and death.
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Affiliation(s)
- Elham Shams
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
| | - Vijayvardhan Kamalumpundi
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
- Carver College of MedicineUniversity of IowaEUACarver College of Medicine, University of Iowa - EUA
| | - Linhai Cheng
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
| | - Adeyinka Taiwo
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
- Carver College of MedicineUniversity of IowaEUACarver College of Medicine, University of Iowa - EUA
| | - Amal Shibli-Rahhal
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
- Carver College of MedicineUniversity of IowaEUACarver College of Medicine, University of Iowa - EUA
| | - Ayotunde O. Dokun
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
- Carver College of MedicineUniversity of IowaEUACarver College of Medicine, University of Iowa - EUA
| | - Marcelo L.G. Correia
- Division of Endocrinology and MetabolismDepartment of Internal MedicineUniversity of lowaEUADivision of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa – EUA
- Carver College of MedicineUniversity of IowaEUACarver College of Medicine, University of Iowa - EUA
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13
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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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14
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Zhang Y, Fan X, Zhao C, Yuan Z, Cheng Y, Wu Y, Han J, Yuan Z, Zhao Y, Lu K. Association between metabolic obesity phenotypes and multiple myeloma hospitalization burden: A national retrospective study. Front Oncol 2023; 13:1116307. [PMID: 36910611 PMCID: PMC9996033 DOI: 10.3389/fonc.2023.1116307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Background & purpose Obesity and metabolic disorders were associated with increased risk of MM, a disease characterized by high risk of relapsing and require frequent hospitalizations. In this study, we conducted a retrospective cohort study to explore the association of metabolic obesity phenotypes with the readmission risk of MM. Patients & methods We analyzed 34,852 patients diagnosed with MM from the Nationwide Readmissions Database (NRD), a nationally representative database from US. Hospitalization diagnosis of patients were obtained using ICD-10 diagnosis codes. According to obesity and metabolic status, the population was divided into four phenotypes: metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). The patients with different phenotypes were observed for hospital readmission at days 30-day, 60-day, 90-day and 180-day. Multivariate cox regression model was used to estimate the relationship between obesity metabolic phenotypes and readmissions risk. Results There were 5,400 (15.5%), 7,255 (22.4%), 8,025 (27.0%) and 7,839 (35.6%) unplanned readmissions within 30-day, 60-day, 90-day and 180-day follow-up, respectively. For 90-day and 180-day follow-up, compared with patients with the MHNO phenotype, those with metabolic unhealthy phenotypes MUNO (90-day: P = 0.004; 180-day: P = < 0.001) and MUO (90-day: P = 0.049; 180-day: P = 0.004) showed higher risk of readmission, while patients with only obesity phenotypes MHO (90-day: P = 0.170; 180-day: P = 0.090) experienced no higher risk. However, similar associations were not observed for 30-day and 60-day. Further analysis in 90-day follow-up revealed that, readmission risk elevated with the increase of the combined factor numbers, with aHR of 1.068 (CI: 1.002-1.137, P = 0.043, with one metabolic risk factor), 1.109 (CI: 1.038-1.184, P = 0.002, with two metabolic risk factors) and 1.125 (95% CI: 1.04-1.216, P = 0.003, with three metabolic risk factors), respectively. Conclusion Metabolic disorders, rather than obesity, were independently associated with higher readmission risk in patients with MM, whereas the risk elevated with the increase of the number of combined metabolic factors. However, the effect of metabolic disorders on MM readmission seems to be time-dependent. For MM patient combined with metabolic disorders, more attention should be paid to advance directives to reduce readmission rate and hospitalization burden.
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Affiliation(s)
- Yue Zhang
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Xiude Fan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Chunhui Zhao
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Zinuo Yuan
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Yiping Cheng
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Yafei Wu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Junming Han
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.,Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China.,Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Yuanfei Zhao
- Beijing Institute of Heart, Lung and Blood, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
| | - Keke Lu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.,Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
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15
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Ponjoan A, Jacques-Aviñó C, Medina-Perucha L, Romero V, Martí-Lluch R, Alves-Cabratosa L, Ramos R, Berenguera A, Garcia-Gil MDM. Axes of social inequities in COVID-19 clinical trials: A systematic review. Front Public Health 2023; 11:1069357. [PMID: 36891333 PMCID: PMC9987589 DOI: 10.3389/fpubh.2023.1069357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objective The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants' characteristics, loss of follow-up, stratification of efficacy and safety results). Methods We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them. Results Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants' characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females' health. Conclusions Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.
