1
|
Rani A, Stadler JT, Marsche G. HDL-based therapeutics: A promising frontier in combating viral and bacterial infections. Pharmacol Ther 2024; 260:108684. [PMID: 38964560 DOI: 10.1016/j.pharmthera.2024.108684] [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: 02/26/2024] [Revised: 06/03/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024]
Abstract
Low levels of high-density lipoprotein (HDL) and impaired HDL functionality have been consistently associated with increased susceptibility to infection and its serious consequences. This has been attributed to the critical role of HDL in maintaining cellular lipid homeostasis, which is essential for the proper functioning of immune and structural cells. HDL, a multifunctional particle, exerts pleiotropic effects in host defense against pathogens. It functions as a natural nanoparticle, capable of sequestering and neutralizing potentially harmful substances like bacterial lipopolysaccharides. HDL possesses antiviral activity, preventing viruses from entering or fusing with host cells, thereby halting their replication cycle. Understanding the complex relationship between HDL and the immune system may reveal innovative targets for developing new treatments to combat infectious diseases and improve patient outcomes. This review aims to emphasize the role of HDL in influencing the course of bacterial and viral infections and its and its therapeutic potential.
Collapse
Affiliation(s)
- Alankrita Rani
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Styria, Austria
| | - Julia T Stadler
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Styria, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Styria, Austria; BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Styria, Austria.
| |
Collapse
|
2
|
Omondi AA, Day AM, Washington R, Burns PB. Attitudes and Misconceptions of Coronavirus Disease and Vaccination Among African Americans in Rural Mississippi. HEALTH COMMUNICATION 2024; 39:1358-1370. [PMID: 37190668 DOI: 10.1080/10410236.2023.2212443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Despite the recommendations for COVID-19 preventive health behaviors, it continues to increase alarmingly. This study examined how media coverage, myths, political leaders, and community leaders influence the attitudes and misconceptions about COVID-19 and COVID-19 vaccination uptake in the Mississippi Delta region. This qualitative study employed focus group discussions (FDGs) with representatives from three rural counties in the Mississippi Delta. A thematic analysis approach was used for data analysis. Participants were aware of how COVID-19 is transmitted, the preventative measures that can be used to mitigate the spread of the virus, and misconceptions and beliefs that lingered in their communities. Participants were uncertain about the need for the COVID-19 vaccine in terms of perceived risks (e.g., side effects, efficacy, and safety) and its novelty. Participants also discussed a wide range of COVID-19 misinformation that resulted in distress and distrust of the vaccine and health behavior recommendations. There are varying misconceptions and beliefs about COVID-19 and COVID-19 vaccine among communities in the rural Mississippi Delta. Thus, multi-sectoral collaborations between agencies that can use risk communication frameworks to deliver accurate health information that can resolve misinformation about COVID-19 in rural communities are needed.
Collapse
Affiliation(s)
- Angela A Omondi
- Department of Behavioral and Environmental Health, Jackson State University
| | | | - Rodney Washington
- Department of Population Health, University of Mississippi Medical Center
| | - Paul B Burns
- Department of Population Health, University of Mississippi Medical Center
| |
Collapse
|
3
|
Hunter PR, Brainard J. Changing risk factors for developing SARS-CoV-2 infection from Delta to Omicron. PLoS One 2024; 19:e0299714. [PMID: 38748651 PMCID: PMC11095668 DOI: 10.1371/journal.pone.0299714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/14/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND One of the few studies to estimate infection risk with SARS-CoV-2 in the general population was the UK Office of National Statistics Infection Survey. This survey provided data that allowed us to describe and interpret apparent risk factors for testing positive for SARS-CoV-2 in a period when variants and COVID-19 controls experienced large changes. METHOD The ONS published estimates of likelihood of individuals testing positive in two week monitoring periods between 21st November 2021 and 7th May 2022, relating this positivity to social and behavioural factors. We applied meta-regression to these estimates of likelihood of testing positive to determine whether the monitored potential risk factors remained constant during the pandemic. RESULTS Some risk factors had consistent relationship with risk of infection (always protective or always linked to higher risk, throughout monitoring period). Other risk factors had variable relationship with risk of infection, with changes seeming to especially correlate with the emergence of Omicron BA.2 dominance. These variable factors were mask-wearing habits, history of foreign travel, household size, working status (retired or not) and contact with children or persons age over 70. CONCLUSION Relevance of some risk factors to likelihood of testing positive for SARS-CoV-2 may relate to reinfection risk, variant infectiousness and status of social distancing regulations.
Collapse
Affiliation(s)
- Paul R. Hunter
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| |
Collapse
|
4
|
Takács J, Deák D, Koller A. Higher level of physical activity reduces mental and neurological symptoms during and two years after COVID-19 infection in young women. Sci Rep 2024; 14:6927. [PMID: 38519586 PMCID: PMC10960016 DOI: 10.1038/s41598-024-57646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
Previous studies found that regular physical activity (PA) can lower the risk of SARS-CoV-2 (COVID-19) infection and post-COVID-19 condition (PCC), yet its specific effects in young women have not yet been investigated. Thus, we aimed to examine whether regular physical activity reduces the number of symptoms during and after COVID-19 infection among young women aged between 18 and 34 (N = 802), in which the confounding effect of other morbidities could be excluded. The average time since infection was 23.5 months. Participants were classified into low, moderate, and high PA categories based on the reported minutes per week of moderate and vigorous PA. Using the Post-COVID-19 Case Report Form, 50 different symptoms were assessed. Although regular PA did not decrease the prevalence of COVID-19 infection and PCC but significantly reduced the number of mental and neurological symptoms both in acute COVID-19 and PCC. Importantly, the high level of PA had a greater impact on health improvements. In addition, the rate of reinfection decreased with an increased level of PA. In conclusion, a higher level of regular PA can reduce the risk of reinfection and the number of mental and neurological symptoms in PCC underlying the importance of regular PA, even in this and likely other viral disease conditions.
Collapse
Affiliation(s)
- Johanna Takács
- Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.
| | - Darina Deák
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Akos Koller
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
- Department of Translational Medicine, Faculty of Medicine, HUN-REN-SE Cerebrovascular and Neurocognitive Disease Research Group, Semmelweis University, Budapest, Hungary
- Research Center for Sport Physiology, Hungarian University of Sports Science, Budapest, Hungary
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| |
Collapse
|
5
|
Hopkins R, Young KG, Thomas NJ, Godwin J, Raja D, Mateen BA, Challen RJ, Vollmer SJ, Shields BM, McGovern AP, Dennis JM. Risk factor associations for severe COVID-19, influenza and pneumonia in people with diabetes to inform future pandemic preparations: UK population-based cohort study. BMJ Open 2024; 14:e078135. [PMID: 38296292 PMCID: PMC10831438 DOI: 10.1136/bmjopen-2023-078135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE This study aimed to compare clinical and sociodemographic risk factors for severe COVID-19, influenza and pneumonia, in people with diabetes. DESIGN Population-based cohort study. SETTING UK primary care records (Clinical Practice Research Datalink) linked to mortality and hospital records. PARTICIPANTS Individuals with type 1 and type 2 diabetes (COVID-19 cohort: n=43 033 type 1 diabetes and n=584 854 type 2 diabetes, influenza and pneumonia cohort: n=42 488 type 1 diabetes and n=585 289 type 2 diabetes). PRIMARY AND SECONDARY OUTCOME MEASURES COVID-19 hospitalisation from 1 February 2020 to 31 October 2020 (pre-COVID-19 vaccination roll-out), and influenza and pneumonia hospitalisation from 1 September 2016 to 31 May 2019 (pre-COVID-19 pandemic). Secondary outcomes were COVID-19 and pneumonia mortality. Associations between clinical and sociodemographic risk factors and each outcome were assessed using multivariable Cox proportional hazards models. In people with type 2 diabetes, we explored modifying effects of glycated haemoglobin (HbA1c) and body mass index (BMI) by age, sex and ethnicity. RESULTS In type 2 diabetes, poor glycaemic control and severe obesity were consistently associated with increased risk of hospitalisation for COVID-19, influenza and pneumonia. The highest HbA1c and BMI-associated relative risks were observed in people aged under 70 years. Sociodemographic-associated risk differed markedly by respiratory infection, particularly for ethnicity. Compared with people of white ethnicity, black and south Asian groups had a greater risk of COVID-19 hospitalisation, but a lesser risk of pneumonia hospitalisation. Risk factor associations for type 1 diabetes and for type 2 diabetes mortality were broadly consistent with the primary analysis. CONCLUSIONS Clinical risk factors of high HbA1c and severe obesity are consistently associated with severe outcomes from COVID-19, influenza and pneumonia, especially in younger people. In contrast, associations with sociodemographic risk factors differed by type of respiratory infection. This emphasises that risk stratification should be specific to individual respiratory infections.
Collapse
Affiliation(s)
- Rhian Hopkins
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Katherine G Young
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Nicholas J Thomas
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - James Godwin
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Daniyal Raja
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Bilal A Mateen
- The Alan Turing Institute, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Robert J Challen
- Engineering Mathematics, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration South West Peninsula, Exeter, UK
| | | | - Beverley M Shields
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Andrew P McGovern
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - John M Dennis
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| |
Collapse
|
6
|
Fernández-Elgueta AM, Retamal-Matus HF, Núñez-Espinosa C, Barria Aburto P. [Quality of life of people with Parkinson's disease during confinement due to the covid-19 pandemic]. Rehabilitacion (Madr) 2024; 58:100821. [PMID: 37862775 DOI: 10.1016/j.rh.2023.100821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/13/2023] [Accepted: 01/31/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION The study was aimed to explore the quality of life of people with Parkinson's disease during confinement due to the coronavirus infectious disease 2019 (covid-19) pandemic. MATERIAL AND METHODS The study was quantitative, descriptive and correlational. The sample was 51 people with Parkinson's disease, from the region of Magallanes and Chilean Antarctica, and whose information was collected from the database of the Rehabilitation Corporation Club de Leones Cruz del Sur, to which they belong. RESULTS The main results show that 51.6% of people with Parkinson's disease report a «good and very good» quality of life and that the main domains of the Parkinson's Disease Questionnaire (PDQ-39) affected are: body discomfort, mobility and emotional well-being. According to the analysis of the qualitative ranges of the PDQ-39, the dimensions that were most compromised during the confinement by the covid-19 pandemic were: communication, stigma and emotional well-being. In addition, women had a poorer quality of life than men. Finally, it was shown that the progression of symptoms affects the quality of life of people with Parkinson's disease. CONCLUSIONS In conclusion, during the confinement due to the covid-19 pandemic people with Parkinson's disease increased symptoms and presented a lower quality of life, especially women.
Collapse
Affiliation(s)
- A M Fernández-Elgueta
- Departamento de Kinesiología, Universidad de Magallanes, Punta Arenas, Chile; Departamento de Fisioterapia, Universidad de Valencia, Valencia, España.
| | - H F Retamal-Matus
- Departamento de Kinesiología, Universidad de Magallanes, Punta Arenas, Chile; Departamento de Fisioterapia, Universidad de Valencia, Valencia, España; Escuela de Medicina, Universidad de Magallanes, Punta Arenas, Chile; Centro Asistencial Docente e Investigación (CADI-UMAG), Punta Arenas, Chile
| | - C Núñez-Espinosa
- Escuela de Medicina, Universidad de Magallanes, Punta Arenas, Chile; Interuniversity Center for Healthy Aging, Punta Arenas, Chile
| | - P Barria Aburto
- Corporación de Rehabilitación Club de Leones Cruz del Sur, Punta Arenas, Chile
| |
Collapse
|
7
|
Yang Y, Song Y, Hou D. Obesity and COVID-19 Pandemics: Epidemiology, Mechanisms, and Management. Diabetes Metab Syndr Obes 2023; 16:4147-4156. [PMID: 38145256 PMCID: PMC10749174 DOI: 10.2147/dmso.s441762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023] Open
Abstract
Obesity is a principle causative factor of various metabolic dysfunctions, chronic inflammation, and multi-organ impairment. The global epidemic of obesity has constituted the greatest threat to global health. Emerging evidence has associated obesity with an increased risk of severe infection and poor outcomes from coronavirus disease 2019 (COVID-19). During current COVID-19 pandemic, the interaction between COVID-19 and obesity has exaggerated the disease burden of obesity more than ever before. Thus, there is an urgent need for consideration of universal measures to reduce the risk of complications and severe illness from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in obesity population. In this review, we first summarized the clinical evidence on the effect of obesity on susceptibility, severity, and prognosis of COVID-19. Then we discussed and the underlying mechanisms, including respiratory pathophysiology of obesity, dysregulated inflammation, upregulated angiotensin-converting enzyme 2 (ACE2) expression, hyperglycemia, and adipokines. Finally, we proposed recommendations on how to reduce the spread and pandemic of SARS-CoV-2 infection by prevention and treatment of obesity.
Collapse
Affiliation(s)
- Yanping Yang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
| | - Yuanlin Song
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- Shanghai Respiratory Research Institute, Shanghai, People’s Republic of China
| | - Dongni Hou
- Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| |
Collapse
|
8
|
Urdiales T, Dernie F, Català M, Prats-Uribe A, Prats C, Prieto-Alhambra D. Association between ethnic background and COVID-19 morbidity, mortality and vaccination in England: a multistate cohort analysis using the UK Biobank. BMJ Open 2023; 13:e074367. [PMID: 37734898 PMCID: PMC10514643 DOI: 10.1136/bmjopen-2023-074367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/26/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES Despite growing evidence suggesting increased COVID-19 mortality among people from ethnic minorities, little is known about milder forms of SARS-CoV-2 infection. We sought to explore the association between ethnic background and the probability of testing, testing positive, hospitalisation, COVID-19 mortality and vaccination uptake. DESIGN A multistate cohort analysis. Participants were followed between 8 April 2020 and 30 September 2021. SETTING The UK Biobank, which stores medical data on around half a million people who were recruited between 2006 and 2010. PARTICIPANTS 405 541 subjects were eligible for analysis, limited to UK Biobank participants living in England. 23 891 (6%) of participants were non-white. PRIMARY AND SECONDARY OUTCOME MEASURES The associations between ethnic background and testing, testing positive, hospitalisation and COVID-19 mortality were studied using multistate survival analyses. The association with single and double-dose vaccination was also modelled. Multistate models adjusted for age, sex and socioeconomic deprivation were fitted to estimate adjusted HRs (aHR) for each of the multistate transitions. RESULTS 18 172 (4.5%) individuals tested positive, 3285 (0.8%) tested negative and then positive, 1490 (6.9% of those tested positive) were hospitalised, and 129 (0.6%) tested positive at the moment of hospital admission (ie, direct hospitalisation). Finally, 662 (17.4%) died after admission. Compared with white participants, Asian participants had an increased risk of negative to positive transition (aHR 1.24 (95% CI 1.02 to 1.52)), testing positive (95% CI 1.44 (1.33 to 1.55)) and direct hospitalisation (1.61 (95% CI 1.28 to 2.03)). Black participants had an increased risk of hospitalisation following a positive test (1.71 (95% CI 1.29 to 2.27)) and direct hospitalisation (1.90 (95% CI 1.51 to 2.39)). Although not the case for Asians (aHR 1.00 (95% CI 0.98 to 1.02)), black participants had a reduced vaccination probability (0.63 (95% CI 0.62 to 0.65)). In contrast, Chinese participants had a reduced risk of testing negative (aHR 0.64 (95% CI 0.57 to 0.73)), of testing positive (0.40 (95% CI 0.28 to 0.57)) and of vaccination (0.78 (95% CI 0.74 to 0.83)). CONCLUSIONS We identified inequities in testing, vaccination and COVID-19 outcomes according to ethnicity in England. Compared with whites, Asian participants had increased risks of infection and admission, and black participants had almost double hospitalisation risk, and a 40% lower vaccine uptake.
