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Hauner H, Blanken CPS, Holzapfel C. Long-lasting effects of the COVID-19 pandemic on lifestyle and body weight: results of representative cross-sectional surveys in adults in Germany. BMC Public Health 2024; 24:1199. [PMID: 38684999 PMCID: PMC11059715 DOI: 10.1186/s12889-024-18680-x] [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: 09/19/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic severely affected people's daily lives and health. Few studies have looked into the persistence of these changes. In the current study, we investigated to what extent changes in lifestyle and body weight were sustained after two years of restrictions. METHODS We performed two representative online surveys among adults living in Germany. The first survey (S1) was performed in April 2021; the second survey (S2) in June 2022. The questionnaire focused on changes in physical activity, dietary habits, body weight, and mental stress levels. The data were weighted to optimally represent the general population of Germany. Using Chi-square tests, results were compared between the two surveys, and - per survey - between subgroups based on sociodemographic factors and mental stress levels. Furthermore, binomial logistic regression was performed to identify factors associated with weight gain. RESULTS A total of 1,001 (S1) and 1,005 (S2) adults completed the survey, of which 50.4% were men and 49.6% were women in both surveys. Mean body mass index (BMI) at the time of the survey was 27.4 ± 6.0 kg/m2 (S1) and 27.1 ± 5.5 kg/m2 (S2). Reduced physical activity was reported by 52% of the participants in S1 and by 40% in S2 (p < .001). Moderate to severe stress was reported by 71% of the participants in S1 and by 62% in S2 (p < .001). Less healthy eating compared to before the pandemic was reported by 16% of the participants in S1 and by 12% in S2 (p = 0.033). Weight gain was reported by 40% of the participants in S1 and by 35% in S2 (p = 0.059). Weight gain was associated with higher BMI, reduced physical activity levels, less healthy nutrition and increased consumption of energy-dense food. CONCLUSIONS Our results indicate that two years and three months after the start of the COVID-19 pandemic, the adverse effects on health-related lifestyle factors and body weight still existed, albeit to a lesser degree than directly after the first year of the pandemic. Targeted strategies are needed to better support the population subgroups most likely to change their lifestyle in unfavorable ways when faced with disruptions of their everyday lives.
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Affiliation(s)
- Hans Hauner
- Institute of Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 62, Munich, 80992, Germany.
- Else Kröner Fresenius Center for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, Munich, 80992, Germany.
| | - Carmen P S Blanken
- Institute of Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 62, Munich, 80992, Germany
| | - Christina Holzapfel
- Institute of Nutritional Medicine, School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 62, Munich, 80992, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
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2
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Laganà A, Visalli G, Di Pietro A, Facciolà A. Vaccinomics and adversomics: key elements for a personalized vaccinology. Clin Exp Vaccine Res 2024; 13:105-120. [PMID: 38752004 PMCID: PMC11091437 DOI: 10.7774/cevr.2024.13.2.105] [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: 12/14/2023] [Revised: 02/07/2024] [Accepted: 03/12/2024] [Indexed: 05/18/2024] Open
Abstract
Vaccines are one of the most important and effective tools in the prevention of infectious diseases and research about all the aspects of vaccinology are essential to increase the number of available vaccines more and more safe and effective. Despite the unquestionable value of vaccinations, vaccine hesitancy has spread worldwide compromising the success of vaccinations. Currently, the main purpose of vaccination campaigns is the immunization of whole populations with the same vaccine formulations and schedules for all individuals. A personalized vaccinology approach could improve modern vaccinology counteracting vaccine hesitancy and giving great benefits for human health. This ambitious purpose would be possible by facing and deepening the areas of vaccinomics and adversomics, two innovative areas of study investigating the role of a series of variables able to influence the immune response to vaccinations and the development of serious side effects, respectively. We reviewed the recent scientific knowledge about these innovative sciences focusing on genetic and non-genetic basis involved in the individual response to vaccines in terms of both immune response and side effects.
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Affiliation(s)
- Antonio Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Istituto Clinico Polispecialistico C.O.T., Cure Ortopediche Traumatologiche S.P.A., Messina, Italy
| | - Giuseppa Visalli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Angela Di Pietro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Alessio Facciolà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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3
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Wang Y, Yao P, Li K, Qin S. GDF-15 (a biomarker for metformin) and the risk of COVID-19: A two-sample Mendelian randomization study. Medicine (Baltimore) 2023; 102:e34675. [PMID: 37773870 PMCID: PMC10545159 DOI: 10.1097/md.0000000000034675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/19/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Regarding the impact of metformin on COVID-19, there are currently varying opinions from multiple studies. Growth differentiation factor 15 (GDF-15) is a biomarker of metformin use and dosage, and we used two-sample Mendelian randomization (MR) to assess the causal effect of GDF-15 (metformin) on COVID-19 susceptibility, hospitalization, and severe COVID-19, thereby guiding the selection of glucose-lowering agents for diabetic patients during the COVID-19 pandemic. METHODS Two sets of genetic tools were utilized for MR analysis, derived from publicly available genetic data. The first set was GDF-15 genome-wide association study (GWAS) data from a study with 5440 participants, while the second set was COVID-19 GWAS data from the Host Genetics Initiative (HGI) GWAS meta-analysis. The primary method used to assess causal effects was random effects inverse variance weighted estimation. Complementary methods included weighted median and MR-Egger analyses. Sensitivity analysis was performed using Cochran Q tests, MR-Egger intercept tests, MR-PRESSO, leave-one-out analyses, and funnel plots. RESULTS GDF-15 increased the risk of severe COVID-19 in patients (OR = 1.10, 95% CI 1.03-1.19; P = .006); there was no causal effect of GDF-15 on hospitalization for COVID-19 (OR = 1.02, 95% CI 0.96-1.07; P = .47) or susceptibility to COVID-19 in the general population (OR = 1.010, 95% CI 0.988-1.034; P = .354). CONCLUSIONS Our study supports the notion that GDF-15 increases the risk of severe COVID-19 in patients. However, there is no causal relationship between GDF-15 and hospitalization or susceptibility to COVID-19.