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Affiliation(s)
- Anna Ponjoan
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Constanza Jacques-Aviñó
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Laura Medina-Perucha
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain
| | - Victor Romero
- Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain
| | - Ruth Martí-Lluch
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lia Alves-Cabratosa
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
| | - Rafel Ramos
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain.,Department of Medical Sciences, School of Medicine, Universitat de Girona, Girona, Spain
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Barcelona, Spain.,Department of Nursing, Universitat de Girona, Girona, Spain
| | - María Del Mar Garcia-Gil
- Grup en Salut Vascular de Girona (ISV-Girona), Institut Universitari d'Investigació en Atenció Primària (IDIAPJGol), Girona, Spain
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16
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Ou X, Jiang J, Lin B, Liu Q, Lin W, Chen G, Wen J. Antibody responses to COVID-19 vaccination in people with obesity: A systematic review and meta-analysis. Influenza Other Respir Viruses 2022; 17:e13078. [PMID: 36535669 PMCID: PMC9835425 DOI: 10.1111/irv.13078] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
COVID-19 vaccine is critical in preventing SARS-CoV-2 infection and transmission. However, obesity's effect on immune responses to COVID-19 vaccines is still unknown. We performed a meta-analysis of the literature and compared antibody responses with COVID-19 vaccines among persons with and without obesity. We used Pubmed, Embase, Web of Science, and Cochrane Library to identify all related studies up to April 2022. The Stata.14 software was used to analyze the selected data. Eleven studies were included in the present meta-analysis. Five of them provided absolute values of antibody titers in the obese group and non-obese group. Overall, we found that the obese population was significantly associated with lower antibody titers (standardized mean difference [SMD] = -0.228, 95% CI [-0.437, -0.019], P < 0.001) after COVID-19 vaccination. Significant heterogeneity was present in most pooled analyses but was reduced after subgroup analyses. No publication bias was observed in the present analysis. The Trim and Fill method did not change the results in the primary analysis. The present meta-analysis suggested that obesity was significantly associated with decreased antibody responses to SARS-CoV-2 vaccines. Future studies should be performed to unravel the mechanism of response to the COVID-19 vaccine in obese individuals.
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Affiliation(s)
- Xiaodan Ou
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
| | - Jialin Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
| | - Bingqian Lin
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
| | - Qinyu Liu
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
| | - Wei Lin
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
| | - Gang Chen
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
| | - Junping Wen
- Department of Endocrinology, Key Laboratory of Endocrinology, Fujian Provincial HospitalShengli Clinical Medical College of Fujian Medical UniversityFuzhouChina
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17
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The prevalence of SARS-CoV-2 antibodies within the community of a private tertiary university in the Philippines: A serial cross sectional study. PLoS One 2022; 17:e0268145. [PMID: 36469505 PMCID: PMC9721473 DOI: 10.1371/journal.pone.0268145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has caused a public health emergency in all sectors of society, including universities and other academic institutions. This study determined the seroprevalence of SARS-CoV-2 antibodies among administrators, faculty, staff, and students of a private tertiary academic institution in the Philippines over a 7 month period. It employed a serial cross-sectional method using qualitative and quantitative COVID-19 antibody test kits. A total of 1,318 participants were tested, showing 47.80% of the study population yielding IgG antibodies to SARS-CoV-2 virus. A general increase in seroprevalence was observed from June to December 2021, which coincided with the vaccine roll-out of the country. All brands yielded positive antibody formation, with mRNA vaccines having higher levels than other types of vaccines. A decreasing trend in IgG reactivity was found in vaccinated individuals after 1 to 6 months of completion of the 2 doses of the COVID-19 vaccine. Where possible, IgG and T-cell reactivity and/or neutralizing capacity against SAR-CoV-2 need to be monitored regardless of vaccine brand. Together with uptake of COVID-19 vaccines and boosters, other public health interventions such as wearing of masks and regular testing need to be continued for better protection. Effective communication is also needed to inform risks associated with activities across different settings. Investments in long-term measures such as air filtration and ventilation systems, and wastewater surveillance need to be made.