Collapse
Affiliation(s)
- Tomás Urdiales
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
- Department of Energy Technology, Royal Institute of Technology, Stockholm, Sweden
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Francesco Dernie
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Martí Català
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Albert Prats-Uribe
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
9
|
Raventós B, Fernández-Bertolín S, Aragón M, Voss EA, Blacketer C, Méndez-Boo L, Recalde M, Roel E, Pistillo A, Reyes C, van Sandijk S, Halvorsen L, Rijnbeek PR, Burn E, Duarte-Salles T. Transforming the Information System for Research in Primary Care (SIDIAP) in Catalonia to the OMOP Common Data Model and Its Use for COVID-19 Research. Clin Epidemiol 2023; 15:969-986. [PMID: 37724311 PMCID: PMC10505380 DOI: 10.2147/clep.s419481] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/03/2023] [Indexed: 09/20/2023] Open
Abstract
Purpose The primary aim of this work was to convert the Information System for Research in Primary Care (SIDIAP) from Catalonia, Spain, to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). Our second aim was to provide a descriptive analysis of COVID-19-related outcomes among the general population. Patients and Methods We mapped patient-level data from SIDIAP to the OMOP CDM and we performed more than 3,400 data quality checks to assess its readiness for research. We established a general population cohort as of the 1st March 2020 and identified outpatient COVID-19 diagnoses or tested positive for, hospitalised with, admitted to intensive care units (ICU) with, died with, or vaccinated against COVID-19 up to 30th June 2022. Results After verifying the high quality of the transformed dataset, we included 5,870,274 individuals in the general population cohort. Of those, 604,472 had either an outpatient COVID-19 diagnosis or positive test result, 58,991 had a hospitalisation, 5,642 had an ICU admission, and 11,233 died with COVID-19. A total of 4,584,515 received a COVID-19 vaccine. People who were hospitalised or died were more commonly older, male, and with more comorbidities. Those admitted to ICU with COVID-19 were generally younger and more often male than those hospitalised and those who died. Conclusion We successfully transformed SIDIAP to the OMOP CDM. From this dataset, a general population cohort of 5.9 million individuals was identified and their COVID-19-related outcomes over time were described. The transformed SIDIAP database is a valuable resource that can enable distributed network research in COVID-19 and beyond.
Collapse
Affiliation(s)
- Berta Raventós
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Sergio Fernández-Bertolín
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - María Aragón
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Erica A Voss
- Janssen Pharmaceutical Research and Development, Titusville, NJ, USA
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
- OHDSI Collaborators, Observational Health Data Sciences and Informatics (OHDSI), New York, NY, USA
| | - Clair Blacketer
- Janssen Pharmaceutical Research and Development, Titusville, NJ, USA
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
- OHDSI Collaborators, Observational Health Data Sciences and Informatics (OHDSI), New York, NY, USA
| | - Leonardo Méndez-Boo
- Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Elena Roel
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Carlen Reyes
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | | | - Peter R Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
- OHDSI Collaborators, Observational Health Data Sciences and Informatics (OHDSI), New York, NY, USA
| | - Edward Burn
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
10
|
Nigro E, D’Agnano V, Quarcio G, Mariniello DF, Bianco A, Daniele A, Perrotta F. Exploring the Network between Adipocytokines and Inflammatory Response in SARS-CoV-2 Infection: A Scoping Review. Nutrients 2023; 15:3806. [PMID: 37686837 PMCID: PMC10490077 DOI: 10.3390/nu15173806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Adipose tissue is actually regarded as an endocrine organ, rather than as an organ that merely stores energy. During the COVID-19 pandemic, obesity has undoubtedly emerged as one of the most important risk factors for disease severity and poor outcomes related to SARS-CoV-2 infection. The aberrant production of cytokine-like hormones, called adipokines, may contribute to alterations in metabolism, dysfunction in vascular endothelium and the creation of a state of general chronic inflammation. Moreover, chronic, low-grade inflammation linked to obesity predisposes the host to immunosuppression and excessive cytokine activation. In this respect, understanding the mechanisms that link obesity with the severity of SARS-CoV-2 infection could represent a real game changer in the development of new therapeutic strategies. Our review therefore examines the pathogenic mechanisms of SARS-CoV-2, the implications with visceral adipose tissue and the influences of the adipose tissue and its adipokines on the clinical behavior of COVID-19.
Collapse
Affiliation(s)
- Ersilia Nigro
- CEINGE-Biotecnologie Avanzate Scarl “Franco Salvatore”, Via G. Salvatore 486, 80145 Napoli, Italy; (E.N.); (A.D.)
- Dipartimento di Scienze e Tecnologie Ambientali, Biologiche e Farmaceutiche, Università della Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy
| | - Vito D’Agnano
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy; (V.D.); (G.Q.); (D.F.M.); (A.B.)
| | - Gianluca Quarcio
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy; (V.D.); (G.Q.); (D.F.M.); (A.B.)
| | - Domenica Francesca Mariniello
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy; (V.D.); (G.Q.); (D.F.M.); (A.B.)
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy; (V.D.); (G.Q.); (D.F.M.); (A.B.)
| | - Aurora Daniele
- CEINGE-Biotecnologie Avanzate Scarl “Franco Salvatore”, Via G. Salvatore 486, 80145 Napoli, Italy; (E.N.); (A.D.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, 80055 Naples, Italy
| | - Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80138 Naples, Italy; (V.D.); (G.Q.); (D.F.M.); (A.B.)
| |
Collapse
|
11
|
Abstract
COVID-19 infections decrease total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I, A-II, and B levels while triglyceride levels may be increased or inappropriately normal for the poor nutritional status. The degree of reduction in total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I are predictive of mortality. With recovery lipid/lipoprotein levels return towards pre-infection levels and studies have even suggested an increased risk of dyslipidemia post-COVID-19 infection. The potential mechanisms for these changes in lipid and lipoprotein levels are discussed. Decreased HDL-C and apolipoprotein A-I levels measured many years prior to COVID-19 infections are associated with an increased risk of severe COVID-19 infections while LDL-C, apolipoprotein B, Lp (a), and triglyceride levels were not consistently associated with an increased risk. Finally, data suggest that omega-3-fatty acids and PCSK9 inhibitors may reduce the severity of COVID-19 infections. Thus, COVID-19 infections alter lipid/lipoprotein levels and HDL-C levels may affect the risk of developing COVID-19 infections.
Collapse
|
12
|
Chenchula S, Vidyasagar K, Pathan S, Sharma S, Chavan MR, Bhagavathula AS, Padmavathi R, Manjula M, Chhabra M, Gupta R, Amerneni KC, Ghanta MK, Mudda S. Global prevalence and effect of comorbidities and smoking status on severity and mortality of COVID-19 in association with age and gender: a systematic review, meta-analysis and meta-regression. Sci Rep 2023; 13:6415. [PMID: 37076543 PMCID: PMC10115382 DOI: 10.1038/s41598-023-33314-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
A COVID-19 patient often presents with multiple comorbidities and is associated with adverse outcomes. A comprehensive assessment of the prevalence of comorbidities in patients with COVID-19 is essential. This study aimed to assess the prevalence of comorbidities, severity and mortality with regard to geographic region, age, gender and smoking status in patients with COVID-19. A systematic review and multistage meta-analyses were reported using PRISMA guidelines. PubMed/MEDLINE, SCOPUS, Google Scholar and EMBASE were searched from January 2020 to October 2022. Cross-sectional studies, cohort studies, case series studies, and case-control studies on comorbidities reporting among the COVID-19 populations that were published in English were included. The pooled prevalence of various medical conditions in COVID-19 patients was calculated based on regional population size weights. Stratified analyses were performed to understand the variations in the medical conditions based on age, gender, and geographic region. A total of 190 studies comprising 105 million COVID-19 patients were included. Statistical analyses were performed using STATA software, version 16 MP (StataCorp, College Station, TX). Meta-analysis of proportion was performed to obtain pooled values of the prevalence of medical comorbidities: hypertension (39%, 95% CI 36-42, n = 170 studies), obesity (27%, 95% CI 25-30%, n = 169 studies), diabetes (27%, 95% CI 25-30%, n = 175), and asthma (8%, 95% CI 7-9%, n = 112). Moreover, the prevalence of hospitalization was 35% (95% CI 29-41%, n = 61), intensive care admissions 17% (95% CI 14-21, n = 106), and mortality 18% (95% CI 16-21%, n = 145). The prevalence of hypertension was highest in Europe at 44% (95% CI 39-47%, n = 68), obesity and diabetes at 30% (95% CI, 26-34, n = 79) and 27% (95%CI, 24-30, n = 80) in North America, and asthma in Europe at 9% (95% CI 8-11, n = 41). Obesity was high among the ≥ 50 years (30%, n = 112) age group, diabetes among Men (26%, n = 124) and observational studies reported higher mortality than case-control studies (19% vs. 14%). Random effects meta-regression found a significant association between age and diabetes (p < 0.001), hypertension (p < 0.001), asthma (p < 0.05), ICU admission (p < 0.05) and mortality (p < 0.001). Overall, a higher global prevalence of hypertension (39%) and a lower prevalence of asthma (8%), and 18% of mortality were found in patients with COVID-19. Hence, geographical regions with respective chronic medical comorbidities should accelerate regular booster dose vaccination, preferably to those patients with chronic comorbidities, to prevent and lower the severity and mortality of COVID-19 disease with novel SARS-CoV-2 variants of concern (VOC).
Collapse
Affiliation(s)
- Santenna Chenchula
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522503, India.
| | - Kota Vidyasagar
- Department of Pharmaceutical Sciences, University College of Pharmaceutical Sciences (UCPSc), Hanmakonda, Telangana, India
| | - Saman Pathan
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - Sushil Sharma
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522503, India
| | - Madhav Rao Chavan
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522503, India
| | | | - R Padmavathi
- SVS Medical College and Hospital, Mahbubnagar, Telangana, India
| | - M Manjula
- Balaji College of Nursing, Tirupathi, Andhra Pradesh, India
| | - Manik Chhabra
- Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga, India
| | - Rupesh Gupta
- Department of Internal Medicine, GMC, Shahdol, Madhya Pradesh, India
| | | | | | - Sofia Mudda
- Department of AYUSH, All India Institute of Medical Sciences, Bhopal, India
| |
Collapse
|
13
|
Montini F, Nozzolillo A, Rancoita PMV, Zanetta C, Moiola L, Cugnata F, Esposito F, Rocca MA, Martinelli V, Filippi M. Modifiable risk factors of COVID-19 in patients with multiple sclerosis: a single-centre case-control study. J Neurol 2023; 270:1835-1842. [PMID: 36795147 PMCID: PMC9933018 DOI: 10.1007/s00415-023-11618-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Disease and treatment-associated immune system abnormalities may confer higher risk of Coronavirus disease 2019 (COVID-19) to people with multiple sclerosis (PwMS). We assessed modifiable risk factors associated with COVID-19 in PwMS. METHODS Among patients referring to our MS Center, we retrospectively collected epidemiological, clinical and laboratory data of PwMS with confirmed COVID-19 between March 2020 and March 2021 (MS-COVID, n = 149). We pursued a 1:2 matching of a control group by collecting data of PwMS without history of previous COVID-19 (MS-NCOVID, n = 292). MS-COVID and MS-NCOVID were matched for age, expanded disability status scale (EDSS) and line of treatment. We compared neurological examination, premorbid vitamin D levels, anthropometric variables, life-style habits, working activity, and living environment between the two groups. Logistic regression and Bayesian network analyses were used to evaluate the association with COVID-19. RESULTS MS-COVID and MS-NCOVID were similar in terms of age, sex, disease duration, EDSS, clinical phenotype and treatment. At multiple logistic regression, higher levels of vitamin D (OR 0.93, p < 0.0001) and active smoking status (OR 0.27, p < 0.0001) emerged as protective factors against COVID-19. In contrast, higher number of cohabitants (OR 1.26, p = 0.02) and works requiring direct external contact (OR 2.61, p = 0.0002) or in the healthcare sector (OR 3.73, p = 0.0019) resulted risk factors for COVID-19. Bayesian network analysis showed that patients working in the healthcare sector, and therefore exposed to increased risk of COVID-19, were usually non-smokers, possibly explaining the protective association between active smoking and COVID-19. CONCLUSIONS Higher Vitamin D levels and teleworking may prevent unnecessary risk of infection in PwMS.