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Affiliation(s)
- Ya Wang
- Endocrinology Department, Liuzhou Peoples’ Hospital Affiliated to Guangxi Medical University, Liuzhou, China
| | - Peishan Yao
- Gastroenterology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Kai Li
- Orthopedics Department, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Shanyu Qin
- Gastroenterology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Tsiakalos A, Ziakas PD, Polyzou E, Schinas G, Akinosoglou K. Early Fluvoxamine Reduces the Risk for Clinical Deterioration in Symptomatic Outpatients with COVID-19: A Real-World, Retrospective, before-after Analysis. Microorganisms 2023; 11:2073. [PMID: 37630633 PMCID: PMC10459506 DOI: 10.3390/microorganisms11082073] [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: 06/29/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Fluvoxamine, a selective serotonin reuptake inhibitor with anti-inflammatory properties, has gained attention as a repurposed drug to treat COVID-19. We aimed to explore the potential benefit of fluvoxamine on outpatients with early SARS-CoV-2 infection. We performed a retrospective study of fluvoxamine adult outpatients with symptomatic COVID-19 disease of early onset (<5 days), in the context of an infectious diseases private practice, between September-December 2021, in Greece. Patients with disease duration ≥5 days, dyspnea and/or hypoxemia with oxygen saturation <94% in room air and pregnancy were excluded from the analysis. In total, 103 patients, 54 males/49 females with a median age of 47 years (39-56), were included in this study. Patient characteristics were balanced before and after the introduction of fluvoxamine. Two patients in the fluvoxamine arm (3.8%; 95% CI 0.4-13) had clinical deterioration compared to 8 patients in the standard of care group (16%; 95% CI 7.2-29.1, p < 0.04). After controlling for age, sex, body mass index > 30 and vaccination status, fluvoxamine was independently associated with a lower risk of clinical deterioration (adj. OR 0.12; 95% CI 0.02-0.70, p < 0.02). Adding on fluvoxamine to treatment for early symptomatic COVID-19 patients may protect them from clinical deterioration and hospitalization, and it is an appealing low-cost, low-toxicity option in the community setting and warrants further investigation.
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Affiliation(s)
| | | | - Eleni Polyzou
- Dept of Internal Medicine and Infectious Diseases, Medical School, University General Hospital of Patras, University of Patras, 26504 Rio, Greece; (E.P.); (G.S.); (K.A.)
| | - Georgios Schinas
- Dept of Internal Medicine and Infectious Diseases, Medical School, University General Hospital of Patras, University of Patras, 26504 Rio, Greece; (E.P.); (G.S.); (K.A.)
| | - Karolina Akinosoglou
- Dept of Internal Medicine and Infectious Diseases, Medical School, University General Hospital of Patras, University of Patras, 26504 Rio, Greece; (E.P.); (G.S.); (K.A.)
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Fotea S, Ghiciuc CM, Stefanescu G, Cianga AL, Mihai CM, Lupu A, Butnariu LI, Starcea IM, Salaru DL, Mocanu A, Chisnoiu T, Thet AA, Miron L, Lupu VV. Pediatric COVID-19 and Diabetes: An Investigation into the Intersection of Two Pandemics. Diagnostics (Basel) 2023; 13:2436. [PMID: 37510181 PMCID: PMC10378192 DOI: 10.3390/diagnostics13142436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a complex infectious disease caused by the SARS-CoV-2 virus, and it currently represents a worldwide public health emergency. The pediatric population is less prone to develop severe COVID-19 infection, but children presenting underlying medical conditions, such as diabetes mellitus, are thought to be at increased risk of developing more severe forms of COVID-19. Diabetic children face new challenges when infected with SARS-CoV-2. On one hand, the glycemic values become substantially more difficult to manage as COVID-19 is a predisposing factor for hyperglycemia. On the other hand, alongside other risk factors, high glycemic values are incriminated in modulating immune and inflammatory responses, leading to potentially severe COVID-19 cases in the pediatric population. Also, there are hypotheses of SARS-CoV-2 being diabetogenic itself, but this information is still to be confirmed. Furthermore, it is reported that there was a noticeable increase in the number of cases of new-onset type 2 diabetes among the pediatric population, and the complications in these patients with COVID-19 include the risk of developing autoimmune diseases under the influence of stress. Additionally, children with diabetes mellitus are confronted with lifestyle changes dictated by the pandemic, which can potentially lead to the onset or exacerbation of a potential underlying anxiety disorder or depression. Since the literature contains a series of unknowns related to the impact of COVID-19 in both types of diabetes in children, the purpose of our work is to bring together the data obtained so far and to identify potential knowledge gaps and areas for future investigation regarding COVID-19 and the onset of diabetes type 1 or type 2 among the pediatric population.