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18
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Geerling E, Hameed M, Weger-Lucarelli J, Pinto AK. Metabolic syndrome and aberrant immune responses to viral infection and vaccination: Insights from small animal models. Front Immunol 2022; 13:1015563. [PMID: 36532060 PMCID: PMC9747772 DOI: 10.3389/fimmu.2022.1015563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
This review outlines the propensity for metabolic syndrome (MetS) to induce elevated disease severity, higher mortality rates post-infection, and poor vaccination outcomes for viral pathogens. MetS is a cluster of conditions including high blood glucose, an increase in circulating low-density lipoproteins and triglycerides, abdominal obesity, and elevated blood pressure which often overlap in their occurrence. MetS diagnoses are on the rise, as reported cases have increased by greater than 35% since 1988, resulting in one-third of United States adults currently diagnosed as MetS patients. In the aftermath of the 2009 H1N1 pandemic, a link between MetS and disease severity was established. Since then, numerous studies have been conducted to illuminate the impact of MetS on enhancing virally induced morbidity and dysregulation of the host immune response. These correlative studies have emphasized the need for elucidating the mechanisms by which these alterations occur, and animal studies conducted as early as the 1940s have linked the conditions associated with MetS with enhanced viral disease severity and poor vaccine outcomes. In this review, we provide an overview of the importance of considering overall metabolic health in terms of cholesterolemia, glycemia, triglyceridemia, insulin and other metabolic molecules, along with blood pressure levels and obesity when studying the impact of metabolism-related malignancies on immune function. We highlight the novel insights that small animal models have provided for MetS-associated immune dysfunction following viral infection. Such animal models of aberrant metabolism have paved the way for our current understanding of MetS and its impact on viral disease severity, dysregulated immune responses to viral pathogens, poor vaccination outcomes, and contributions to the emergence of viral variants.
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Affiliation(s)
- Elizabeth Geerling
- Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Muddassar Hameed
- Department of Biomedical Science and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States,Center for Zoonotic and Arthropod-borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - James Weger-Lucarelli
- Department of Biomedical Science and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States,Center for Zoonotic and Arthropod-borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Amelia K. Pinto
- Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, St. Louis, MO, United States,*Correspondence: Amelia K. Pinto,
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19
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Drożdżyńska J, Jakubowska W, Kemuś M, Krokowska M, Karpezo K, Wiśniewska M, Bogdański P, Skrypnik D. SARS-CoV-2 and Influenza Vaccines in People with Excessive Body Mass-A Narrative Review. Life (Basel) 2022; 12:1617. [PMID: 36295052 PMCID: PMC9605570 DOI: 10.3390/life12101617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 08/30/2023] Open
Abstract
In the face of a growing number of overweight people and two widely known viral diseases, SARS-CoV-2 and influenza, it is crucial to be aware of the impact of excess body weight on immunisation against these diseases. The aim of this review is to show the effectiveness of SARS-CoV-2 and influenza vaccines in overweight and obese patients. Excessive adipose tissue releases cytokines and maintains local hypoxia, which causes persistent low-grade inflammation. These factors make excess body mass patients' immune systems weaker. Under such conditions, the humoral response becomes less efficient, leading to a weakened ability to fight against infection and an increased risk of developing lower antibody titres. Vaccines help to reduce morbidity both in normal-weight and excess body mass people, although most studies show that patients with higher BMI tend to lose the antibodies produced more quickly. It is shown that the most effective vaccines (in terms of preventing the infection and potential post-illness complications) are the BNT162b2 vaccine against SARS-CoV-2 and the inactivated influenza vaccine against influenza among both obese and non-obese subjects.
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Affiliation(s)
- Julia Drożdżyńska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Wiktoria Jakubowska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Marika Kemuś
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Martyna Krokowska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Konrad Karpezo
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Marcelina Wiśniewska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego St. 82/84, 60-569 Poznan, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego St. 82/84, 60-569 Poznan, Poland
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20
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Importance of the COVID-19 Vaccine Booster Dose in Protection and Immunity. Vaccines (Basel) 2022; 10:vaccines10101708. [PMID: 36298573 PMCID: PMC9610198 DOI: 10.3390/vaccines10101708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background: There is debate on the necessity of booster doses of COVID-19 vaccination, especially in countries with limited resources. Methods: This cross-sectional study was conducted in a referral laboratory in Tehran, Iran. The level of COVID-19 antibodies was measured and compared between individuals regarding the number of COVID-19 vaccine shots. Results: In this study, 176 individuals with a mean age of 36.3 (±11.7) years participated. A total of 112 individuals received two doses of the COVID-19 vaccine, and 64 individuals received three doses. Level of all antibodies was higher in those who received three doses than in those who received two doses of the COVID-19 vaccine. Considering the SARS-CoV-2 Spike IgG, the difference was not statistically significant but for the SARS-CoV-2 RBD IgG and SARS-CoV-2 NAB the difference was statistically significant. Regarding to the background variables, receiving influenza vaccine in the past year, history of autoimmune diseases and past medical history of chicken pox showed a significant association with the number of vaccine doses received. Their effects on the outcome variables assessed with multivariate logistic regression analysis. Conclusion: The results of our study show that a booster dose of the COVID-19 vaccine enhances the antibody response.