Collapse
Affiliation(s)
- Federico Montini
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Agostino Nozzolillo
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Paola M V Rancoita
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy
| | - Chiara Zanetta
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Lucia Moiola
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Federica Cugnata
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Esposito
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Maria A Rocca
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Vittorio Martinelli
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| |
Collapse
|
14
|
Javid FA, Waheed FA, Zainab N, Khan H, Amin I, Bham A, Ghoghawala M, Sheraz A, Haloub R. COVID-19 and diabetes in 2020: a systematic review. J Pharm Policy Pract 2023; 16:42. [PMID: 36895058 PMCID: PMC9998019 DOI: 10.1186/s40545-023-00546-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
Attempts were made to review the literature on diabetic patients who experience complications when they contract COVID-19, and to determine whether ethnicity and other risk factors play an important role in the development of symptoms and their severity, as well as responding to medications. A literature search was performed using five keywords, namely COVID-19, diabetes, ethnicity, medications, and risk factors between January 2019 and December 2020 using electronic databases such as PubMed, Science Direct, Google Scholar, Springer Link, and Scopus. Forty studies were included. The review indicated that diabetes was a significant risk factor for poorer outcomes and increased mortality associated with COVID-19. There were several risk factors for diabetic patients that increased their likelihood of poorer outcomes associated with COVID-19. These included black and Asian ethnicity, male sex with high BMI. In conclusion, patients with diabetes of black or Asian origin with high BMI, male sex, and older age had an increased risk of poorer outcomes associated with COVID-19. This highlights the importance of considering the history of the patient in prioritising care and treatment.
Collapse
Affiliation(s)
- Farideh A Javid
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK.
| | - Fadi Abdul Waheed
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Nisa Zainab
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Hamza Khan
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Ibrahim Amin
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Ammar Bham
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Mohammed Ghoghawala
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Aneem Sheraz
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Radi Haloub
- Biotech and Pharmaceutical Management, Global Business School for Health (GBSH), University College London (UCL), London, UK
| |
Collapse
|
15
|
Harris WS, Tintle NL, Sathyanarayanan SP, Westra J. Association between blood N-3 fatty acid levels and the risk of coronavirus disease 2019 in the UK Biobank. Am J Clin Nutr 2023; 117:357-363. [PMID: 36863828 PMCID: PMC9972865 DOI: 10.1016/j.ajcnut.2022.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The role of nutritional status and the risk of contracting and/or experiencing adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are unclear. Preliminary studies suggest that higher n-3 PUFA intakes are protective. OBJECTIVES This study aimed to compare the risk of 3 coronavirus disease 2019 (COVID-19) outcomes (testing positive for SARS-CoV-2, hospitalization, and death) as a function of the baseline plasma DHA levels. METHODS The DHA levels (% of total fatty acids [FAs]) were measured by nuclear magnetic resonance. The 3 outcomes and relevant covariates were available for 110,584 subjects (hospitalization and death) and for 26,595 ever-tested subjects (positive for SARS-CoV-2) in the UK Biobank prospective cohort study. Outcome data between 1 January, 2020, and 23 March, 2021, were included. The Omega-3 Index (O3I) (RBC EPA + DHA%) values across DHA% quintiles were estimated. The multivariable Cox proportional hazards models were constructed, and linear (per 1 SD) relations with the risk of each outcome were computed as HRs. RESULTS In the fully adjusted models, comparing the fifth to the first DHA% quintiles, the HRs (95% confidence intervals) for testing positive, being hospitalized, and dying with COVID-19 were 0.79 (0.71, 0.89, P < 0.001), 0.74 (0.58, 0.94, P < 0.05), and 1.04 (0.69-1.57, not significant), respectively. On a per 1-SD increase in DHA% basis, the HRs for testing positive, hospitalization, and death, were 0.92 (0.89, 0.96, P < 0.001), 0.89 (0.83, 0.97, P < 0.01), and 0.95 (0.83, 1.09), respectively. The estimated O3I values across DHA quintiles ranged from 3.5% (quintile 1) to 8% (quintile 5). CONCLUSIONS These findings suggest that nutritional strategies to increase the circulating n-3 PUFA levels, such as increased consumption of oily fish and/or use of n-3 FA supplements, may reduce the risk of adverse COVID-19 outcomes.
Collapse
Affiliation(s)
- William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
| | - Nathan L Tintle
- Fatty Acid Research Institute, Sioux Falls, SD, USA; Department of Population Health Nursing Science, College of Nursing, University of Illinois-Chicago, Chicago, IL, USA
| | | | - Jason Westra
- Fatty Acid Research Institute, Sioux Falls, SD, USA
| |
Collapse
|
16
|
Galanti MR, Andersson F, Caspersen IH, Peña S, Karvonen S, Magnus P, Raffetti E, Orsini N, Magnusson C, Shaaban AN, Hergens MP, Skott P. Current tobacco use and COVID-19 diagnoses in a cohort of adult clients of public dental clinics in Sweden. Sci Rep 2023; 13:1204. [PMID: 36681700 PMCID: PMC9862224 DOI: 10.1038/s41598-023-28091-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
Smoking has been linked with both increased and decreased risk of COVID-19, prompting the hypothesis of a protective role of nicotine in the pathogenesis of the disease. Studies of the association between use of smokeless tobacco and COVID-19 would help refining this hypothesis. We analysed data from 424,386 residents in the Stockholm Region, Sweden, with information on smoking and smokeless tobacco (snus) use prior to the pandemic obtained from dental records. Diagnoses of COVID-19 between February and October 2020 were obtained from health-care registers. We estimated the risk of receiving a diagnosis of COVID-19 for current smokers and for current snus users relative to non-users of tobacco, adjusting for potential confounders (aRR). The aRR of COVID -19 was elevated for current snus users (1.09 ;95%CI = 0.99-1.21 among men and 1.15; 95%CI = 1.00-1.33 among women). The risk for women consuming more than 1 can/day was twice as high as among non-users of tobacco. Current smoking was negatively associated with risk of COVID-19 (aRR = 0.68; 95% CI = 0.61-0.75); including hospital admission (aRR = 0.60; 95% CI = 0.47-0.76) and intensive care (aRR = 0.43; 95% CI = 0.21-0.89). The hypothesis of a protective effect of tobacco nicotine on COVID-19 was not supported by the findings. The negative association between smoking and COVID-19 remains unexplained.
Collapse
Affiliation(s)
- M R Galanti
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden.
| | - F Andersson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - I H Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Skøyen, Postbox 222, 0213, Oslo, Norway
| | - S Peña
- Finnish Institute for Health and Welfare, Postbox 30, 00271, Helsinki, Finland
| | - S Karvonen
- Finnish Institute for Health and Welfare, Postbox 30, 00271, Helsinki, Finland
| | - P Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Skøyen, Postbox 222, 0213, Oslo, Norway
| | - E Raffetti
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - N Orsini
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - C Magnusson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - A N Shaaban
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - M P Hergens
- Unit for Communicable Disease Control, Postbox 6909, 102 39, Stockholm Region, Sweden
| | - P Skott
- Department of Orofacial Medicine, Folktandvården Stockholm, Postbox 6420, 113 82, Stockholm, Sweden
| |
Collapse
|
17
|
Mongraw-Chaffin M, Tjaden AH, Seals AL, Miller K, Ahmed N, Espeland MA, Gibbs M, Thomas D, Uschner D, Weintraub WS, Edelstein SL. Association of Obesity and Diabetes with SARS-Cov-2 Infection and Symptoms in the COVID-19 Community Research Partnership. J Clin Endocrinol Metab 2022; 108:dgac715. [PMID: 36482096 DOI: 10.1210/clinem/dgac715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Obesity and diabetes are established risk factors for severe SARS-CoV-2 outcomes, but less is known about their impact on susceptibility to COVID-19 infection and general symptom severity. We hypothesized that those with obesity or diabetes would be more likely to self-report a positive SARS-CoV-2 test, and among those with a positive test, have greater symptom severity and duration. METHODS Among 44,430 COVID-19 Community Research Partnership participants, we evaluated the association of self-reported and electronic health record obesity and diabetes with a self-reported positive COVID-19 test at any time. Among the 2,663 participants with a self-reported positive COVID-19 test during the study, we evaluated the association of obesity and diabetes with self-report of symptom severity, duration, and hospitalization. Logistic regression models were adjusted for age, sex, race/ethnicity, socioeconomic status, and healthcare worker status. RESULTS We found a positive graded association between Body Mass Index (BMI) category and positive COVID-19 test (Overweight OR = 1.14 [1.05-1.25]; Obesity I OR = 1.29 [1.17-2.42]; Obesity II OR = 1.34 [1.19-1.50]; Obesity III OR = 1.53 [1.35-1.73]), and a similar but weaker association with COVID-19 symptoms and severity among those with a positive test. Diabetes was associated with COVID-19 infection but not symptoms after adjustment, with some evidence of an interaction between obesity and diabetes. CONCLUSIONS While the limitations of this health system convenience sample include generalizability and selection around test-seeking, the strong graded association of BMI and diabetes with self-reported COVID-19 infection suggests that obesity and diabetes may play a role in risk for symptomatic SARS-CoV-2 beyond co-occurrence with socioeconomic factors.
Collapse
Affiliation(s)
| | | | | | - Kristen Miller
- MedStar Health Research Institute, Georgetown University Washington, District of Columbia
| | | | | | | | - Dorey Thomas
- Wake Forest School of Medicine, Winston-Salem, NC
| | - Diane Uschner
- The Biostatistics Center, George Washington University, Rockville, Maryland
| | - William S Weintraub
- MedStar Health Research Institute, Georgetown University Washington, District of Columbia
| | - Sharon L Edelstein
- The Biostatistics Center, George Washington University, Rockville, Maryland
| |
Collapse
|
18
|
Notz Q, Herrmann J, Schlesinger T, Kranke P, Sitter M, Helmer P, Stumpner J, Roeder D, Amrein K, Stoppe C, Lotz C, Meybohm P. Vitamin D deficiency in critically ill COVID-19 ARDS patients. Clin Nutr 2022; 41:3089-3095. [PMID: 33745749 PMCID: PMC7937427 DOI: 10.1016/j.clnu.2021.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/16/2021] [Accepted: 03/01/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Vitamin D's pleiotropic effects include immune modulation, and its supplementation has been shown to prevent respiratory tract infections. The effectivity of vitamin D as a therapeutic intervention in critical illness remains less defined. The current study analyzed clinical and immunologic effects of vitamin D levels in patients suffering from coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). METHODS This was a single-center retrospective study in patients receiving intensive care with a confirmed SARS-CoV-2 infection and COVID-19 ARDS. 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D serum levels, pro- and anti-inflammatory cytokines and immune cell subsets were measured on admission as well as after 10-15 days. Clinical parameters were extracted from the patient data management system. Standard operating procedures included the daily administration of vitamin D3 via enteral feeding. RESULTS A total of 39 patients with COVID-19 ARDS were eligible, of which 26 were included in this study as data on vitamin D status was available. 96% suffered from severe COVID-19 ARDS. All patients without prior vitamin D supplementation (n = 22) had deficient serum levels of 25-hydroxyvitamin D. Vitamin D supplementation resulted in higher serum levels of 25-hydroxyvitamin D but not did not increase 1,25-dihydroxyvitamin D levels after 10-15 days. Clinical parameters did not differ between patients with sufficient or deficient levels of 25-hydroxyvitamin D. Only circulating plasmablasts were higher in patients with 25-hydroxyvitamin D levels ≥30 ng/ml (p = 0.029). Patients with 1,25-dihydroxyvitamin D levels below 20 pg/ml required longer mechanical ventilation (p = 0.045) and had a worse acute physiology and chronic health evaluation (APACHE) II score (p = 0.048). CONCLUSION The vast majority of COVID-19 ARDS patients had vitamin D deficiency. 25-hydroxyvitamin D status was not related to changes in clinical course, whereas low levels of 1,25-dihydroxyvitamin D were associated with prolonged mechanical ventilation and a worse APACHE II score.
Collapse
Affiliation(s)
- Quirin Notz
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany,Corresponding author. Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany. Fax: +49 0 931 201 30019
| | - Johannes Herrmann
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Tobias Schlesinger
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Peter Kranke
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Magdalena Sitter
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Philipp Helmer
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Jan Stumpner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Daniel Roeder
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Karin Amrein
- Division of Endocrinology and Diabetology, Medical University of Graz, Austria
| | - Christian Stoppe
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Christopher Lotz
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| | - Patrick Meybohm
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Wuerzburg, Germany
| |
Collapse
|
19
|
Hollinghurst J, North L, Szakmany T, Pugh R, Davies GA, Sivakumaran S, Jarvis R, Rolles M, Pickrell WO, Akbari A, Davies G, Griffiths R, Lyons J, Torabi F, Fry R, Gravenor MB, Lyons RA. SARS-CoV-2 infection risk among 77,587 healthcare workers: a national observational longitudinal cohort study in Wales, United Kingdom, April to November 2020. J R Soc Med 2022; 115:467-478. [PMID: 35796183 PMCID: PMC9747896 DOI: 10.1177/01410768221107119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/29/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To better understand the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers, leading to recommendations for the prioritisation of personal protective equipment, testing, training and vaccination. DESIGN Observational, longitudinal, national cohort study. SETTING Our cohort were secondary care (hospital-based) healthcare workers employed by NHS Wales (United Kingdom) organisations from 1 April 2020 to 30 November 2020. PARTICIPANTS We included 577,756 monthly observations among 77,587 healthcare workers. Using linked anonymised datasets, participants were grouped into 20 staff roles. Additionally, each role was deemed either patient-facing, non-patient-facing or undetermined. This was linked to individual demographic details and dates of positive SARS-CoV-2 PCR tests. MAIN OUTCOME MEASURES We used univariable and multivariable logistic regression models to determine odds ratios (ORs) for the risk of a positive SARS-CoV-2 PCR test. RESULTS Patient-facing healthcare workers were at the highest risk of SARS-CoV-2 infection with an adjusted OR (95% confidence interval [CI]) of 2.28 (95% CI 2.10-2.47). We found that after adjustment, foundation year doctors (OR 1.83 [95% CI 1.47-2.27]), healthcare support workers [OR 1.36 [95% CI 1.20-1.54]) and hospital nurses (OR 1.27 [95% CI 1.12-1.44]) were at the highest risk of infection among all staff groups. Younger healthcare workers and those living in more deprived areas were at a higher risk of infection. We also observed that infection rates varied over time and by organisation. CONCLUSIONS These findings have important policy implications for the prioritisation of vaccination, testing, training and personal protective equipment provision for patient-facing roles and the higher risk staff groups.