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Affiliation(s)
- Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Stefanescu
- I-st Medical Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anca Lavinia Cianga
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Maria Mihai
- Pediatrics, Faculty of General Medicine, Ovidius University, 900470 Constanta, Romania
| | - Ancuta Lupu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Lacramioara Ionela Butnariu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Iuliana Magdalena Starcea
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Delia Lidia Salaru
- Faculty of General Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Mocanu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Tatiana Chisnoiu
- Pediatrics, Faculty of General Medicine, Ovidius University, 900470 Constanta, Romania
| | - Aye Aung Thet
- Faculty of General Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Lucian Miron
- III-rd Medical Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Vasile Valeriu Lupu
- Mother and Child Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Fedorchenko Y, Zimba O. Comorbidities in the COVID-19 Pandemic: Scopus-Based Bibliometric Analysis. J Korean Med Sci 2023; 38:e93. [PMID: 36942396 PMCID: PMC10027540 DOI: 10.3346/jkms.2023.38.e93] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/16/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Comorbidities attract enormous attention amid the coronavirus disease 2019 (COVID-19) pandemic. Mapping knowledge based on these clinical conditions is increasingly important since the pandemic is still raging and primarily affecting subjects with chronic diseases and comorbidities. Clinical presentation and complications of COVID-19 are still hot topics which are explored in numerous evidence-based publications. The aim of this study was to analyze Scopus-indexed COVID-19 papers covering comorbidities. METHODS Searches through the Scopus database were performed on September 19, 2022 using the following keywords: "Diabetes mellitus" OR "Cardiovascular Diseases" OR "Rheumatic Diseases" OR "Obesity" OR "Malignancies" AND "COVID-19." All retrieved articles were analyzed using the following categories: document type, authorship, keywords, journal, citation score, country of origin, and language. Using the software tool VOSviewer version 1.6.18, we visualized the network of authors and keywords co-occurrence of the most prevalent comorbidities reported in connection with COVID-19. RESULTS Reports on COVID-19 and diabetes mellitus (DM) were most frequently published (n = 12,282). The US was the most productive country (n = 3,005) in the field of COVID-19 and comorbidities. There were 1,314 documents on COVID-19 and rheumatic diseases which is the least number in comparison with other comorbidities (COVID-19 and DM: 12,282, COVID-19 and cardiovascular disease: 9,911, COVID-19 and obesity: 7,070, and COVID-19 and malignancies: 1,758). CONCLUSION This mapping of COVID-19-related documents in connection with comorbidities may prioritize future research directions.
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Affiliation(s)
- Yuliya Fedorchenko
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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Bonfrate L, Di Ciaula A, Khalil M, Farella I, Chirico R, Vilahur G, Portincasa P. Gender-dependent impact of COVID-19 lockdown on metabolic and psychological aspects. Intern Emerg Med 2023; 18:385-395. [PMID: 36703077 PMCID: PMC9879743 DOI: 10.1007/s11739-022-03173-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/06/2022] [Indexed: 01/28/2023]
Abstract
The first COVID-19 lockdown resulted in enforced quarantine of heavily affected areas with social isolation and related measures by several governments to slow the spread of the disease. The general population experienced several mental and lifestyle changes. Herein, we aimed to evaluate the metabolic and psychological effects induced by lifestyle changes during COVID-19 self-isolation among an Apulian overweight/obese cohort with metabolic disturbances. The study assessed anthropometric data (weight, abdominal circumferences), dietary habits (adherence to the Mediterranean diet, junk food score), lifestyle habits (i.e., smoking, and physical activity), levels of stress and anxiety, and depression. Subjects underwent bioumoral exams before and after self-isolation to monitor glycemic and lipid profiles. A total of 245 subjects (M:F = 118:127) have been included in the study. After lockdown, the number of obese subjects significantly increased in both sexes, and was higher in females than in males (P < 0.0001). Glycemic and lipid profiles worsened, with higher levels of insulinemia, lower levels of HDL cholesterol, and higher levels of triglycerides in females than in males. Adherence to the Mediterranean diet and consumption of junk foods were altered in both groups, especially in females. Psychological aspects were significantly higher in females than in males. Finally, work activities and familial status strongly affected the metabolic and psychological profile. In conclusion, COVID-19 self-isolation induced changes in lifestyle and dietary habits with psychological distress and detrimental effects on metabolic patterns, which were more pronounced in female gender.
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Affiliation(s)
- Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy.
| | - Agostino Di Ciaula
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Mohamad Khalil
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Ilaria Farella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Roberta Chirico
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Gemma Vilahur
- Research Institute, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
- CiberCV, Instituto Salud Carlos III, Barcelona, Spain
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
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Towards a Future of Personalized Vaccinology: Study on Individual Variables Influencing the Antibody Response to the COVID-19 Vaccine. Vaccines (Basel) 2023; 11:vaccines11020217. [PMID: 36851095 PMCID: PMC9961107 DOI: 10.3390/vaccines11020217] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
The COVID-19 pandemic has hugely impacted many different aspects of human health, and vaccination is one of the most effective weapons to manage it. However, many different factors, such as age, gender, comorbidities and lifestyles, play a role in the response to infections and vaccines. We carried out this study to evaluate the potential role played by some individual factors in the production of anti-COVID-19 antibodies in the light of personalized and future vaccinology. We conducted an observational study consisting of a retrospective phase, exploiting previous data about anti-COVID-19 antibody responses, with a prospective phase to investigate individual variables through the use of a questionnaire. The antibody response after the COVID-19 vaccination was inversely related to old age, increased BMI and the number of smoking years, while a positive correlation was found with moderate alcohol consumption and especially with circulating levels of vitamin D, as clearly shown by the multivariate regression analysis. Our study showed that a number of variables are involved in the COVID-19 vaccine antibody response. These findings are very important and can be considered in the light of a future and personalized vaccinology.