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21
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Canorio J, Sánchez F, Ramírez-Soto MC. COVID-19, Non-Communicable Diseases, and Behavioral Factors in the Peruvian Population ≥ 15 Years: An Ecological Study during the First and Second Year of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11757. [PMID: 36142027 PMCID: PMC9517029 DOI: 10.3390/ijerph191811757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
A range of health-related and behavioral risk factors are associated with COVID-19 incidence and mortality. In the present study, we assess the association between incidence, mortality, and case fatality rate due to COVID-19 and the prevalence of hypertension, obesity, overweight, tobacco and alcohol use in the Peruvian population aged ≥15 years during the first and second year of the COVID-19 pandemic. In this ecological study, we used the prevalence rates of hypertension, overweight, obesity, tobacco, and alcohol use obtained from the Encuesta Demográfica y de Salud Familiar (ENDES) 2020 and 2021. We estimated the crude incidence and mortality rates (per 100,000 habitants) and case fatality rate (%) of COVID-19 in 25 Peruvian regions using data from the Peruvian Ministry of Health that were accurate as of 31 December 2021. Spearman correlation and lineal regression analysis was applied to assess the correlations between the study variables as well as multivariable regression analysis adjusted by confounding factors affecting the incidence and mortality rate and case fatality rate of COVID-19. In 2020, adjusted by confounding factors, the prevalence rate of obesity (β = 0.582; p = 0.037) was found to be associated with the COVID-19 mortality rate (per 100,000 habitants). There was also an association between obesity and the COVID-19 case fatality rate (β = 0.993; p = 0.014). In 2021, the prevalence of obesity was also found to be associated with the COVID-19 mortality rate (β = 0.713; p = 0.028); however, adjusted by confounding factors, including COVID-19 vaccination coverage rates, no association was found between the obesity prevalence and the COVID-19 mortality rate (β = 0.031; p = 0.895). In summary, Peruvian regions with higher obesity prevalence rates had higher COVID-19 mortality and case fatality rates during the first year of the COVID-19 pandemic. However, adjusted by the COVID-19 vaccination coverage, no association between the obesity prevalence rate and the COVID-19 mortality rate was found during the second year of the COVID-19 pandemic.
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22
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Liu J, Li ZB, Lu QQ, Yu Y, Zhang SQ, Ke PF, Zhang F, Li JC. Metabolite profile of COVID-19 revealed by UPLC-MS/MS-based widely targeted metabolomics. Front Immunol 2022; 13:894170. [PMID: 35924246 PMCID: PMC9339702 DOI: 10.3389/fimmu.2022.894170] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/28/2022] [Indexed: 02/05/2023] Open
Abstract
The metabolic characteristics of COVID-19 disease are still largely unknown. Here, 44 patients with COVID-19 (31 mild COVID-19 patients and 13 severe COVID-19 patients), 42 healthy controls (HC), and 42 patients with community-acquired pneumonia (CAP), were involved in the study to assess their serum metabolomic profiles. We used widely targeted metabolomics based on an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The differentially expressed metabolites in the plasma of mild and severe COVID-19 patients, CAP patients, and HC subjects were screened, and the main metabolic pathways involved were analyzed. Multiple mature machine learning algorithms confirmed that the metabolites performed excellently in discriminating COVID-19 groups from CAP and HC subjects, with an area under the curve (AUC) of 1. The specific dysregulation of AMP, dGMP, sn-glycero-3-phosphocholine, and carnitine was observed in the severe COVID-19 group. Moreover, random forest analysis suggested that these metabolites could discriminate between severe COVID-19 patients and mild COVID-19 patients, with an AUC of 0.921. This study may broaden our understanding of pathophysiological mechanisms of COVID-19 and may offer an experimental basis for developing novel treatment strategies against it.