Collapse
Affiliation(s)
- Joe Hollinghurst
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Laura North
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Tamas Szakmany
- Critical Care Directorate, Grange University Hospital, Aneurin Bevan University Health Board, Llanyravon, Cwmbran, NP44 2XJ
| | - Richard Pugh
- Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Heath Park Campus, Cardiff, CF14 4XN
| | - Gwyneth A Davies
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Shanya Sivakumaran
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Rebecca Jarvis
- Department of Anaesthetics, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board
| | - Martin Rolles
- Digital Workforce, NHS Wales Shared Services Partnership
| | - W Owen Pickrell
- South West Wales Cancer Centre, Singleton Hospital, Swansea SA2 8QA
| | - Ashley Akbari
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Gareth Davies
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Rowena Griffiths
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Jane Lyons
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Fatemeh Torabi
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Richard Fry
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Mike B Gravenor
- Swansea University Medical School and Neurology Department, Morriston Hospital, Swansea Bay University Health Board
| | - Ronan A Lyons
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| |
Collapse
|
20
|
Suh J, Horvitz E, White RW, Althoff T. Disparate impacts on online information access during the Covid-19 pandemic. Nat Commun 2022; 13:7094. [PMID: 36402817 PMCID: PMC9675823 DOI: 10.1038/s41467-022-34592-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022] Open
Abstract
The COVID-19 pandemic has stimulated important changes in online information access as digital engagement became necessary to meet the demand for health, economic, and educational resources. Our analysis of 55 billion everyday web search interactions during the pandemic across 25,150 US ZIP codes reveals that the extent to which different communities of internet users enlist digital resources varies based on socioeconomic and environmental factors. For example, we find that ZIP codes with lower income intensified their access to health information to a smaller extent than ZIP codes with higher income. We show that ZIP codes with higher proportions of Black or Hispanic residents intensified their access to unemployment resources to a greater extent, while revealing patterns of unemployment site visits unseen by the claims data. Such differences frame important questions on the relationship between differential information search behaviors and the downstream real-world implications on more and less advantaged populations.
Collapse
Affiliation(s)
- Jina Suh
- grid.419815.00000 0001 2181 3404Microsoft Research, Redmond, WA USA ,grid.34477.330000000122986657University of Washington, Seattle, WA USA
| | - Eric Horvitz
- grid.419815.00000 0001 2181 3404Microsoft Research, Redmond, WA USA ,grid.34477.330000000122986657University of Washington, Seattle, WA USA
| | - Ryen W. White
- grid.419815.00000 0001 2181 3404Microsoft Research, Redmond, WA USA ,grid.34477.330000000122986657University of Washington, Seattle, WA USA
| | - Tim Althoff
- grid.34477.330000000122986657University of Washington, Seattle, WA USA
| |
Collapse
|
21
|
Nieman DC, Sakaguchi CA. Physical activity lowers the risk for acute respiratory infections: Time for recognition. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:648-655. [PMID: 35995362 PMCID: PMC9391085 DOI: 10.1016/j.jshs.2022.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/19/2022] [Accepted: 08/04/2022] [Indexed: 05/30/2023]
Abstract
Physical inactivity is a well-established risk factor for chronic diseases, such as cardiovascular disease, cancer, and diabetes mellitus. There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections (ARIs). ARIs, such as the common cold, influenza, pneumonia, and coronavirus disease 2019 (COVID-19), are among the most pervasive diseases on earth and cause widespread morbidity and mortality. Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the COVID-19 pandemic because of increased scientific scrutiny. Large-scale studies have consistently reported that the risk for severe COVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness, even after adjusting for other risk factors. The lowered risk for severe COVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects, including enhanced surveillance of key immune cells and reduced chronic inflammation. Scientific consensus groups, including those who submitted the Physical Activity Guidelines for Americans, have not yet given this area of research the respect that is due. It is time to add "reduced risk for ARIs" to the "Exercise is Medicine" list of physical activity-related health benefits.
Collapse
Affiliation(s)
- David C Nieman
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA.
| | - Camila A Sakaguchi
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA
| |
Collapse
|
22
|
Van Bortel T, Lombardo C, Guo L, Solomon S, Martin S, Hughes K, Weeks L, Crepaz-Keay D, McDaid S, Chantler O, Thorpe L, Morton A, Davidson G, John A, Kousoulis AA. The mental health experiences of ethnic minorities in the UK during the Coronavirus pandemic: A qualitative exploration. Front Public Health 2022; 10:875198. [PMID: 36276403 PMCID: PMC9582845 DOI: 10.3389/fpubh.2022.875198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Background Worldwide, the Coronavirus pandemic has had a major impact on people's health, lives, and livelihoods. However, this impact has not been felt equally across various population groups. People from ethnic minority backgrounds in the UK have been more adversely affected by the pandemic, especially in terms of their physical health. Their mental health, on the other hand, has received less attention. This study aimed to explore the mental health experiences of UK adults from ethnic minorities during the Coronavirus pandemic. This work forms part of our wider long-term UK population study "Mental Health in the Pandemic." Methods We conducted an exploratory qualitative study with people from ethnic minority communities across the UK. A series of in-depth interviews were conducted with 15 women, 14 men and 1 non-binary person from ethnic minority backgrounds, aged between 18 and 65 years old (mean age = 40). We utilized purposefully selected maximum variation sampling in order to capture as wide a variety of views, perceptions and experiences as possible. Inclusion criteria: adults (18+) from ethnic minorities across the UK; able to provide full consent to participate; able to participate in a video- or phone-call interview. All interviews took place via MS Teams or Zoom. The gathered data were transcribed verbatim and underwent thematic analysis following Braun and Clarke carried out using NVivo 12 software. Results The qualitative data analysis yielded seven overarching themes: (1) pandemic-specific mental health and wellbeing experiences; (2) issues relating to the media; (3) coping mechanisms; (4) worries around and attitudes toward vaccination; (5) suggestions for support in moving forward; (6) best and worst experiences during pandemic and lockdowns; (7) biggest areas of change in personal life. Generally, participants' mental health experiences varied with some not being affected by the pandemic in a way related to their ethnicity, some sharing positive experiences and coping strategies (exercising more, spending more time with family, community cohesion), and some expressing negative experiences (eating or drinking more, feeling more isolated, or even racism and abuse, especially toward Asian communities). Concerns were raised around trust issues in relation to the media, the inadequate representation of ethnic minorities, and the spread of fake news especially on social media. Attitudes toward vaccinations varied too, with some people more willing to have the vaccine than others. Conclusion This study's findings highlight the diversity in the pandemic mental health experiences of ethnic minorities in the UK and has implications for policy, practice and further research. To enable moving forward beyond the pandemic, our study surfaced the need for culturally appropriate mental health support, financial support (as a key mental health determinant), accurate media representation, and clear communication messaging from the Governments of the UK.
Collapse
Affiliation(s)
- Tine Van Bortel
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, Gateway House, De Montfort University, Leicester, United Kingdom,Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom,*Correspondence: Tine Van Bortel ;
| | - Chiara Lombardo
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom,Mental Health Foundation, London, United Kingdom
| | - Lijia Guo
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom,Department of Sociology, School of Humanities and Social Sciences, University of Cambridge, Cambridge, United Kingdom
| | | | - Steven Martin
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, Gateway House, De Montfort University, Leicester, United Kingdom
| | - Kate Hughes
- Mental Health Foundation, London, United Kingdom
| | - Lauren Weeks
- Mental Health Foundation, London, United Kingdom
| | | | - Shari McDaid
- Mental Health Foundation, London, United Kingdom
| | | | - Lucy Thorpe
- Mental Health Foundation, London, United Kingdom
| | - Alec Morton
- Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, United Kingdom
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, United Kingdom
| | - Ann John
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | | |
Collapse
|
23
|
Rosengren A, Lundberg CE, Söderberg M, Santosa A, Edqvist J, Lindgren M, Åberg M, Gisslén M, Robertson J, Cronie O, Sattar N, Lagergren J, Brandén M, Björk J, Adiels M. Severe COVID-19 in people 55 and older during the first year of the pandemic in Sweden. J Intern Med 2022; 292:641-653. [PMID: 35612518 PMCID: PMC9348046 DOI: 10.1111/joim.13522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Exposure to many contacts is the main risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while risk of serious disease and death is chiefly determined by old age and comorbidities. Relative and population-attributable fractions (PAFs) of multiple medical and social exposures for COVID-19 outcomes have not been evaluated among older adults. OBJECTIVES We describe the effect of multiple exposures on the odds of testing positive for the virus and of severe disease (hospital care or death) and PAFs in Swedish citizens aged 55 years and above. METHODS We used national registers to follow all citizens aged 55 years and above with respect to (1) testing positive, (2) hospitalization, and (3) death between 31 January 2020 and 1 February 2021. RESULTS Of 3,410,241 persons, 156,017 (4.6%, mean age 68.3 years) tested positive for SARS-CoV-2, while 35,999 (1.1%, mean age 76.7 years) were hospitalized or died (12,384 deaths, 0.4%, mean age 84.0 years). Among the total cohort, the proportion living without home care or long-term care was 98.8% among persons aged 55-64 and 22.1% of those aged 95 and above. After multiple adjustment, home care and long-term care were associated with odds ratios of 7.9 (95% confidence interval [CI] 6.8-9.1) and 22.5 (95% CI 19.6-25.7) for mortality, with PAFs of 21.9% (95% CI 20.9-22.9) and 33.3% (95% CI 32.4-34.3), respectively. CONCLUSION Among Swedish residents aged 55 years and above, those with home care or long-term care had markedly increased risk for COVID-19 death during the first year of the pandemic, with over 50% of deaths attributable to these factors.
Collapse
Affiliation(s)
- Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Christina E Lundberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mia Söderberg
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jon Edqvist
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Lindgren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - Magnus Gisslén
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefina Robertson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ottmar Cronie
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Naveed Sattar
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Maria Brandén
- Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm University, Stockholm, Sweden.,Institute for Analytical Sociology (IAS), Linköping University, Norrköping, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Martin Adiels
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
24
|
Mostaza JM, Salinero-Fort MA, Cardenas-Valladolid J, Rodríguez-Artalejo F, Díaz-Almirón M, Vich-Pérez P, San Andrés-Rebollo FJ, Vicente I, Lahoz C. Factores asociados con la mortalidad por SARS-CoV-2 en la población mayor de 75 años de la Comunidad de Madrid. Rev Clin Esp 2022; 222:468-478. [PMID: 35720162 PMCID: PMC9193184 DOI: 10.1016/j.rce.2022.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/04/2022] [Indexed: 11/17/2022]
Abstract
Objetivo Pacientes y métodos Resultados Conclusión
Collapse
Affiliation(s)
- J M Mostaza
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - M A Salinero-Fort
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Instituto de Investigación del Hospital La Paz (IdIPAZ); Red de Investigación en pacientes crónicos (REDISSEC); Subdirección general de Investigación en Salud, Ministerio de Sanidad, Madrid, España
| | - J Cardenas-Valladolid
- Dirección Técnica de Sistemas de Información Sanitaria, Gerencia Adjunta de Procesos Asistenciales, Gerencia Asistencial de Atención Primaria, Madrid, España
| | - F Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid-IdIPAZ, CIBER de Epidemiología y Salud Pública (CIBERESP) e IMDEA-Alimentación, CEI UAM + CSIC, Madrid, España
| | - M Díaz-Almirón
- Unidad de Investigación, Instituto de Investigación Hospital La Paz, IdiPAZ, Madrid, España
| | - P Vich-Pérez
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Los Alpes, Madrid, España
| | - F J San Andrés-Rebollo
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Las Calesas, Madrid, España
| | - I Vicente
- Centro de Salud Monovar, Madrid, España
| | - C Lahoz
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| |
Collapse
|
25
|
van Laak A, Verhees R, Knottnerus JA, Hooiveld M, Winkens B, Dinant GJ. Impact of influenza vaccination on GP-diagnosed COVID-19 and all-cause mortality: a Dutch cohort study. BMJ Open 2022; 12:e061727. [PMID: 36137620 PMCID: PMC9511012 DOI: 10.1136/bmjopen-2022-061727] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES As clinical presentation and complications of both viruses overlap, it was hypothesised that influenza vaccination was associated with lower general practitioner (GP)-diagnosed COVID-19 rates and lower all-cause mortality rates. STUDY DESIGN From a primary care population-based cohort in the Netherlands, GP-diagnosed COVID-19 (between 10 March and 22 November 2020) and all-cause mortality events (between 30 December 2019 and 22 November 2020) were recorded. 223 580 persons were included, representing the influenza vaccination 2019 target group (all aged ≥60 years, and those <60 years with a medical indication). Proportional hazards regression analyses evaluated associations between influenza vaccination in 2019 and two outcomes: GP-diagnosed COVID-19 and all-cause mortality. Covariables were sex, age, comorbidities and number of acute respiratory infection primary care consultations in 2019. RESULTS A slightly positive association (HR 1.15; 95% CI 1.08 to 1.22) was found between influenza vaccination in 2019 and GP-diagnosed COVID-19, after adjusting for covariables. A slightly protective effect for all-cause mortality rates (HR 0.90; 95% CI 0.83 to 0.97) was found for influenza vaccination, after adjusting for covariables. A subgroup analysis among GP-diagnosed COVID-19 cases showed no significant association between influenza vaccination in 2019 and all-cause mortality. CONCLUSIONS Our hypothesis of a possibly negative association between influenza vaccination in 2019 and GP-diagnosed COVID-19 was not confirmed as we found a slightly positive association. A slightly protective effect on all-cause mortality was found after influenza vaccination, possibly by a wider, overall protective effect on health. Future research designs should include test-confirmed COVID-19 cases and controls, adjustments for behavioural, socioeconomic and ethnic factors and validated cause-specific mortality cases.