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Capra ME, Stanyevic B, Giudice A, Monopoli D, Decarolis NM, Esposito S, Biasucci G. The Effects of COVID-19 Pandemic and Lockdown on Pediatric Nutritional and Metabolic Diseases: A Narrative Review. Nutrients 2022; 15:nu15010088. [PMID: 36615746 PMCID: PMC9823544 DOI: 10.3390/nu15010088] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
SARS-CoV-2 was the first pathogen implied in a worldwide health emergency in the last decade. Containment measures have been adopted by various countries to try to stop infection spread. Children and adolescents have been less clinically involved by COVID-19, but the pandemic and consequent containment measures have had an important influence on the developmental ages. The COVID-19 pandemic and the subsequent lockdown periods have influenced the nutrition and lifestyles of children and adolescents, playing an epigenetic role in the development of nutrition and metabolic diseases in this delicate age group. The aim of our review is to investigate the effects of the COVID-19 pandemic on nutrition and metabolic diseases in the developmental ages. Moreover, we have analyzed the effect of different containment measures in children and adolescents. An increase in being overweight, obesity and type 2 diabetes mellitus has been detected. Concerning type 1 diabetes mellitus, although a validated mechanism possibly linking COVID-19 with new onset type 1 diabetes mellitus has not been yet demonstrated, barriers to the accessibility to healthcare services led to delayed diagnosis and more severe presentation of this disease. Further studies are needed to better investigate these relationships and to establish strategies to contain the nutritional and metabolic impact of new pandemics in the developmental ages.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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10
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Barazzoni R, Bischoff SC, Busetto L, Cederholm T, Chourdakis M, Cuerda C, Delzenne N, Genton L, Schneider S, Singer P, Boirie Y. Nutritional management of individuals with obesity and COVID-19: ESPEN expert statements and practical guidance. Clin Nutr 2022; 41:2869-2886. [PMID: 34140163 PMCID: PMC8110326 DOI: 10.1016/j.clnu.2021.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemics has created unprecedented challenges and threats to patients and healthcare systems worldwide. Acute respiratory complications that require intensive care unit (ICU) management are a major cause of morbidity and mortality in COVID-19 patients. Among other important risk factors for severe COVID-19 outcomes, obesity has emerged along with undernutrition-malnutrition as a strong predictor of disease risk and severity. Obesity-related excessive body fat may lead to respiratory, metabolic and immune derangements potentially favoring the onset of COVID-19 complications. In addition, patients with obesity may be at risk for loss of skeletal muscle mass, reflecting a state of hidden malnutrition with a strong negative health impact in all clinical settings. Also importantly, obesity is commonly associated with micronutrient deficiencies that directly influence immune function and infection risk. Finally, the pandemic-related lockdown, deleterious lifestyle changes and other numerous psychosocial consequences may worsen eating behaviors, sedentarity, body weight regulation, ultimately leading to further increments of obesity-associated metabolic complications with loss of skeletal muscle mass and higher non-communicable disease risk. Therefore, prevention, diagnosis and treatment of malnutrition and micronutrient deficiencies should be routinely included in the management of COVID-19 patients in the presence of obesity; lockdown-induced health risks should also be specifically monitored and prevented in this population. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing clinical practice guidance for nutritional management of COVID-19 patients with obesity in various clinical settings.
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Affiliation(s)
- Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy,Azienda sanitaria universitaria Giuliano Isontina (ASUGI), Cattinara Hospital, Trieste, Italy,Corresponding author. Department of Medical, Surgical and Health Sciences and Azienda sanitaria universitaria Giuliano Isontina (ASUGI), Cattinara University Hospital, Strada di Fiume 447, Trieste, Italy
| | - Stephan C. Bischoff
- Department of Nutritional Medicine and Prevention, University of Hohenheim, Stuttgart, Germany
| | - Luca Busetto
- Department of Medicine, University of Padova, Italy
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Michael Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Schneider
- Gastroenterology and Nutrition, Nice University Hospital, Université Côte d’Azur, Nice, France
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Yves Boirie
- Department of Clinical Nutrition, CHU Clermont-Ferrand, University of Clermont Auvergne, Human Nutrition Unit, CRNH Auvergne, F-63000, Clermont-Ferrand, France
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11
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Park MY, Chung N. Changes in physical activity and energy intake according to abdominal obesity in Korean adult men before and after COVID-19: Data from 2019 and 2020 Korea National Health and Nutrition Examination Survey (KNHANES). J Exerc Nutrition Biochem 2022; 26:6-15. [DOI: 10.20463/pan.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/01/2022] [Indexed: 11/07/2022] Open
Abstract
[Purpose] This study aimed to investigate changes in physical activity and energy intake according to abdominal obesity in Korean adult men before and after COVID-19.[Methods] Using data from the 2019 and 2020 KNHANES, the physical activity level measured by the Global Physical Activity Questionnaire (GPAQ) the physical activity level by GPAQ, number of days of walking and strength training, aerobic exercise, and total energy, protein, fat, carbohydrate, dietary fiber, and sugar intake for a total of 2,799 participants were analyzed.[Results] There were no changes in energy intake during the pandemic. The number of days of weekly walking was higher (2019, <i>p</i> = 0.006; 2020, <i>p</i> = 0.012) and strength training was significantly higher (2019, <i>p</i> < 0.0001; 2020 <i>p</i> < 0.0001) in the non-abdominal obesity group than in the abdominal obesity group before and after COVID-19. Strength training at least once a week suppressed abdominal obesity (0.628 times in 2019, <i>p</i> < 0.0001; 0.605 times in 2020, <i>p</i> < 0.0001). In addition, even when the total energy intake and age were adjusted for, strength training influenced the suppression of abdominal obesity (0.634 times in 2019, <i>p</i> < 0.0001; 0.614 times in 2020, <i>p</i> < 0.0001).[Conclusion] Even with the change in the physical activity level, such as walking and aerobic exercise, due to the influence of social distancing measures, strength training influenced the suppression of abdominal obesity, regardless of the COVID-19 pandemic.