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Affiliation(s)
- Jun Liu
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Zhi-Bin Li
- The Central Laboratory, Yangjiang People’s Hospital, Yangjiang, China
| | - Qi-Qi Lu
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Yi Yu
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
- The Central Laboratory, Yangjiang People’s Hospital, Yangjiang, China
| | - Shan-Qiang Zhang
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Pei-Feng Ke
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Fan Zhang
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Ji-Cheng Li
- Medical Research Center, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
- The Central Laboratory, Yangjiang People’s Hospital, Yangjiang, China
- Department of Histology and Embryology, Shaoguan University School of Medicine, Shaoguan, China
- Institute of Cell Biology, Zhejiang University School of Medicine, Hangzhou, China
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23
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Yu L, Zhang X, Ye S, Lian H, Wang H, Ye J. Obesity and COVID-19: Mechanistic Insights From Adipose Tissue. J Clin Endocrinol Metab 2022; 107:1799-1811. [PMID: 35262698 PMCID: PMC8992328 DOI: 10.1210/clinem/dgac137] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Indexed: 02/08/2023]
Abstract
Obesity is associated with an increase in morbidity and mortality from coronavirus disease 2019 (COVID-19). The risk is related to the cytokine storm, a major contributor to multiorgan failure and a pathological character of COVID-19 patients with obesity. While the exact cause of the cytokine storm remains elusive, disorders in energy metabolism has provided insights into the mechanism. Emerging data suggest that adipose tissue in obesity contributes to the disorders in several ways. First, adipose tissue restricts the pulmonary function by generation of mechanical pressures to promote systemic hypoxia. Second, adipose tissue supplies a base for severe acute respiratory syndrome coronavirus 2 entry by overexpression of viral receptors [angiotensin-converting enzyme 2 and dipeptidyl peptidase 4]. Third, impaired antiviral responses of adipocytes and immune cells result in dysfunction of immunologic surveillance as well as the viral clearance systems. Fourth, chronic inflammation in obesity contributes to the cytokine storm by secreting more proinflammatory cytokines. Fifth, abnormal levels of adipokines increase the risk of a hyperimmune response to the virus in the lungs and other organs to enhance the cytokine storm. Mitochondrial dysfunction in adipocytes, immune cells, and other cell types (endothelial cells and platelets, etc) is a common cellular mechanism for the development of cytokine storm, which leads to the progression of mild COVID-19 to severe cases with multiorgan failure and high mortality. Correction of energy surplus through various approaches is recommended in the prevention and treatment of COVID-19 in the obese patients.
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Affiliation(s)
- Lili Yu
- Department of Immunology, Institute of Precision Medicine, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang 453003, China
| | - Xiaoying Zhang
- Metabolic Disease Research Center, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhengzhou 450007, China
| | - Sarah Ye
- Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Hongkai Lian
- Metabolic Disease Research Center, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhengzhou 450007, China
| | - Hui Wang
- Henan Key Laboratory of Immunology and Targeted Therapy, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang 453003, China
| | - Jianping Ye
- Metabolic Disease Research Center, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhengzhou 450007, China
- Center for Advanced Medicine, College of Medicine, Zhengzhou University, Zhengzhou 450007, China
- Corresponding author:
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24
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When to operate after SARS-CoV-2 infection? A review on the recent consensus recommendation of the DGC/BDC and the DGAI/BDA. Langenbecks Arch Surg 2022; 407:1315-1332. [PMID: 35307746 PMCID: PMC8934603 DOI: 10.1007/s00423-022-02495-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 02/07/2023]
Abstract
Since the eruption of the worldwide SARS-CoV-2 pandemic in late 2019/early 2020, multiple elective surgical interventions were postponed. Through pandemic measures, elective operation capacities were reduced in favour of intensive care treatment for critically ill SARS-CoV-2 patients. Although intermittent low-incidence infection rates allowed an increase in elective surgery, surgeons have to include long-term pulmonary and extrapulmonary complications of SARS-CoV-2 infections (especially “Long Covid”) in their perioperative management considerations and risk assessment procedures. This review summarizes recent consensus statements and recommendations regarding the timepoint for surgical intervention after SARS-CoV-2 infection released by respective German societies and professional representatives including DGC/BDC (Germany Society of Surgery/Professional Association of German Surgeons e.V.) and DGAI/BDA (Germany Society of Anesthesiology and Intensive Care Medicine/Professional Association of German Anesthesiologists e.V.) within the scope of the recent literature. The current literature reveals that patients with pre- and perioperative SARS-CoV-2 infection have a dramatically deteriorated postoperative outcome. Thereby, perioperative mortality is mainly caused by pulmonary and thromboembolic complications. Notably, perioperative mortality decreases to normal values over time depending on the duration of SARS-CoV-2 infection.