Collapse
Affiliation(s)
- Arjan van Laak
- Department of General Practice, CAPHRI, Maastricht UMC+, Maastricht, The Netherlands
| | - Ruud Verhees
- Department of General Practice, CAPHRI, Maastricht UMC+, Maastricht, The Netherlands
| | - J André Knottnerus
- Department of General Practice, CAPHRI, Maastricht UMC+, Maastricht, The Netherlands
| | - Mariëtte Hooiveld
- General Practice Care, Otterstraat 118, Nivel, Utrecht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, CAPHRI, Maastricht UMC+, Maastricht, The Netherlands
| | - Geert-Jan Dinant
- Department of General Practice, CAPHRI, Maastricht UMC+, Maastricht, The Netherlands
| |
Collapse
|
26
|
Stadler JT, Mangge H, Rani A, Curcic P, Herrmann M, Prüller F, Marsche G. Low HDL Cholesterol Efflux Capacity Indicates a Fatal Course of COVID-19. Antioxidants (Basel) 2022; 11:1858. [PMID: 36290581 PMCID: PMC9598682 DOI: 10.3390/antiox11101858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/02/2022] Open
Abstract
Plasma membrane cholesterol is required for proper trafficking and localization of receptors that facilitate severe acute respiratory syndrome coronavirus 2 infection. High-density lipoproteins (HDL) mobilize plasma membrane cholesterol, and HDL-cholesterol levels are associated with the severity of COVID-19 disease and mortality. However, HDL-cholesterol levels poorly reflect the function of this complex family of particles, and a detailed assessment of COVID-19-associated changes in HDL functionality and its prognostic value is lacking. In the present study, we assessed HDL cholesterol efflux capacity, HDL anti-inflammatory and antioxidant properties, and changes in HDL composition and metabolism in COVID-19 (n = 48) and non-COVID pneumonia patients (n = 32). COVID-19 infection markedly reduced the activity of lecithin-cholesteryl-acyltransferase and functional parameters of HDL, such as the cholesterol efflux capacity, arylesterase activity of paraoxonase 1, and anti-oxidative capacity of apoB-depleted serum when compared to non-COVID pneumonia at baseline, paralleled by markedly reduced levels of HDL-cholesterol. Of particular interest, low HDL cholesterol efflux capacity was associated with increased mortality risk in COVID-19 patients, independent of HDL-C levels. Our results highlight profound effects of COVID-19 infection on HDL function, metabolism, and composition. Low HDL cholesterol efflux capacity indicates a fatal course of COVID-19, independent of HDL-cholesterol levels.
Collapse
Affiliation(s)
- Julia T. Stadler
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Alankrita Rani
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - Pero Curcic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Florian Prüller
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| |
Collapse
|
27
|
Bartolomeo N, Giotta M, Tafuri S, Trerotoli P. Impact of Socioeconomic Deprivation on the Local Spread of COVID-19 Cases Mediated by the Effect of Seasons and Restrictive Public Health Measures: A Retrospective Observational Study in Apulia Region, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811410. [PMID: 36141682 PMCID: PMC9517341 DOI: 10.3390/ijerph191811410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 05/22/2023]
Abstract
The aim of this study was to investigate the spatiotemporal association between socioeconomic deprivation and the incidence of COVID-19 and how this association changes through the seasons due to the existence of restrictive public health measures. A retrospective observational study was conducted among COVID-19 cases that occurred in the Apulia region from 29 February 2020 to 31 December 2021, dividing the period into four phases with different levels of restrictions. A generalized estimating equation (GEE) model was applied to test the independent effect of deprivation on the incidence of COVID-19, taking into account age, sex, and regional incidence as possible confounding effects and covariates, such as season and levels of restrictions, as possible modifying effects. The highest incidence was in areas with a very high deprivation index (DI) in winter. During total lockdown, no rate ratio between areas with different levels of DI was significant, while during soft lockdown, areas with very high DI were more at risk than all other areas. The effects of social inequalities on the incidence of COVID-19 changed in association with the seasons and restrictions on public health. Disadvantaged areas showed a higher incidence of COVID-19 in the cold seasons and in the phases of soft lockdown.
Collapse
|
28
|
Abdullah Y. The Incidence and Severity of COVID-19 in the Liverpool Severe Asthma Population Undergoing Biologic Therapy. Cureus 2022; 14:e28790. [PMID: 36105903 PMCID: PMC9443068 DOI: 10.7759/cureus.28790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/22/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) infection can have a variable impact on patients. Various host factors have been identified that play a significant role in the risk of COVID-19 infection and its severity. Patients with severe asthma have been clinically vulnerable since the first wave of the pandemic and the resurgence of COVID-19 in the United Kingdom in January 2020. In addition, those on treatment with monoclonal antibodies (mAbs) have been identified as being vulnerable to COVID-19 infection and severity by the World Health Organization and the Department of Health. However, the evidence to support this notion is limited, and there has been contrary evidence to suggest severe asthma is protective against COVID-19. In this study, a retrospective review of severe asthma patients in the Liverpool population between 1st January 2020 and 31st January 2021 was conducted. This study aimed to determine the association between asthma severity and the risk of COVID-19 infection and/or its severity for patients on mAb treatment. Methodology We conducted a review of all patients from the Liverpool severe asthma database/spreadsheet who tested positive in the community and at the hospital. Admission records, primary records, emails, and microbiological data for Anglia ICE were reviewed at the Royal Liverpool and Aintree University Hospital. A COVID-19 diagnosis was predefined as a positive lateral flow test and a positive polymerase chain reaction test. The proportion of patients with COVID-19 pneumonia and severe COVID-19 disease requiring hospital admission and escalation to intensive care (observation, intubation, continuous positive airway pressure) was noted. Other patient characteristics were recorded including age, weight, body mass index (BMI), gender, smoking status (never, former, current smoker), bronchiectasis, and the forced expiratory volume. Results In total, 760 patients were identified to have severe asthma, of whom 59 (7.8%) tested positive for COVID-19 and 701 (92.2%) tested negative. A total of 244 (32%) patients were taking mAbs, and 516 (68%) were not on mAb treatment. Patients were more susceptible to COVID-19 on an mAb (13.5%) versus non-mAb (5%) (odds ratio (OR) = 2.95; 95% confidence interval (CI) = 1.72 to 5.05) . A larger proportion of severe asthma patients on mAb treatment testing positive for COVID-19 were current smokers and had a higher BMI. Furthermore, severe asthmatics taking mAbs did not have a higher risk of severe COVID-19 disease, hospitalisation, and intensive care admission. Conclusions In the Liverpool severe asthma population, patients undergoing mAb therapy had a higher incidence of COVID-19 compared to non-mAb groups; however, they were not at a higher risk of severe disease progression. These findings suggest that continuing biologic therapy in severe asthmatics with COVID-19 appears to be safe to prevent exacerbations.
Collapse
|
29
|
Holt H, Talaei M, Greenig M, Zenner D, Symons J, Relton C, Young KS, Davies MR, Thompson KN, Ashman J, Rajpoot SS, Kayyale AA, El Rifai S, Lloyd PJ, Jolliffe D, Timmis O, Finer S, Iliodromiti S, Miners A, Hopkinson NS, Alam B, Lloyd-Jones G, Dietrich T, Chapple I, Pfeffer PE, McCoy D, Davies G, Lyons RA, Griffiths C, Kee F, Sheikh A, Breen G, Shaheen SO, Martineau AR. Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK). Thorax 2022; 77:900-912. [PMID: 34848555 PMCID: PMC8646971 DOI: 10.1136/thoraxjnl-2021-217487] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/09/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Risk factors for severe COVID-19 include older age, male sex, obesity, black or Asian ethnicity and underlying medical conditions. Whether these factors also influence susceptibility to developing COVID-19 is uncertain. METHODS We undertook a prospective, population-based cohort study (COVIDENCE UK) from 1 May 2020 to 5 February 2021. Baseline information on potential risk factors was captured by an online questionnaire. Monthly follow-up questionnaires captured incident COVID-19. We used logistic regression models to estimate multivariable-adjusted ORs (aORs) for associations between potential risk factors and odds of COVID-19. RESULTS We recorded 446 incident cases of COVID-19 in 15 227 participants (2.9%). Increased odds of developing COVID-19 were independently associated with Asian/Asian British versus white ethnicity (aOR 2.28, 95% CI 1.33 to 3.91), household overcrowding (aOR per additional 0.5 people/bedroom 1.26, 1.11 to 1.43), any versus no visits to/from other households in previous week (aOR 1.31, 1.06 to 1.62), number of visits to indoor public places (aOR per extra visit per week 1.05, 1.02 to 1.09), frontline occupation excluding health/social care versus no frontline occupation (aOR 1.49, 1.12 to 1.98) and raised body mass index (BMI) (aOR 1.50 (1.19 to 1.89) for BMI 25.0-30.0 kg/m2 and 1.39 (1.06 to 1.84) for BMI >30.0 kg/m2 versus BMI <25.0 kg/m2). Atopic disease was independently associated with decreased odds (aOR 0.75, 0.59 to 0.97). No independent associations were seen for age, sex, other medical conditions, diet or micronutrient supplement use. CONCLUSIONS After rigorous adjustment for factors influencing exposure to SARS-CoV-2, Asian/Asian British ethnicity and raised BMI were associated with increased odds of developing COVID-19, while atopic disease was associated with decreased odds. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04330599).
Collapse
Affiliation(s)
- Hayley Holt
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mohammad Talaei
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Matthew Greenig
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Dominik Zenner
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Clare Relton
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Katherine S Young
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Molly R Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katherine N Thompson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jed Ashman
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sultan Saeed Rajpoot
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ahmed Ali Kayyale
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sarah El Rifai
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Philippa J Lloyd
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David Jolliffe
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Olivia Timmis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sarah Finer
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stamatina Iliodromiti
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Alec Miners
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Thomas Dietrich
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Iain Chapple
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Paul E Pfeffer
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David McCoy
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Gwyneth Davies
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Christopher Griffiths
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Frank Kee
- Centre for Public Health Research (NI), Queen's University Belfast, Belfast, UK
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Seif O Shaheen
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adrian R Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
30
|
Mostaza JM, Salinero-Fort MA, Cardenas-Valladolid J, Rodríguez-Artalejo F, Díaz-Almirón M, Vich-Pérez P, San Andrés-Rebollo FJ, Vicente I, Lahoz C. Factors associated with mortality due to SARS-CoV-2 in the population over 75 years of age in the Community of Madrid. Rev Clin Esp 2022; 222:468-478. [PMID: 35970758 PMCID: PMC9372797 DOI: 10.1016/j.rceng.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/04/2022] [Indexed: 11/30/2022]
Abstract
Objective Various studies have identified factors associated with risk of mortality in patients with SARS-CoV-2 infection. However, their sample size has often been limited and their results partially contradictory. This study evaluated factors associated with COVID-19 mortality in the population of Madrid over 75 years of age, in infected patients, and in hospitalized patients up to January 2021. Patients and Methods This population-based cohort study analyzed all residents of the Community of Madrid born before January 1, 1945 who were alive as of December 31, 2019. Demographic and clinical data were obtained from primary care electronic medical records (PC-Madrid), data on hospital admissions from the Conjunto Mínimo Básico de Datos (CMBD, Minimum Data Set), and data on mortality from the Índice Nacional de Defunciones (INDEF, National Death Index). Data on SARS-CoV-2 infection, hospitalization, and death were collected from March 1, 2020 to January 31, 2021. Results A total of 587,603 subjects were included in the cohort. Of them, 41,603 (7.1%) had confirmed SARS-CoV-2 infection, of which 22,362 (53.7% of the infected individuals) were hospitalized and 11,251 (27%) died. Male sex and age were the factors most closely associated with mortality, though many comorbidities also had an influence. The associations were stronger in the analysis of the total population than in the analysis of infected or hospitalized patients. Mortality among hospitalized patients was lower during the second wave (33.4%) than during the first wave (41.2%) of the pandemic. Conclusion Age, sex, and numerous comorbidities are associated with risk of death due to COVID-19. Mortality in hospitalized patients declined notably after the first wave of the pandemic.
Collapse
Affiliation(s)
- J M Mostaza
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna. Hospital La Paz-Carlos III, Madrid, Spain.
| | - M A Salinero-Fort
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Instituto de Investigación del Hospital La Paz (IdIPAZ), Red de Investigación en pacientes crónicos (REDISSEC), Subdirección general de Investigación en Salud, Ministerios de Sanidad, Madrid, Spain
| | - J Cardenas-Valladolid
- Dirección Técnica de Sistemas de Información Sanitaria, Gerencia Adjunta de Procesos Asistenciales, Gerencia Asistencial de Atención Primaria, Madrid. Spain
| | - F Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid-IdIPAZ, CIBER de Epidemiología y Salud Pública (CIBERESP) e IMDEA-Alimentación, CEI UAM + CSIC, Madrid, Spain
| | - M Díaz-Almirón
- Unidad de Investigación, Instituto de Investigación Hospital La Paz, IdiPAZ, Madrid, Spain
| | - P Vich-Pérez
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Los Alpes, Madrid, Spain
| | - F J San Andrés-Rebollo
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Las Calesas, Madrid, Spain
| | - I Vicente
- Centro de Salud Monovar, Madrid, Spain
| | - C Lahoz
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna. Hospital La Paz-Carlos III, Madrid, Spain
| |
Collapse
|
31
|
Assessing Smoking Status and Risk of SARS-CoV-2 Infection: A Machine Learning Approach among Veterans. Healthcare (Basel) 2022; 10:healthcare10071244. [PMID: 35885771 PMCID: PMC9319659 DOI: 10.3390/healthcare10071244] [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: 05/03/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 12/30/2022] Open
Abstract
The role of smoking in the risk of SARS-CoV-2 infection is unclear. We used a retrospective cohort design to study data from veterans’ Electronic Medical Record to assess the impact of smoking on the risk of SARS-CoV-2 infection. Veterans tested for the SARS-CoV-2 virus from 02/01/2020 to 02/28/2021 were classified as: Never Smokers (NS), Former Smokers (FS), and Current Smokers (CS). We report the adjusted odds ratios (aOR) for potential confounders obtained from a cascade machine learning algorithm. We found a 19.6% positivity rate among 1,176,306 veterans tested for SARS-CoV-2 infection. The positivity proportion among NS (22.0%) was higher compared with FS (19.2%) and CS (11.5%). The adjusted odds of testing positive for CS (aOR:0.51; 95%CI: 0.50, 0.52) and FS (aOR:0.89; 95%CI:0.88, 0.90) were significantly lower compared with NS. Four pre-existing conditions, including dementia, lower respiratory infections, pneumonia, and septic shock, were associated with a higher risk of testing positive, whereas the use of the decongestant drug phenylephrine or having a history of cancer were associated with a lower risk. CS and FS compared with NS had lower risks of testing positive for SARS-CoV-2. These findings highlight our evolving understanding of the role of smoking status on the risk of SARS-CoV-2 infection.