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Ohno M, Dzúrová D. Body Mass Index and Risk for COVID-19-Related Hospitalization in Adults Aged 50 and Older in Europe. Nutrients 2022; 14:nu14194001. [PMID: 36235653 PMCID: PMC9572204 DOI: 10.3390/nu14194001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Higher body mass index (BMI) has been associated with a higher risk for severe COVID-19 outcomes. The aim of this study was to investigate associations among BMI, underlying health conditions and hospital admission as well as the effects of COVID-19 vaccines in adults aged 50 years and older in Europe using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) which was collected from June to August 2021, shortly after the second wave of the COVID-19 pandemic occurred in Europe. Survey data totalling 1936 individuals were used for statistical analyses to calculate the likelihood of hospitalization due to COVID-19 infection in relation to BMI, sociodemographic factors, comorbidities and COVID vaccination status. Approximately 16% of individuals testing positive for COVID-19 were hospitalized for COVID-19, and over 75% of these hospitalized individuals were either overweight or obese. The likelihood of hospitalization for individuals with obesity was approximately 1.5 times (CI [1.05–2.05]) higher than those with a healthy weight (BMI = 18.5–24.9 kg/m2) after adjusting for BMI, sex and age. After adjusting for sociodemographic factors, vaccination and comorbidities, the likelihood of hospitalization for individuals with obesity was 1.34 times higher than those with a healthy weight (CI [0.94–1.90]). Vaccine uptake was lowest in individuals with obesity (BMI ≥ 30 kg/m2) in all age groups. Individuals who had not received a vaccine were 1.8 times more likely to be hospitalized (CI [1.34–2.30]). Across European regions, obesity is associated with higher odds of hospitalization, and vaccination may be effective to reduce these odds for older adults.
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Presti EL, Nuzzo D, Al Mahmeed W, Al-Rasadi K, Al-Alawi K, Banach M, Banerjee Y, Ceriello A, Cesur M, Cosentino F, Firenze A, Galia M, Goh SY, Janez A, Kalra S, Kapoor N, Kempler P, Lessan N, Lotufo P, Papanas N, Rizvi AA, Sahebkar A, Santos RD, Stoian AP, Toth PP, Viswanathan V, Rizzo M. Molecular and pro-inflammatory aspects of COVID-19: The impact on cardiometabolic health. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166559. [PMID: 36174875 PMCID: PMC9510069 DOI: 10.1016/j.bbadis.2022.166559] [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: 08/08/2022] [Revised: 09/03/2022] [Accepted: 09/21/2022] [Indexed: 12/15/2022]
Abstract
Obesity, type 2 diabetes (T2DM), hypertension (HTN), and Cardiovascular Disease (CVD) often cluster together as “Cardiometabolic Disease” (CMD). Just under 50% of patients with CMD increased the risk of morbidity and mortality right from the beginning of the COVID-19 pandemic as it has been reported in most countries affected by the SARS-CoV2 virus. One of the pathophysiological hallmarks of COVID-19 is the overactivation of the immune system with a prominent IL-6 response, resulting in severe and systemic damage involving also cytokines such as IL2, IL4, IL8, IL10, and interferon-gamma were considered strong predictors of COVID-19 severity. Thus, in this mini-review, we try to describe the inflammatory state, the alteration of the adipokine profile, and cytokine production in the obese state of infected and not infected patients by SARS-CoV2 with the final aim to find possible influences of COVID-19 on CMD and CVD. The immunological-based discussion of the molecular processes could inspire the study of promising targets for managing CMD patients and its complications during COVID-19.
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Affiliation(s)
- Elena Lo Presti
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Domenico Nuzzo
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Wael Al Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | | | - Kamila Al-Alawi
- Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat, Oman
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Yajnavalka Banerjee
- Department of Biochemistry, Mohamed Bin Rashid University, Dubai, United Arab Emirates
| | | | - Mustafa Cesur
- Clinic of Endocrinology, Ankara Güven Hospital, Ankara, Turkey
| | - Francesco Cosentino
- Unit of Cardiology, Karolinska Institute and Karolinska University Hospital, University of Stockholm, Sweden
| | - Alberto Firenze
- Unit of Research and International Cooperation, University Hospital of Palermo, Italy
| | - Massimo Galia
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bind), University of Palermo, Italy
| | - Su-Yen Goh
- Department of Endocrinology, Singapore General Hospital, Singapore
| | - Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Slovenia
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital & BRIDE, Karnal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Peter Kempler
- Department of Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Nader Lessan
- The Research Institute, Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Nikolaos Papanas
- Diabetes Center, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Ali A Rizvi
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raul D Santos
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Anca P Stoian
- Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, Bucharest, Romania
| | - Peter P Toth
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Italy.