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25
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Papadopoulos D, Ntanasis-Stathopoulos I, Gavriatopoulou M, Evangelakou Z, Malandrakis P, Manola MS, Gianniou DD, Kastritis E, Trougakos IP, Dimopoulos MA, Karalis V, Terpos E. Predictive Factors for Neutralizing Antibody Levels Nine Months after Full Vaccination with BNT162b2: Results of a Machine Learning Analysis. Biomedicines 2022; 10:biomedicines10020204. [PMID: 35203412 PMCID: PMC8869256 DOI: 10.3390/biomedicines10020204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/07/2023] Open
Abstract
Vaccination against SARS-CoV-2 with BNT162b2 mRNA vaccine plays a critical role in COVID-19 prevention. Although BNT162b2 is highly effective against COVID-19, a time-dependent decrease in neutralizing antibodies (NAbs) is observed. The aim of this study was to identify the individual features that may predict NAbs levels after vaccination. Machine learning techniques were applied to data from 302 subjects. Principal component analysis (PCA), factor analysis of mixed data (FAMD), k-means clustering, and random forest were used. PCA and FAMD showed that younger subjects had higher levels of neutralizing antibodies than older subjects. The effect of age is strongest near the vaccination date and appears to decrease with time. Obesity was associated with lower antibody response. Gender had no effect on NAbs at nine months, but there was a modest association at earlier time points. Participants with autoimmune disease had lower inhibitory levels than participants without autoimmune disease. K-Means clustering showed the natural grouping of subjects into five categories in which the characteristics of some individuals predominated. Random forest allowed the characteristics to be ordered by importance. Older age, higher body mass index, and the presence of autoimmune diseases had negative effects on the development of NAbs against SARS-CoV-2, nine months after full vaccination.
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Affiliation(s)
- Dimitris Papadopoulos
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece;
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Zoi Evangelakou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Maria S. Manola
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Despoina D. Gianniou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Ioannis P. Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Vangelis Karalis
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece;
- Correspondence: (V.K.); (E.T.)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
- Correspondence: (V.K.); (E.T.)
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Watanabe M, Balena A, Masi D, Tozzi R, Risi R, Caputi A, Rossetti R, Spoltore ME, Biagi F, Anastasi E, Angeloni A, Mariani S, Lubrano C, Tuccinardi D, Gnessi L. Rapid Weight Loss, Central Obesity Improvement and Blood Glucose Reduction Are Associated with a Stronger Adaptive Immune Response Following COVID-19 mRNA Vaccine. Vaccines (Basel) 2022; 10:vaccines10010079. [PMID: 35062740 PMCID: PMC8780354 DOI: 10.3390/vaccines10010079] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 02/07/2023] Open
Abstract
Obesity is associated with a poor COVID-19 prognosis, and it seems associated with reduced humoral response to vaccination. Public health campaigns have advocated for weight loss in subjects with obesity, hoping to eliminate this risk. However, no evidence proves that weight loss leads to a better prognosis or a stronger immune response to vaccination. We aimed to investigate the impact of rapid weight loss on the adaptive immune response in subjects with morbid obesity. Twenty-one patients followed a hypocaloric, very-low-carbohydrate diet one week before to one week after the two mRNA vaccine doses. The diet’s safety and efficacy were assessed, and the adaptive humoral (anti-SARS CoV-2 S antibodies, Abs) and cell-mediated responses (IFNγ secretion on stimulation with two different SARS CoV-2 peptide mixes, IFNγ-1 and IFNγ-2) were evaluated. The patients lost ~10% of their body weight with metabolic improvement. A high baseline BMI correlated with a poor immune response (R −0.558, p = 0.013 for IFNγ-1; R −0.581, p = 0.009 for IFNγ-2; R −0.512, p = 0.018 for Abs). Furthermore, there was a correlation between weight loss and higher IFNγ-2 (R 0.471, p = 0.042), and between blood glucose reduction and higher IFNγ-1 (R 0.534, p = 0.019), maintained after weight loss and waist circumference reduction adjustment. Urate reduction correlated with higher Abs (R 0.552, p = 0.033). In conclusion, obesity is associated with a reduced adaptive response to a COVID-19 mRNA vaccine, and weight loss and metabolic improvement may reverse the effect.