Collapse
|
32
|
Bouillon K, Baricault B, Semenzato L, Botton J, Bertrand M, Drouin J, Dray-Spira R, Weill A, Zureik M. Association of Statins for Primary Prevention of Cardiovascular Diseases With Hospitalization for COVID-19: A Nationwide Matched Population-Based Cohort Study. J Am Heart Assoc 2022; 11:e023357. [PMID: 35699173 PMCID: PMC9238639 DOI: 10.1161/jaha.121.023357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background There is little evidence on the relationship between statin use and the risk of hospitalization attributable to COVID‐19. Methods and Results The French National Healthcare Data System database was used to conduct a matched‐cohort study. For each adult aged ≥40 years receiving statins for the primary prevention of cardiovascular diseases, one nonuser was randomly selected and matched for year of birth, sex, residence area, and comorbidities. The association between statin use and hospitalization for COVID‐19 was examined using conditional Cox proportional hazards models, adjusted for baseline characteristics, comorbidities, and long‐term medications. Its association with in‐hospital death from COVID‐19 was also explored. All participants were followed up from February 15, 2020, to June 15, 2020. The matching procedure generated 2 058 249 adults in the statin group and 2 058 249 in the control group, composed of 46.6% of men with a mean age of 68.7 years. Statin users had a 16% lower risk of hospitalization for COVID‐19 than nonusers (adjusted hazard ratio [HR], 0.84; 95% CI, 0.81–0.88). All types of statins were significantly associated with a lower risk of hospitalization, with the adjusted HR ranging from 0.75 for fluvastatin to 0.89 for atorvastatin. Low‐ and moderate‐intensity statins also showed a lower risk compared with nonusers (HR, 0.78 [95% CI, 0.71–0.86] and HR, 0.84 [95% CI, 0.80–0.89], respectively), whereas high‐intensity statins did not (HR, 1.01; 95% CI, 0.86–1.18). We found similar results with in‐hospital death from COVID‐19. Conclusions Our findings support that the use of statins for primary prevention is associated with lower risks of hospitalization for COVID‐19 and of in‐hospital death from COVID‐19.
Collapse
Affiliation(s)
- Kim Bouillon
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Bérangère Baricault
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Laura Semenzato
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Jérémie Botton
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France.,Faculty of Pharmacy Paris-Saclay University Châtenay-Malabry France
| | - Marion Bertrand
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Jérôme Drouin
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Rosemary Dray-Spira
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products Saint-Denis France.,Paris-Saclay University UVSQ CESP-Inserm, Anti-infective evasion and pharmacoepidemiology Montigny le Bretonneux France
| |
Collapse
|
33
|
Widyahening IS, Vidiawati D, Pakasi TA, Soewondo P, Ahsan A. Noncommunicable diseases risk factors and the risk of COVID-19 among university employees in Indonesia. PLoS One 2022; 17:e0263146. [PMID: 35666734 PMCID: PMC9170090 DOI: 10.1371/journal.pone.0263146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/23/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Noncommunicable diseases (NCDs) are still a major public health problem in Indonesia. Studies have shown that risk factors of NCDs are associated with coronavirus disease 2019 (COVID-19) severity and mortality. However, it is unclear whether NCD risk factors are also risks for new COVID-19 cases. This study aimed to obtain an NCD risk profile among university employees and its associations with contracting COVID-19. Methods A cross-sectional study was conducted in October 2021. Participants were administrative employees of Universitas Indonesia (UI), Depok City, West Java. Assessment of NCD risk factors was based on the World Health Organization STEPwise approach to NCD risk factor surveillance (WHO STEPS). Demographic, working, and medical-history data were obtained electronically by using a Google Form. Physical and laboratory examinations were done in the Integrated Post for NCDs. Risks were expressed as adjusted odds ratio (ORadj) and 95% confidence interval (CI) in multivariate analyses. Results A total of 613 employees were enrolled. Men were predominant (54.8%), and about 36% of them work in shift as security personnel. About 66.7% were overweight or obese and 77.8% had hypertension. There were 138 (22.8%) employees who had COVID-19. Nearly all (95.6%) had been fully vaccinated against COVID-19. At-risk waist circumference (ORadj 1.72, 95% CI 1.15–2.56, p = 0.008) and total cholesterol level of 200–239 mg/dL (ORadj 2.30, 95% CI 1.19–4.44, p = 0.013) were independent risk factors, but shift work (ORadj 0.52, 95% CI 0.34–0.80, p = 0.003) was protective against COVID-19. Conclusion The prevalence of NCD risk factors among university administrative employees was high, increasing the risk of contracting COVID-19. A behavioral intervention program to manage NCD risk factors at the university level is urgently needed according to the Health Promoting University framework.
Collapse
Affiliation(s)
- Indah Suci Widyahening
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat, Indonesia
- Southeast Asian Ministers of Education Organization—Regional Centre for Food and Nutrition (SEAMEO-RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta, Indonesia
- * E-mail:
| | - Dhanasari Vidiawati
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat, Indonesia
| | - Trevino A. Pakasi
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta Pusat, Indonesia
| | - Pradana Soewondo
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia–Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Abdillah Ahsan
- Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Depok, Indonesia
| |
Collapse
|
34
|
Collins R, Balaconis MK, Brunak S, Chen Z, De Silva M, Gaziano JM, Ginsburg GS, Jha P, Kuri P, Metspalu A, Mulder N, Risch N. Global priorities for large-scale biomarker-based prospective cohorts. CELL GENOMICS 2022; 2:100141. [PMID: 36778137 PMCID: PMC9903754 DOI: 10.1016/j.xgen.2022.100141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The focus of this paper is on strategic approaches for establishing population-based prospective cohorts that collect and store biological samples from very large numbers of participants to help identify the determinants of common health outcomes. In particular, it aims to address key issues related to investigation of genetic, as well as social, environmental, and ancestral, diversity; generation of detailed genetic and other types of assay data; collection of detailed lifestyle and environmental exposure information; follow-up and characterization of incident health outcomes; and overcoming obstacles to data sharing and access (including capacity building). It concludes that there is a need for strategic planning at an international level (rather than the current ad hoc approach) toward the development of a carefully selected set of deeply characterized large-scale prospective cohorts that are readily accessible by researchers around the world.
Collapse
Affiliation(s)
- Rory Collins
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Corresponding author
| | | | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit and Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mary De Silva
- Head of Population Health, Wellcome Trust, London, UK
| | - J. Michael Gaziano
- Department of Medicine, Division of Aging, Brigham and Women’s Hospital and the VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
| | | | - Prabhat Jha
- Dalla Lana School of Public Health, Centre for Global Health Research, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Pablo Kuri
- Instituto Tecnológico de Estudios Superiores de Monterrey, Monterrey, Mexico
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, Estonian Biobank, University of Tartu, Tartu, Estonia
| | - Nicola Mulder
- Department of Integrative Biomedical Sciences, Computational Biology Division, IDM, CIDRI-Africa WT Centre, University of Cape Town, Cape Town, South Africa
| | - Neil Risch
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| |
Collapse
|
35
|
Ward ZJ, Willett WC, Hu FB, Pacheco LS, Long MW, Gortmaker SL. Excess mortality associated with elevated body weight in the USA by state and demographic subgroup: A modelling study. EClinicalMedicine 2022; 48:101429. [PMID: 35516446 PMCID: PMC9065308 DOI: 10.1016/j.eclinm.2022.101429] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 10/25/2022] Open
Abstract
Background The obesity epidemic in the USA continues to grow nationwide. Although excess weight-related mortality has been studied in general, less is known about how it varies by demographic subgroup within the USA. In this study we estimated excess mortality associated with elevated body weight nationally and by state and subgroup. Methods We developed a nationally-representative microsimulation (individual-level) model of US adults between 1999 and 2016, based on risk factor data from 6,002,012 Behavioral Risk Factor Surveillance System respondents. Prior probability distributions for hazard ratios relating body-mass index (BMI) to mortality were informed by a global pooling dataset. Individual-level mortality risks were modelled accounting for demographics, smoking history, and BMI adjusted for self-report bias. We calibrated the model to empirical all-cause mortality rates from CDC WONDER by state and subgroup, and assessed the predictive accuracy of the model using a random sample of data withheld from model fitting. We simulated counterfactual scenarios to estimate excess mortality attributable to different levels of excess weight and smoking history. Findings We estimated that excess weight was responsible for more than 1300 excess deaths per day (nearly 500,000 per year) and a loss in life expectancy of nearly 2·4 years in 2016, contributing to higher excess mortality than smoking. Relative excess mortality rates were nearly twice as high for women compared to men in 2016 (21·9% vs 13·9%), and were higher for Black non-Hispanic adults. By state, overall excess weight-related life expectancy loss ranged from 1·75 years (95% UI 1·57-1·94) in Colorado to 3·18 years (95% UI 2·86-3·51) in Mississippi. Interpretation Excess weight has substantial impacts on mortality in the USA, with large disparities by state and subgroup. Premature mortality will likely increase as obesity continues to rise. Funding The JPB Foundation, NIH, CDC.
Collapse
Affiliation(s)
- Zachary J. Ward
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, 718 Huntington Ave, Boston, MA 02115, USA
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lorena S. Pacheco
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael W. Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA
| | - Steven L. Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
36
|
Bliss JW, Lavery JA, Underwood WP, Chun SS, Fickera GA, Lee CP, Corcoran S, Maloy MA, Polubriaginof FC, Kelly DW, Scott JM, Boutros PC, Moskowitz CS, Jones LW. Impact of Exercise on Susceptibility and Severity of COVID-19 in Patients with Cancer: A Retrospective Study. Cancer Epidemiol Biomarkers Prev 2022; 31:1036-1042. [PMID: 35506245 DOI: 10.1158/1055-9965.epi-21-1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/30/2021] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Modifiable lifestyle-related factors heighten the risk and severity of coronavirus disease 2019 (COVID-19) in patients with cancer. Whether exercise lowers susceptibility or severity is not known. METHODS We identified 944 cancer patients from Memorial Sloan Kettering Cancer Center (mean age: 64; 85% female; 78% White) completing an exercise survey before receiving a confirmed positive or negative SARS-CoV-2 test. Exercise was defined as reporting moderate-intensity ≥5 days per week, ≥30 minutes/session or strenuous-intensity ≥3 days per week, ≥20 minutes/session. Multivariable logistic regression was used to determine the relationship between exercise and COVID-19 susceptibility and severity (i.e., composite of hospital admission or death events) with adjustment for clinical-epidemiologic covariates. RESULTS Twenty-four percent (230/944) of the overall cohort were diagnosed with COVID-19 and 35% (333/944) were exercisers. During a median follow-up of 10 months, 26% (156/611) of nonexercising patients were diagnosed with COVID-19 compared with 22% (74/333) of exercising patients. The adjusted OR for risk of COVID-19 was 0.65 [95% confidence interval (CI), 0.44-0.96, P = 0.03] for exercisers compared with nonexercisers. A total of 20% (47/230) of COVID-19 positive patients were hospitalized or died. No difference in the risk of severe COVID-19 as a function of exercise status was observed (P > 0.9). CONCLUSIONS Exercise may reduce the risk of COVID-19 infection in patients with a history of cancer, but not its severity. IMPACT This study provides the first data showing that exercise might lower the risk of COVID-19 in cancer patients, but further research is required.
Collapse
Affiliation(s)
- Joshua W Bliss
- New York Presbyterian - Weill Cornell Medicine, New York, New York
| | | | | | - Su S Chun
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gina A Fickera
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Molly A Maloy
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Daniel W Kelly
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jessica M Scott
- New York Presbyterian - Weill Cornell Medicine, New York, New York.,Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul C Boutros
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, California.,Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Institute for Precision Health, University of California, Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California
| | - Chaya S Moskowitz
- New York Presbyterian - Weill Cornell Medicine, New York, New York.,Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lee W Jones
- New York Presbyterian - Weill Cornell Medicine, New York, New York.,Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
37
|
Lahoz C, Salinero-Fort MA, Cárdenas J, Rodríguez-Artalejo F, Díaz-Almiron M, Vich-Pérez P, San Andrés-Rebollo FJ, Vicente I, Mostaza JM. HDL-cholesterol concentration and risk of SARS-CoV-2 infection in people over 75 years of age: A cohort with half a million participants from the Community of Madrid. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS (ENGLISH EDITION) 2022. [PMCID: PMC9132787 DOI: 10.1016/j.artere.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective The aim of this study was to analyze the relationship between HDL-cholesterol and the risk of SARS-CoV-2 infection in over 75-year-olds residing in the Community of Madrid. Methods Study of a population-based cohort, composed of all residents in Madrid (Spain) born before January 1, 1945 and alive on December 31, 2019. Demographic, clinical and analytical data were obtained from primary care electronic medical records from January 2015. Confirmed SARS-CoV-2 infection was defined as a positive RT-PCR or antigen test result. Infection data correspond to the period March 1, 2020 through December 31, 2020. Results Of the 593,342 cohort participants, 501,813 had at least one HDL-cholesterol determination in the past 5 years. Their mean age was 83.4 ± 5.6 years and 62.4% were women. A total of 36,996 (7.4%) had a confirmed SARS-CoV2 infection during 2020. The risk of infection [odds ratio (95% confidence interval)] for SARS-CoV2 according to increasing quintiles of HDL-cholesterol was 1, 0,960 (0,915–1,007), 0,891 (0,848–0,935), 0,865 (0,824–0,909) y 0,833 (0.792–0,876), after adjusting for age, sex, cardiovascular risk factors and comorbidities. Conclusions There is an inverse and dose-dependent relationship between HDL-cholesterol concentration and the risk of SARS-CoV2 infection in subjects aged over 75 years of age in the Community of Madrid.
Collapse
|
38
|
Association between influenza vaccination and mortality due to COVID-19. VACUNAS (ENGLISH EDITION) 2022. [PMCID: PMC9247262 DOI: 10.1016/j.vacune.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background It has recently been suggested that influenza vaccination may be a factor associated with decreased COVID-19 mortality. Methods An age-matched case–control study based on hospital cases. We included subjects aged 18 years and older with a diagnosis of moderate to severe COVID-19. Infection was corroborated by RT-PCR test for SARS-COV-2. Deceased subjects were considered cases, controls were patients discharged due to improvement of acute symptoms. We used bivariate analysis to determine factors associated with death from COVID-19, and calculated odds ratios and 95% confidence intervals. Results A total of 560 patients were included in the study, 214 (38.2%) were considered cases and 346 (61.7%) controls. A significant difference was observed with the presence of type 2 diabetes mellitus [54% vs. 39.3% between cases and controls, respectively (P = 0.04)] and having received influenza vaccination (P = 0.02). Type 2 diabetes mellitus was associated with higher COVID-19 mortality [OR 1.8 (95% CI 1.2–2.5) P = 0.01], whereas having been immunised against influenza in 2019 was associated with lower mortality in this group of patients [OR 0.6 (95% CI 0.4–0.9) P = 0.02]. Conclusions Influenza vaccination in the previous year appears to be associated with lower mortality from COVID-19; whereas type 2 diabetes mellitus is confirmed as a condition associated with higher mortality.