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Woźniak J, Woźniak K, Wojciechowska O, Wrzosek M, Włodarek D. Effect of Age and Gender on the Efficacy of a 12-Month Body Weight Reduction Program Conducted Online-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12009. [PMID: 36231310 PMCID: PMC9566561 DOI: 10.3390/ijerph191912009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Overweight and obesity are a cause of many non-communicable diseases leading to an increased risk of death. There are many programs aimed at weight reduction, but few publications have evaluated their effectiveness according to the gender and age of the subjects. The purpose of this study is to evaluate the effects of age and gender on weight loss outcomes in subjects participating in a 12-month online weight loss program. 400 subjects, 190 men and 210 women, were included in the study. The online intervention consisted of a 15% energy deficit diet and training (RESPO method). Changes in body weight over 12 months were similar (p = 0.14) across age groups. Weight reductions by month were statistically significant (p = 0.0001) in both groups. We noted no differences in weight loss between men and women expressed in kilograms. However, women reduced their body weight to a greater extent, i.e., by 2.7 percentage points, than men. Gender is a factor that may influence the effectiveness of weight loss programs, while age demonstrates no such influence. Our study shows that significant weight reduction during weight loss therapy is achieved by both men and women, but women can expect better results.
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Affiliation(s)
- Jakub Woźniak
- Department of Dietetics, Institute of Human Nutrition, Warsaw University of Life Sciences (WULS–SGGW), Nowoursynowska 159 C, 02-776 Warsaw, Poland
| | | | | | | | - Dariusz Włodarek
- Department of Dietetics, Institute of Human Nutrition, Warsaw University of Life Sciences (WULS–SGGW), Nowoursynowska 159 C, 02-776 Warsaw, Poland
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15
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Eisenburger N, Friesen D, Haas F, Klaudius M, Schmidt L, Vandeven S, Joisten C. Short report: Weight management of children and adolescents with obesity during the COVID-19 pandemic in Germany. PLoS One 2022; 17:e0267601. [PMID: 35486630 PMCID: PMC9053772 DOI: 10.1371/journal.pone.0267601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this analysis was to assess the effectiveness of a juvenile outpatient weight management program during the coronavirus pandemic in Germany, which was implemented digitally during the initial lockdown and thereafter under strict hygiene rules (e.g., adapted exercise sessions). Changes in body mass index standard deviation scores (BMI SDS), physical fitness, media consumption, health-related quality of life (HRQOL), and social self-concept of 28 children and adolescents were compared to data of 30 participants before the pandemic. Adjusted mean changes from baseline to follow-up in BMI SDS (M = −0.07 ± 0.30), relative physical fitness (M = 0.0 ± 0.3 W/kg), media use (M = 0.5 ± 2.6 hours/day), HRQOL (M = −1.6 ± 15.3), and social self-concept (M = −3.8 ± 13.2) during the pandemic were not significantly different from those of the pre-pandemic participants (all p > 0.05). Therefore, the results suggest that an adjusted approach to weight management, which combined digital and adapted in-person components to meet hygiene requirements during the pandemic, was as effective as the pre-pandemic program. It could thus be a potential solution to ensure continuity of care for vulnerable children with obesity during the pandemic and the associated restrictions.
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Affiliation(s)
- Nina Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- * E-mail:
| | - David Friesen
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Fabiola Haas
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Marlen Klaudius
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Lisa Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Susanne Vandeven
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
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Effect of COVID-19 Lockdowns on Physical Activity, Eating Behavior, Body Weight and Psychological Outcomes in a Post-Bariatric Cohort. Obes Surg 2022; 32:1-9. [PMID: 35486289 PMCID: PMC9051813 DOI: 10.1007/s11695-022-06069-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 01/23/2023]
Abstract
PURPOSE Little is known about the consequences of COVID-19 lockdowns on physical activity (PA), eating behavior, and mental health in post-bariatric surgery (BS) patients. We aimed to analyze the relations between changes in PA during COVID-19 lockdowns and changes in body weight and a comprehensive set of lifestyle and psychological outcomes in patients who have undergone BS. MATERIAL AND METHODS In April-May 2020 (lockdown#1), we performed an online survey in a cohort of 937 adults who underwent BS and were followed-up at our university medical center for at least one year. We assessed changes in PA, eating behavior, body weight, fatigue, and depression (PHQ-9). In November-December 2020 (lockdown#2), we recorded body weight in 280 patients who had reported decreased PA during lockdown #1. RESULTS During lockdown #1 (N = 420 patients included, 44% response rate), decreased PA was reported by 67% patients. Compared to those who reported increased or unchanged PA, patients with decreased PA were more likely to report a ≥ 5% weight gain (OR (95% CI): 3.15 (1.46-7.65), increased fatigue (2.08 (1.36-3.23)), a worsening of eating behavior (2.29 (1.47-3.58)), and moderate-to-severe depressive symptoms (4.74 (2.14-11.76)). During lockdown #2 (N = 225 patients, 80% response rate), significant weight gain since before lockdown #1 was reported (+ 2.8 (95% CI: 1.7-3.8) kg, p < 0.001), with 36% patients reporting a ≥ 5% weight gain. CONCLUSIONS PA may counteract detrimental effects of COVID-19 lockdown on post-BS weight trajectories and mental health outcomes. Follow-up measures are needed in this setting to assess the long-term impact of lockdown.