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Affiliation(s)
- Mikiko Watanabe
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
- Correspondence:
| | - Angela Balena
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Davide Masi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Rossella Tozzi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy;
| | - Renata Risi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Alessandra Caputi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Rebecca Rossetti
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Maria Elena Spoltore
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Filippo Biagi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Emanuela Anastasi
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (E.A.); (A.A.)
| | - Antonio Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (E.A.); (A.A.)
| | - Stefania Mariani
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Carla Lubrano
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
| | - Dario Tuccinardi
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, 00128 Rome, Italy;
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.B.); (D.M.); (R.R.); (A.C.); (R.R.); (M.E.S.); (F.B.); (S.M.); (C.L.); (L.G.)
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27
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Kara Z, Akçin R, Demir AN, Dinç HÖ, Kocazeybek B, Yumuk VD. Risk Factors Influencing Seroconversion after Inactive SARS-CoV-2 Vaccination in People Living with Obesity. Obes Facts 2022; 15:648-654. [PMID: 35921804 PMCID: PMC9669952 DOI: 10.1159/000525555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to investigate the antibody titers against SARS-CoV-2 spike antigens and the risk factors affecting antibody levels in people living with obesity (PwO) after inactive SARS-CoV-2 vaccine (CoronaVac) administration. METHODS 169 consecutive patients with obesity who visited the Center for Obesity Management at Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty Hospitals, between May and August 2021, were invited to the study. The nonobese control group was recruited from 191 subjects who visited the Cerrahpaşa Hospitals Vaccination Unit. The study group and the nonobese control group have already received two doses of inactive SARS-CoV-2 vaccine. The SARS-CoV-2 IgG nucleocapsid antibody test was administered to patients and control subjects to discover those who had prior SARS-CoV-2 infection. Forty-one patients who had prior infection and received two doses of vaccine were also included in the study as a subgroup. Blood samples were taken on the 3rd to 4th week after the second vaccination. SARS-CoV-2 IgG antibody titers were determined by quantitative serological methods. RESULTS Antibody titers against SARS-CoV-2 spike antigen of individuals with BMI ≥30.0 kg/m2 were significantly lower than those with BMI <30 kg/m2 (p = 0.001) in the study group. Moreover, the antibody titers in people with BMI ≥30.0 kg/m2 were significantly lower than in those having a BMI <30.0 kg/m2 in the subgroup (p = 0.03). Age (p = 0.03), BMI (p = 0.006), and hypertension (p = 0.03) were found to be independent risk factors for antibody response in PwO. Women with non-prior SARS-CoV-2 infection showed a significantly higher antibody response then men (p = 0.001). CONCLUSION SARS-CoV-2-Immunoglobulin G antibody levels against inactive (CoronaVac) vaccine were found to be lower in PwO compared to nonobese individuals. Antibody titers may be measured, and booster doses should be delivered accordingly in PwO for optimal protection.