Collapse
|
39
|
Lahoz C, Salinero-Fort MA, Cárdenas J, Rodríguez-Artalejo F, Díaz-Almiron M, Vich-Pérez P, San Andrés-Rebollo FJ, Vicente I, Mostaza JM. Concentración de colesterol-HDL y riesgo de infección por SARS-CoV-2 en personas mayores de 75 años: una cohorte con medio millón de participantes de la Comunidad de Madrid. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS 2022; 34:113-119. [PMID: 35125250 PMCID: PMC8654578 DOI: 10.1016/j.arteri.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/13/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023]
Abstract
Objetivo El objetivo de este estudio fue analizar la relación entre el colesterol-HDL y el riesgo de infección por SARS-CoV-2 en mayores de 75 años residentes en la Comunidad de Madrid. Métodos Estudio de una cohorte de base poblacional, compuesto por todos los residentes en Madrid (España) nacidos antes del 1 de enero de 1945 y vivos el 31 de diciembre de 2019. Los datos demográficos, clínicos y analíticos se obtuvieron de las historias clínicas electrónicas de atención primaria desde enero de 2015. La infección confirmada por SARS-CoV-2 se definió como un resultado positivo en la RT-PCR o en la prueba de antígeno. Los datos sobre infección por SARS-CoV-2 corresponden al periodo del 1 de marzo de 2020 hasta el 31 de diciembre de 2020. Resultados De los 593.342 participantes de la cohorte, 501.813 tenían al menos una determinación de colesterol-HDL en los últimos 5 años. Su edad media era 83,4 ± 5,6 años y el 62,4% eran mujeres. Un total de 36.996 (7,4%) tuvieron una infección confirmada por SARS-CoV2 durante el año 2020. El riesgo de infección (odds ratio [intervalo de confianza 95%]) por SARS-CoV2 según los quintiles crecientes de colesterol-HDL fue de 1; 0,960 (0,915-1,007), 0,891 (0,848-0,935), 0,865 (0,824-0,909) y 0,833 (0.792-0,876), tras ajustar por edad, sexo, factores de riesgo cardiovascular y comorbilidades. Conclusiones Existe una relación inversa y dosis-dependiente entre la concentración de colesterol-HDL y el riesgo de infección por SARS-CoV2 en los mayores de 75 años de la Comunidad de Madrid.
Collapse
|
40
|
Arce-Salinas CA, Esquivel-Torruco YN, Bejarano-Juvera AA, Bustamante-Flores AK, Aguilar-Martínez N, Azcorra-López JG, Cabañas-Espinosa B, Luna-Rivera EM, Hernández-Alarcón A, Reyna Figueroa J. Asociación entre la vacunación contra influenza y la mortalidad por COVID-19. VACUNAS 2022; 23:113-118. [PMID: 34751213 PMCID: PMC8566694 DOI: 10.1016/j.vacun.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022]
Affiliation(s)
- C A Arce-Salinas
- Servicio de Medicina Interna, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - Y N Esquivel-Torruco
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - A A Bejarano-Juvera
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - A K Bustamante-Flores
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - N Aguilar-Martínez
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - J G Azcorra-López
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - B Cabañas-Espinosa
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - E M Luna-Rivera
- Departamento de Enseñanza e Investigación, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - A Hernández-Alarcón
- Servicio de Consulta Externa, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - J Reyna Figueroa
- Departamento de Enseñanza e Investigación, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| |
Collapse
|
41
|
Olsen F, Schillaci C, Ibrahim M, Lipani A. Borough-level COVID-19 forecasting in London using deep learning techniques and a novel MSE-Moran's I loss function. RESULTS IN PHYSICS 2022; 35:105374. [PMID: 35228988 PMCID: PMC8865939 DOI: 10.1016/j.rinp.2022.105374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
Following its identification in late 2019, COVID-19 has spread around the globe, and been declared a pandemic. With this in mind, modelling the spread of COVID-19 remains important for responding effectively. To date research has focused primarily on modelling the spread of COVID-19 on national and regional scales with just a few studies doing so on a city and sub-city scale. However, no attempts have yet been made to design and optimize a model explicitly for accurately forecasting the spread of COVID-19 at sub-city scale. This research aimed to address this research gap by developing an experimental LSTM-ANN deep learning model. The model is largely autoregressive in nature as it considers temporally lagged borough-level COVID-19 cases data from the last 9 days, but also considers temporally lagged (i) borough-level NO2 concentration data, (ii) government stringency data, and (iii) climatic data from the last 9 days, as well as non-temporally variable borough-level urban characteristics data when modelling and forecasting the spread of the disease. The model was also encouraged to learn the spatial relationships between boroughs with regards to the spread of COVID-19 by a novel MSE-Moran's I loss function. Overall, the model's performance appears promising and so the model represents a useful tool for assisting the decision making and interventions of governing bodies within cities. A sensitivity analysis also indicated that of the non COVID-19 variables, the government stringency is particularly important in the modelling process, with this being closely followed by the climatic variables, the NO2 concentration data, and finally the urban characteristics data. Additionally, the introduction of the novel MSE-Moran's I loss function appeared to improve the model's forecasting performance, and so this research has implications at the intersection of deep learning and disease modelling. It may also have implications within spatio-temporal forecasting more generally because such a feature may have the potential to improve forecasting in other spatio-temporal applications.
Collapse
Affiliation(s)
- Frederik Olsen
- Department of Civil, Environmental and Geomatic Engineering, University College London (UCL), England
| | - Calogero Schillaci
- Department of Agricultural and Environmental Science, University of Milan, Via Celoria 2 Milan, Italy
| | - Mohamed Ibrahim
- Department of Civil, Environmental and Geomatic Engineering, University College London (UCL), England
| | - Aldo Lipani
- Department of Civil, Environmental and Geomatic Engineering, University College London (UCL), England
| |
Collapse
|
42
|
Foster HME, Ho FK, Mair FS, Jani BD, Sattar N, Katikireddi SV, Pell JP, Niedzwiedz CL, Hastie CE, Anderson JJ, Nicholl BI, Gill JMR, Celis-Morales C, O'Donnell CA. The association between a lifestyle score, socioeconomic status, and COVID-19 outcomes within the UK Biobank cohort. BMC Infect Dis 2022; 22:273. [PMID: 35351028 PMCID: PMC8964028 DOI: 10.1186/s12879-022-07132-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Infection with SARS-CoV-2 virus (COVID-19) impacts disadvantaged groups most. Lifestyle factors are also associated with adverse COVID-19 outcomes. To inform COVID-19 policy and interventions, we explored effect modification of socioeconomic-status (SES) on associations between lifestyle and COVID-19 outcomes. METHODS Using data from UK-Biobank, a large prospective cohort of 502,536 participants aged 37-73 years recruited between 2006 and 2010, we assigned participants a lifestyle score comprising nine factors. Poisson regression models with penalised splines were used to analyse associations between lifestyle score, deprivation (Townsend), and COVID-19 mortality and severe COVID-19. Associations between each exposure and outcome were examined independently before participants were dichotomised by deprivation to examine exposures jointly. Models were adjusted for sociodemographic/health factors. RESULTS Of 343,850 participants (mean age > 60 years) with complete data, 707 (0.21%) died from COVID-19 and 2506 (0.76%) had severe COVID-19. There was evidence of a nonlinear association between lifestyle score and COVID-19 mortality but limited evidence for nonlinearity between lifestyle score and severe COVID-19 and between deprivation and COVID-19 outcomes. Compared with low deprivation, participants in the high deprivation group had higher risk of COVID-19 outcomes across the lifestyle score. There was evidence for an additive interaction between lifestyle score and deprivation. Compared with participants with the healthiest lifestyle score in the low deprivation group, COVID-19 mortality risk ratios (95% CIs) for those with less healthy scores in low versus high deprivation groups were 5.09 (1.39-25.20) and 9.60 (4.70-21.44), respectively. Equivalent figures for severe COVID-19 were 5.17 (2.46-12.01) and 6.02 (4.72-7.71). Alternative SES measures produced similar results. CONCLUSIONS Unhealthy lifestyles are associated with higher risk of adverse COVID-19, but risks are highest in the most disadvantaged, suggesting an additive influence between SES and lifestyle. COVID-19 policy and interventions should consider both lifestyle and SES. The greatest public health benefit from lifestyle focussed COVID-19 policy and interventions is likely to be seen when greatest support for healthy living is provided to the most disadvantaged groups.
Collapse
Affiliation(s)
- Hamish M E Foster
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Bhautesh D Jani
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Srinivasa Vittal Katikireddi
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Claire L Niedzwiedz
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Claire E Hastie
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jana J Anderson
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Barbara I Nicholl
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Catherine A O'Donnell
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. Kate.O'
| |
Collapse
|
43
|
Fisk HL, Childs CE, Miles EA, Ayres R, Noakes PS, Paras-Chavez C, Kuda O, Kopecký J, Antoun E, Lillycrop KA, Calder PC. Modification of subcutaneous white adipose tissue inflammation by omega-3 fatty acids is limited in human obesity-a double blind, randomised clinical trial. EBioMedicine 2022; 77:103909. [PMID: 35247847 PMCID: PMC8894262 DOI: 10.1016/j.ebiom.2022.103909] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 12/17/2022] Open
Abstract
Background Obesity is associated with enhanced inflammation. However, investigation in human subcutaneous white adipose tissue (scWAT) is limited and the mechanisms by which inflammation occurs have not been well elucidated. Marine long chain omega-3 polyunsaturated fatty acids (LC n-3 PUFAs) have anti-inflammatory actions and may reduce scWAT inflammation. Methods Subcutaneous white adipose tissue (scWAT) biopsies were collected from individuals living with obesity (n=45) and normal weight individuals (n=39) prior to and following a 12-week intervention with either 3 g/day of a fish oil concentrate (providing 1.1 g eicosapentaenoic acid (EPA) + 0.8 g docosahexaenoic acid (DHA)) or 3 g/day of corn oil. ScWAT fatty acid, oxylipin, and transcriptome profiles were assessed by gas chromatography, ultra-pure liquid chromatography tandem mass spectrometry, RNA sequencing and qRT-PCR, respectively. Findings Obesity was associated with greater scWAT inflammation demonstrated by lower concentrations of specialised pro-resolving mediators (SPMs) and hydroxy-DHA metabolites and an altered transcriptome with differential expression of genes involved in LC n-3 PUFA activation, oxylipin synthesis, inflammation, and immune response. Intervention with LC n-3 PUFAs increased their respective metabolites including the SPM precursor 14-hydroxy-DHA in normal weight individuals and decreased arachidonic acid derived metabolites and expression of genes involved in immune and inflammatory response with a greater effect in normal weight individuals. Interpretation Downregulated expression of genes responsible for fatty acid activation and metabolism may contribute to an inflammatory oxylipin profile and limit the effects of LC n-3 PUFAs in obesity. There may be a need for personalised LC n-3 PUFA supplementation based on obesity status. Funding European Commission Seventh Framework Programme (Grant Number 244995) and Czech Academy of Sciences (Lumina quaeruntur LQ200111901).
Collapse
Affiliation(s)
- Helena L Fisk
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom.
| | - Caroline E Childs
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom
| | - Elizabeth A Miles
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom
| | - Robert Ayres
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom
| | - Paul S Noakes
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom; Medical School, University of Notre Dame Australia, Fremantle, Australia
| | - Carolina Paras-Chavez
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom
| | - Ondrej Kuda
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Jan Kopecký
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Elie Antoun
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom
| | - Karen A Lillycrop
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom; School of Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, IDS Building, MP887, Tremona Road, Southampton SO16 6YD, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| |
Collapse
|
44
|
Opdam MAA, Benoy S, Verhoef LM, Van Bijnen S, Lamers-Karnebeek F, Traksel RAM, Vos P, den Broeder AA, Broen J. Identification of risk factors for COVID-19 hospitalisation in patients with anti-rheumatic drugs: results from a multicentre nested case control study'. Clin Pharmacol Ther 2022; 111:1061-1065. [PMID: 35143039 PMCID: PMC9087006 DOI: 10.1002/cpt.2551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/29/2022] [Indexed: 11/13/2022]
Abstract
Patients with inflammatory rheumatic diseases (IRDs) do not have an increased risk for coronavirus disease 2019 (COVID‐19) compared with the general population. However, it remains uncertain whether subgroups of patients with IRD using different immunosuppressive antirheumatic drugs carry a higher risk for severe COVID‐19 compared with other patients with IRD. The aim of this study is to identify risk factors for severe COVID‐19, requiring hospitalization in patients with IRD. This is a multicenter nested case control study conducted in the Netherlands. Cases are hospital known patients with IRD requiring hospitalization for COVID‐19 between March 1, 2020, and May 31, 2020. Controls are hospital known patients with IRD not requiring hospitalization for COVID‐19 in this period, included at a 4:1 ratio. Patient, disease, and treatment characteristics were extracted from electronic medical records and a questionnaire. Potential risk factors were analyzed using unconditional logistic regression, corrected for confounders and multiple testing. Eighty‐one cases and 396 controls were included. General risk factors of older age and obesity apply to patients with IRD as well (odds ratio (OR) for age ≥ 75 3.5, 95% confidence interval (CI) 1.9–6.3, OR for body mass index ≥ 40 4.5, 95% CI 1.5–14). No significantly increased ORs for COVID‐19 hospitalization were found for any antirheumatic agent or IRD. A protective effect was found for use of methotrexate (OR 0.53, 95% CI 0.31–0.92). In conclusion, similar to the general population, elderly and obese patients with IRD have a higher risk for hospitalization for COVID‐19. We did not identify a specific antirheumatic agent or IRD to increase the risk of COVID‐19 hospitalization in patients with IRD, except for a possible protective effect of methotrexate.