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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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de Macêdo PFC, Nepomuceno CMM, Dos Santos NS, Queiroz VADO, Pereira EM, Leal LDC, Santos LADS, Nascimento LF, Martins PC, de Santana MLP. Weight stigma in the COVID-19 pandemic: a scoping review. J Eat Disord 2022; 10:44. [PMID: 35351201 PMCID: PMC8961493 DOI: 10.1186/s40337-022-00563-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Weight stigma is a phenomenon associated with adverse behavioural and psychological consequences. Although experts suggest that its increase during the COVID-19 pandemic may be associated with worse health outcomes for people with obesity, a thorough analysis of the main findings and gaps is still needed when relating to this subject. OBJECTIVE We aim to answer three questions: (1) How does weight stigma manifest in the COVID-19 pandemic? (2) How can weight stigma affect people with overweight or obesity in times of COVID-19? (3) What are the perceptions and experiences of weight stigma during the pandemic in individuals who experience overweight or obesity? METHODS We conducted a scoping review of studies addressing weight stigma and the COVID-19 pandemic in electronic databases (Medline/PubMed, CINAHL, Embase, PsycInfo, BVS/Lilacs, Scopus, Web of Science, Google Scholar, and OpenGrey) published until 10th August 2021. All relevant studies were reviewed in full by two researchers. In addition, a narrative synthesis of the data was performed. RESULTS The results included 35 studies out of 8,090 records and identified 13 original research publications, 14 text and opinion papers, and 6 narrative reviews. The results revealed the presence of weight stigma in the media, healthcare settings, interpersonal relationships, and public campaigns during the COVID-19 pandemic. The evidence of increasing weight stigma in the COVID-19 outbreak is limited, though. Many weight discrimination consequences were described during this time, such as impairment in accessing healthcare, worst COVID-19 outcomes, and maladaptive eating. However, only maladaptive behaviours and decline in mental health outcomes were demonstrated empirically in all age groups. This effect occurred regardless of body mass index, but people with high body weight were more likely to experience weight stigma. For some people with obesity, weight stigma in the pandemic has made activities of daily routine difficult. CONCLUSIONS The results suggest that weight stigma in the COVID-19 pandemic occurs in several settings; moreover, although weight discrimination impacts mental health, whether before or during the pandemic, this influence between the pandemic and pre-pandemic scenario is still unclear. Therefore, more research is required in this field while the pandemic lasts, especially with people with obesity. Overall, people with overweight or obesity are more vulnerable to weight stigma than individuals without overweight. In addition, weight stigma refers to discrimination or prejudice based on a person's weight and relates to several consequences, for instance, poor healthcare treatment and mental health problems. In the COVID-19 outbreak, these weight stigma effects tend to become even more critical because they may be associated with unfavourable COVID-19 outcomes and eating disorder risks. Thus, it is crucial to investigate how weight stigma occurs during the pandemic and its impact on health, mainly for the most affected people. We investigated 35 studies published between 2019 and 2021 to map and explore how weight stigma was manifested and the related consequences for people with overweight or obesity in the COVID-19 pandemic. Only about a third of them were quantitative or qualitative, limiting the evidence of weight stigma in the COVID-19 context. The available evidence suggests that weight stigma manifests in several settings such as media, healthcare, public campaigns, and is more common in people with excess weight. However, weight discrimination experiences before or during the pandemic were associated with adverse psychological and behavioural consequences across all age groups, regardless of body weight. For some people with obesity, for instance, weight stigma made it difficult to accomplish their activities of daily routine. Nevertheless, it remains unclear whether weight stigma has increased in the pandemic, thus, more studies are required, especially about people with overweight or obesity.
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Urhan M, Okut Aysin E. Nutritional and health behaviour predictors of the weight gain during the COVID-19 pandemic. Eur J Nutr 2022; 61:2993-3002. [PMID: 35322334 PMCID: PMC8942809 DOI: 10.1007/s00394-022-02862-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/02/2022] [Indexed: 11/24/2022]
Abstract
Purpose This study aims to examine the effects of the COVID-19 pandemic on the body weight, nutritional habits, physical activity, and food consumption of adults living in Turkey and evaluate the effects of changes in these health behaviours on body weight. Methods A cross-sectional study was conducted with an online questionnaire. Data were collected through social media platforms using the snowball sampling method. A self-reported questionnaire included socio-demographic information, anthropometric data, dietary habits, food consumption, and lifestyle changes. In this study, 4181 people were included. Logistic regression analysis was used to evaluate the variables associated with the increase in body weight. Results The findings obtained in this study showed that the bodyweight of 58.5% of the participants increased during the COVID-19 pandemic, and this increase was the highest (66.3%) among the obese. The rate of those who stated that their physical activity decreased was 69.5%. The foods consumed the most by individuals were homemade desserts (54%), nuts (53.8%) and fresh fruits (52.3%). Those whose serving size increased [OR = 4.98 (3.76–6.60)], those whose physical activity decreased or increased [OR = 2.94 (2.38–3.63) or 2.52 (1.84–3.45), respectively], and those whose number of main meals consumed increased [OR = 2.17 (1.72) − 2.75)], those with increased consumption of white bread (OR = 1.63 (1.20–2.22) and those with increased consumption of packaged sweet products [OR = 1.53 (1.23–1.89)] were more likely to gain weight. Conclusion The results of this study show that there are significant changes in the body weight, physical activities, and eating habits of the participants during the COVID-19 pandemic. It is necessary to provide and follow-up specific guidance and support services for different groups to protect public health, improve and prevent nutrition-related diseases.