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Affiliation(s)
- Zehra Kara
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey
- *Zehra Kara,
| | - Rüveyda Akçin
- Department of Medical Microbiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Ahmet Numan Demir
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Harika Öykü Dinç
- Department of Medical Microbiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Bezmialem Vakıf University, Istanbul, Turkey
| | - Bekir Kocazeybek
- Department of Medical Microbiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Volkan Demirhan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey
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Isaka Y, Hirasawa Y, Terada J, Shionoya Y, Takeshita Y, Kinouchi T, Koshikawa K, Tajima H, Kinoshita T, Tada Y, Tatsumi K, Tsushima K. Preliminary study regarding the predicted body weight-based dexamethasone therapy in patients with COVID-19 pneumonia. Pulm Pharmacol Ther 2021; 72:102108. [PMID: 34923122 PMCID: PMC8677429 DOI: 10.1016/j.pupt.2021.102108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/30/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The RECOVERY clinical trial reported that 6 mg of dexamethasone once daily for up to 10 days reduces the 28-day mortality in patients with coronavirus disease 2019 (COVID-19) receiving respiratory support. In our clinical setting, a fixed dose of dexamethasone has prompted the question of whether inflammatory modulation effects sufficiently reduce lung injury. Therefore, preliminary verification on the possibility of predicted body weight (PBW)-based dexamethasone therapy was conducted in patients with COVID-19 pneumonia. METHODS This single-center retrospective study was conducted in a Japanese University Hospital to compare the treatment strategies/management in different periods. Consecutive patients (n = 90) with COVID-19 pneumonia requiring oxygen therapy and were treated with dexamethasone between June 2020 and May 2021 were analyzed. Initially, 60 patients administered a fixed dexamethasone dose of 6.6 mg/day were defined as the conventional group, and then, 30 patients were changed to PBW-based therapy. The 30-day discharged alive rate and duration of oxygen therapy were analyzed using the Kaplan-Meier method and compared using the log-rank test. The multivariable Cox regression was used to evaluate the effects of PBW-based dexamethasone therapy on high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), or mechanical ventilation (MV). RESULTS In the PBW-based group, 9, 13, and 8 patients were administered 6.6, 9.9, and 13.2 mg/day of dexamethasone, respectively. Additional respiratory support including HFNC, NIV, or MV was significantly less frequently used in the PBW-based group (P = 0.0046), with significantly greater cumulative incidence of being discharged alive and shorter oxygen demand within 30 days (92 vs. 89%, log-rank P = 0.0094, 90 vs. 92%, log-rank P = 0.0002, respectively). Patients treated with PBW-based therapy significantly decreased the use of additional respiratory support after adjusting for baseline imbalances (adjusted odds ratio, 0.224; 95% confidence interval, 0.062-0.813, P = 0.023). Infection occurred in 13 (21%) and 2 (7%) patients in the conventional and PBW-based groups, respectively (P = 0.082). CONCLUSIONS In patients with COVID-19 pneumonia requiring oxygen therapy, PBW-based dexamethasone therapy may potentially shorten the length of hospital stay and duration of oxygen therapy and risk of using HFNC, NPPV, or MV without increasing serious adverse events or 30-day mortality.
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Affiliation(s)
- Yuri Isaka
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Yasutaka Hirasawa
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan.
| | - Jiro Terada
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
| | - Yu Shionoya
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
| | - Yuichiro Takeshita
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
| | - Toru Kinouchi
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Ken Koshikawa
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Hiroshi Tajima
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
| | - Taku Kinoshita
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
| | - Yuji Tada
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
| | - Koichiro Tatsumi
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Kenji Tsushima
- Department of Pulmonary Medicine, International University of Health and Welfare, Narita Hospital, Hatakeda 852, Narita, Chiba, 286-8520, Japan
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29
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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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30
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Westheim AJF, Bitorina AV, Theys J, Shiri-Sverdlov R. COVID-19 infection, progression, and vaccination: Focus on obesity and related metabolic disturbances. Obes Rev 2021; 22:e13313. [PMID: 34269511 PMCID: PMC8420274 DOI: 10.1111/obr.13313] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
Coronaviruses are constantly circulating in humans, causing common colds and mild respiratory infections. In contrast, infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for coronavirus disease-2019 (COVID-19), can cause additional severe complications, particularly in patients with obesity and associated metabolic disturbances. Obesity is a principal causative factor in the development of the metabolic syndrome; a series of physiological, biochemical, clinical, and metabolic factors that increase the risk of obesity-associated diseases. "Metabolically unhealthy" obesity is, in addition to metabolic disturbances, also associated with immunological disturbances. As such, patients with obesity are more prone to develop serious complications from infections, including those from SARS-CoV-2. In this review, we first describe how obesity and related metabolic disturbances increase the risk of SARS-CoV-2 infection. Then, mechanisms contributing to COVID-19 complications and poor prognosis in these patients are discussed. Finally, we discuss how obesity potentially reduces long-term COVID-19 vaccination efficacy. Despite encouraging COVID-19 vaccination results in patients with obesity and related metabolic disturbances in the short-term, it is becoming increasingly evident that long-term COVID-19 vaccination efficacy should be closely monitored in this vulnerable group.
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Affiliation(s)
- Annemarie J F Westheim
- Department of Precision Medicine, GROW-Research School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Albert V Bitorina
- Department of Molecular Genetics, NUTRIM-School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jan Theys
- Department of Precision Medicine, GROW-Research School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ronit Shiri-Sverdlov
- Department of Molecular Genetics, NUTRIM-School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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