Collapse
Affiliation(s)
- Merel A A Opdam
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Sophie Benoy
- Regional Rheumatology Centre, Máxima Medical Centre, Eindhoven, the Netherlands
| | - Lise M Verhoef
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Sandra Van Bijnen
- Department of Rheumatology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | | | - R A M Traksel
- Regional Rheumatology Centre, Máxima Medical Centre, Eindhoven, the Netherlands
| | - Petra Vos
- Department of Rheumatology, Amphia Hospital, Breda, Netherlands
| | | | - Jasper Broen
- Regional Rheumatology Centre, Máxima Medical Centre, Eindhoven, the Netherlands
| |
Collapse
|
45
|
Khan MA, Menon P, Govender R, Abu Samra AM, Allaham KK, Nauman J, Östlundh L, Mustafa H, Smith JEM, AlKaabi JM. Systematic review of the effects of pandemic confinements on body weight and their determinants. Br J Nutr 2022; 127:298-317. [PMID: 33706844 PMCID: PMC8376925 DOI: 10.1017/s0007114521000921] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pandemics and subsequent lifestyle restrictions such as ‘lockdowns’ may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in grey sources from their inception until 1 July 2020 with an update in PubMed and Scopus on 1 February 2021. In total, 2361 unique records were retrieved, of which forty-one studies were identified eligible: one case–control study, fourteen cohort and twenty-six cross-sectional studies (469, 362 total participants). The participants ranged in age from 6 to 86 years. The proportion of female participants ranged from 37 % to 100 %. Pandemic confinements were associated with weight gain in 7·2–72·4 % of participants and weight loss in 11·1–32·0 % of participants. Weight gain ranged from 0·6 (sd 1·3) to 3·0 (sd 2·4) kg, and weight loss ranged from 2·0 (sd 1·4) to 2·9 (sd 1·5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lockdown. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.
Collapse
Affiliation(s)
- Moien Ab Khan
- Nutrition Studies Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Primary Care, NHS North West London, LondonTW3 3EB, UK
| | - Preetha Menon
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Romona Govender
- Nutrition Studies Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Amal Mb Abu Samra
- Nutrition Studies Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Kholoud K Allaham
- Nutrition Studies Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Javaid Nauman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Linda Östlundh
- National Medical Library, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Halla Mustafa
- Nutrition Studies Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | | | - Juma M AlKaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| |
Collapse
|
46
|
Dai XJ, Tan L, Ren L, Shao Y, Tao W, Wang Y. COVID-19 Risk Appears to Vary Across Different Alcoholic Beverages. Front Nutr 2022; 8:772700. [PMID: 35047542 PMCID: PMC8761797 DOI: 10.3389/fnut.2021.772700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the associations of status, amount, and frequency of alcohol consumption across different alcoholic beverages with coronavirus disease 2019 (COVID-19) risk and associated mortality. Methods: This study included 473,957 subjects, 16,559 of whom tested positive for COVID-19. Multivariate logistic regression analyses were used to evaluate the associations of alcohol consumption with COVID-19 risk and associated mortality. The non-linearity association between the amount of alcohol consumption and COVID-19 risk was evaluated by a generalized additive model. Results: Subjects who consumed alcohol double above the guidelines had a higher risk of COVID-19 (1.12 [1.00, 1.25]). Consumption of red wine above or double above the guidelines played protective effects against the COVID-19. Consumption of beer and cider increased the COVID-19 risk, regardless of the frequency and amount of alcohol intake. Low-frequency of consumption of fortified wine (1-2 glasses/week) within guidelines had a protective effect against the COVID-19. High frequency of consumption of spirits (≥5 glasses/week) within guidelines increased the COVID-19 risk, whereas the high frequency of consumption of white wine and champagne above the guidelines decreased the COVID-19 risk. The generalized additive model showed an increased risk of COVID-19 with a greater number of alcohol consumption. Alcohol drinker status, frequency, amount, and subtypes of alcoholic beverages were not associated with COVID-19 associated mortality. Conclusions: The COVID-19 risk appears to vary across different alcoholic beverage subtypes, frequency, and amount. Red wine, white wine, and champagne have chances to reduce the risk of COVID-19. Consumption of beer and cider and spirits and heavy drinking are not recommended during the epidemics. Public health guidance should focus on reducing the risk of COVID-19 by advocating healthy lifestyle habits and preferential policies among consumers of beer and cider and spirits.
Collapse
Affiliation(s)
- Xi-Jian Dai
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Liang Tan
- Department of Neurosurgery, Southwest Hospital, The Third Military Medical University (Army Military Medical University), Chongqing, China
| | - Lina Ren
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yuan Shao
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Weiqun Tao
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjun Wang
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| |
Collapse
|
47
|
Flegr J, Flegr P, Příplatová L. The effects of 105 biological, socioeconomic, behavioral, and environmental factors on the risk of SARS-CoV-2 infection and a severe course of COVID-19: a prospective, explorative cohort study. Biol Methods Protoc 2022; 7:bpac030. [PMCID: PMC9750789 DOI: 10.1093/biomethods/bpac030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 12/16/2022] Open
Abstract
Abstract
The confirmed number of SARS-CoV-2 infections up to 18 October 2022 is 626 million worldwide, but information about factors affecting the probability of infection or a severe course of COVID-19 remains insufficient and often speculative. Only a small number of factors have been rigorously examined, mostly by retrospective or cross-sectional studies.
We ran a preregistered study on 5164 Internet users who shared information with us about their exposure to 105 risk factors and reported being COVID-19 negative before the beginning of the fourth wave of COVID-19 in the Czech Republic. After the fourth wave, in which 709 (13.7%) of participants were infected, we used a partial Kendall test controlled for sex, age, and urbanization to compare the risk of infection and a severe course of the disease in subjects who initially did and did not report exposure to particular risk factors.
After the correction for multiple tests, we identified 13 factors – including male sex, lower age, blood group B, and larger household size – that increased the risk of infection and 16 factors – including mask-wearing, borreliosis in the past, use of vitamin D supplements, or rooibos drinking – that decreased it. We also identified 23 factors that increased the risk of a severe course of COVID-19 and 12 factors that decreased the risk.
This preregistered longitudinal study is of explorative nature. Therefore, although the observed effects were strong and remained highly significant even after correction for multiple tests, it will be necessary to confirm their existence in future independent studies.
Collapse
Affiliation(s)
- Jaroslav Flegr
- Division of Biology, Faculty of Science, Charles University , Prague 128 00, Czech Republic
| | - Pavel Flegr
- Faculty of Electrical Engineering, Czech Technical University in Prague , Prague 166 27, Czech Republic
| | - Lenka Příplatová
- Division of Biology, Faculty of Science, Charles University , Prague 128 00, Czech Republic
| |
Collapse
|
48
|
Wilkinson TJ, Yates T, Baker LA, Zaccardi F, Smith AC. Sarcopenic obesity and the risk of hospitalization or death from coronavirus disease 2019: findings from UK Biobank. JCSM RAPID COMMUNICATIONS 2022; 5:3-9. [PMID: 34541518 PMCID: PMC8441916 DOI: 10.1002/rco2.47] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/29/2021] [Accepted: 06/08/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The role of skeletal muscle mass in modulating immune response is well documented. Whilst obesity is well established as a key factor in COVID-19 and outcome, no study has examined the influence of both sarcopenia (low muscle mass) and obesity, termed 'sarcopenic obesity' on the risk of severe COVID-19. METHODS This study uses data from UK Biobank. Probable sarcopenia was defined as low handgrip strength. Sarcopenic obesity was mutually exclusively defined as the presence of obesity and low muscle mass [based on two established criteria: appendicular lean mass (ALM) adjusted for either (i) height or (ii) body mass index]. Severe COVID-19 was defined by a positive severe acute respiratory syndrome coronavirus 2 test result in a hospital setting and/or death with a primary cause reported as COVID-19. Fully adjusted logistic regression models were used to analyse the associations between sarcopenic status and severe COVID-19. This work was conducted under UK Biobank Application Number 52553. RESULTS We analysed data from 490 301 UK Biobank participants (median age 70.0 years, 46% male); 2203 (0.4%) had severe COVID-19. Individuals with probable sarcopenia were 64% more likely to have had severe COVID-19 (odds ratio 1.638; P < 0.001). Obesity increased the likelihood of severe COVID-19 by 76% (P < 0.001). Using either ALM index or ALM/body mass index to define low muscle mass, those with sarcopenic obesity were 2.6 times more likely to have severe COVID-19 (odds ratio 2.619; P < 0.001). Sarcopenia alone did not increase the risk of COVID-19. CONCLUSIONS Sarcopenic obesity may increase the risk of severe COVID-19, over that of obesity alone. The mechanisms for this are complex but could be a result of a reduction in respiratory functioning, immune response, and ability to respond to metabolic stress.
Collapse
Affiliation(s)
- Thomas J. Wilkinson
- Leicester Kidney Lifestyle Team, Department of Health SciencesUniversity of LeicesterLeicesterUK
- Leicester NIHR Biomedical Research CentreLeicesterUK
| | - Thomas Yates
- Leicester NIHR Biomedical Research CentreLeicesterUK
- Leicester Diabetes Research CentreLeicesterUK
| | - Luke A. Baker
- Leicester Kidney Lifestyle Team, Department of Health SciencesUniversity of LeicesterLeicesterUK
- Leicester NIHR Biomedical Research CentreLeicesterUK
| | - Francesco Zaccardi
- Leicester Diabetes Research CentreLeicesterUK
- Leicester Real World Evidence UnitUniversity of LeicesterLeicesterUK
- NIHR Applied Research Collaboration (ARC) East Midlands, Diabetes Research CentreLeicesterUK
| | - Alice C. Smith
- Leicester Kidney Lifestyle Team, Department of Health SciencesUniversity of LeicesterLeicesterUK
- Leicester NIHR Biomedical Research CentreLeicesterUK
| |
Collapse
|
49
|
Das P, Igoe M, Lenhart S, Luong L, Lanzas C, Lloyd AL, Odoi A. Geographic disparities and determinants of COVID-19 incidence risk in the greater St. Louis Area, Missouri (United States). PLoS One 2022; 17:e0274899. [PMID: 36170339 PMCID: PMC9518888 DOI: 10.1371/journal.pone.0274899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Evidence seems to suggest that the risk of Coronavirus Disease 2019 (COVID-19) might vary across communities due to differences in population characteristics and movement patterns. However, little is known about these differences in the greater St Louis Area of Missouri and yet this information is useful for targeting control efforts. Therefore, the objectives of this study were to investigate (a) geographic disparities of COVID-19 risk and (b) associations between COVID-19 risk and socioeconomic, demographic, movement and chronic disease factors in the Greater St. Louis Area of Missouri, USA. METHODS Data on COVID-19 incidence and chronic disease hospitalizations were obtained from the Department of Health and Missouri Hospital Association, respectively. Socioeconomic and demographic data were obtained from the 2018 American Community Survey while population mobility data were obtained from the SafeGraph website. Choropleth maps were used to identify geographic disparities of COVID-19 risk and several sociodemographic and chronic disease factors at the ZIP Code Tabulation Area (ZCTA) spatial scale. Global negative binomial and local geographically weighted negative binomial models were used to investigate associations between ZCTA-level COVID-19 risk and socioeconomic, demographic and chronic disease factors. RESULTS There were geographic disparities found in COVID-19 risk. Risks tended to be higher in ZCTAs with high percentages of the population with a bachelor's degree (p<0.0001) and obesity hospitalizations (p<0.0001). Conversely, risks tended to be lower in ZCTAs with high percentages of the population working in agriculture (p<0.0001). However, the association between agricultural occupation and COVID-19 risk was modified by per capita between ZCTA visits. Areas that had both high per capita between ZCTA visits and high percentages of the population employed in agriculture had high COVID-19 risks. The strength of association between agricultural occupation and COVID-19 risk varied by geographic location. CONCLUSIONS Geographic disparities of COVID-19 risk exist in the St. Louis area and are associated with sociodemographic factors, population movements, and obesity hospitalization risks. The latter is particularly concerning due to the growing prevalence of obesity and the known immunological impairments among obese individuals. Therefore, future studies need to focus on improving our understanding of the relationships between COVID-19 vaccination efficacy, obesity and waning of immunity among obese individuals so as to better guide vaccination regimens and reduce disparities.
Collapse
Affiliation(s)
- Praachi Das
- Biomathematics Graduate Program and Department of Mathematics, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Morganne Igoe
- Department of Mathematics, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Suzanne Lenhart
- Department of Mathematics, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Lan Luong
- BJC Healthcare, St. Louis, Missouri, United States of America
| | - Cristina Lanzas
- Department of Population Health and Pathobiology and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Alun L. Lloyd
- Biomathematics Graduate Program and Department of Mathematics, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Agricola Odoi
- Department of Biomedical and Diagnostics Sciences, University of Tennessee, Knoxville, Tennessee, United States of America
- * E-mail:
| |
Collapse
|
50
|
Cheng YC, Liu HC, Hsu CY, Lee IT. Duration of Treatment in a Weight Loss Program Using a Mobile App is Associated with Successful Weight Loss During the COVID-19 Pandemic. Diabetes Metab Syndr Obes 2022; 15:1737-1747. [PMID: 35706478 PMCID: PMC9191578 DOI: 10.2147/dmso.s368608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We aimed to explore the independent factors associated with successful weight loss using a mobile app during the COVID-19 pandemic. PATIENTS AND METHODS For this retrospective cohort study, we collected data from 45 adults in a weight loss program using a mobile app. We defined successful weight loss as a weight reduction by ≥ 5% of the baseline weight. Multivariate logistic analysis was used to assess potential factors influencing successful weight loss. RESULTS All subjects showed a mean 4.1 ± 4.4 kg reduction of baseline weight after using the app for a mean duration of 11 weeks (P < 0.001). Subjects in the successful weight loss group displayed a longer duration of treatment (14.6 ± 6.5 weeks vs 6.9 ± 6.0 weeks, P < 0.001), greater number of dietary records (109.2 ± 84.7 vs 54.7 ± 58.8, P = 0.002), and greater number of outpatient visits (6.1 ± 2.7 vs 3.7 ± 2.3, P < 0.001) than those in the unsuccessful weight loss group. Multivariate logistic analysis showed that duration of treatment was an independent factor associated with successful weight loss (odds ratio = 1.23, 95% confidence interval: 1.08-1.41, P = 0.003). CONCLUSION In a weight management program using a mobile app during the COVID-19 pandemic, the duration of treatment was found to be an independent factor of successful weight loss.
Collapse
Affiliation(s)
- Yu-Cheng Cheng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
| | - Hsiu-Chen Liu
- Department of Nursing, Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan
- Correspondence: I-Te Lee, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 1650, Section 4, Taiwan Boulevard, Taichung City, 40705, Taiwan, Tel +886-4-23592525 ext. 3060, Fax +886-4-23593662, Email
| |
Collapse
|