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Affiliation(s)
- Murat Urhan
- Faculty of Health Science, Department of Nutrition Dietetics, Ege University, Izmir, Turkey.
| | - Elif Okut Aysin
- Henry Community Health, 1000 N 16th St, New Castle, IN, 47362, USA
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Jiang N, Gu P, Sun X, Han H, Liu W, Song N, Jiang X. Acceptance of COVID‐19 vaccines in patients with chronic diseases: A cross‐sectional study. J Clin Nurs 2022; 31:3286-3300. [PMID: 35285111 PMCID: PMC9115274 DOI: 10.1111/jocn.16284] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/22/2022] [Accepted: 02/24/2022] [Indexed: 02/05/2023]
Abstract
Aims and objectives This study aimed to clarify the attitudes, knowledge and vaccination willingness of patients with chronic diseases toward COVID‐19 vaccines and the influencing factors. Background Vaccination against COVID‐19 is an important way to protect patients with chronic diseases, but the vaccination acceptance varies across diseases and populations. A better understanding of this condition will lead to tailored intervention strategies and high vaccination rates. Design Cross‐sectional study. Methods Data were collected between March 2021 and May 2021 in China. A self‐compiled questionnaire was used in the survey. Two independent‐samples t‐tests/one‐way analysis of variance or U test/H test was used to measure the differences between groups. Multivariate regression analysis was used to identify the influencing factors. The study adhered to the EQUATOR checklist, STROBE. Results A total of 998 patients participated in the study. Score rates of attitudes, knowledge and vaccination willingness were 69.9%, 68.4% and 70.6% respectively. Age, vaccination status of family members, education levels, vaccine side effects and economic level were positive factors that could influence patients’ vaccination acceptances, while time of illness, type of disease and political affiliations were negative predictors. The top reasons for willingness toward vaccination were supporting national strategies, belief on the vaccines and fearing of contracting COVID‐19, while physical reasons, side effects and having a wait‐and‐see attitude were unwillingness factors. Conclusions Patients’ attitudes, knowledge and vaccination willingness were medium. Nurses should pay attention to patients who are from lower socioeconomic backgrounds, under 30 or over 70 years old, have no political affiliations, have damage to vital organs, have a long course of illness, family members have not received COVID‐19 vaccines and had no side effects after receiving other vaccines. Relevance to clinical practice Clinical nurses are recommended to take measures from patients’ duration of illness, damaged organs, demographic characteristics and families to improve patients’ vaccination acceptances.
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Affiliation(s)
- Ning Jiang
- West China School of Nursing/West China Hospital Sichuan University Chengdu China
- School of Nursing Shandong First Medical University Taian China
| | - Pengfei Gu
- School of Foreign Languages Shandong First Medical University Taian China
| | - Xian Sun
- Neurology Department Tianjin Third Central Hospital Tianjin China
| | - Hui Han
- Department of Gynecologic Oncology Tai’ an City Tumor Prevention Hospital Taian China
| | - Wenwen Liu
- Department of Respiratory Medicine Joint Logistic Support Force of the People's Liberation Army Taian China
| | - Na Song
- Department of Hemodialysis Joint Logistic Support Force of the People's Liberation Army Taian China
| | - Xiaolian Jiang
- West China School of Nursing/West China Hospital Sichuan University Chengdu China
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21
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Aminian A, Tu C, Milinovich A, Wolski KE, Kattan MW, Nissen SE. Association of Weight Loss Achieved Through Metabolic Surgery With Risk and Severity of COVID-19 Infection. JAMA Surg 2022; 157:221-230. [PMID: 34964827 PMCID: PMC8717211 DOI: 10.1001/jamasurg.2021.6496] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Obesity is an established risk factor for severe COVID-19 infection. However, it is not known whether losing weight is associated with reduced adverse outcomes of COVID-19 infection. OBJECTIVE To investigate the association between a successful weight loss intervention and improved risk and severity of COVID-19 infection in patients with obesity. DESIGN, SETTING, AND PARTICIPANTS This cohort study involved adult patients with a body mass index of 35 or higher (calculated as weight in kilograms divided by height in meters squared) who underwent weight loss surgery between January 1, 2004, and December 31, 2017, at the Cleveland Clinic Health System (CCHS). Patients in the surgical group were matched 1:3 to patients who did not have surgical intervention for their obesity (control group). The source of data was the CCHS electronic health record. Follow-up was conducted through March 1, 2021. EXPOSURES Weight loss surgery including Roux-en-Y gastric bypass and sleeve gastrectomy. MAIN OUTCOMES AND MEASURES Distinct outcomes were examined before and after COVID-19 outbreak on March 1, 2020. Weight loss and all-cause mortality were assessed between the enrollment date and March 1, 2020. Four COVID-19-related outcomes were analyzed in patients with COVID-19 diagnosis between March 1, 2020, and March 1, 2021: positive SARS-CoV-2 test result, hospitalization, need for supplemental oxygen, and severe COVID-19 infection (a composite of intensive care unit admission, need for mechanical ventilation, or death). RESULTS A total of 20 212 patients (median [IQR] age, 46 [35-57] years; 77.6% female individuals [15 690]) with a median (IQR) body mass index of 45 (41-51) were enrolled. The overall median (IQR) follow-up duration was 6.1 (3.8-9.0) years. Before the COVID-19 outbreak, patients in the surgical group compared with control patients lost more weight (mean difference at 10 years from baseline: 18.6 [95% CI, 18.4-18.7] percentage points; P < .001) and had a 53% lower 10-year cumulative incidence of all-cause non-COVID-19 mortality (4.7% [95% CI, 3.7%-5.7%] vs 9.4% [95% CI, 8.7%-10.1%]; P < .001). Of the 20 212 enrolled patients, 11 809 were available on March 1, 2020, for an assessment of COVID-19-related outcomes. The rates of positive SARS-CoV-2 test results were comparable in the surgical and control groups (9.1% [95% CI, 7.9%-10.3%] vs 8.7% [95% CI, 8.0%-9.3%]; P = .71). However, undergoing weight loss surgery was associated with a lower risk of hospitalization (adjusted hazard ratio [HR], 0.51; 95% CI, 0.35-0.76; P < .001), need for supplemental oxygen (adjusted HR, 0.37; 95% CI, 0.23-0.61; P < .001), and severe COVID-19 infection (adjusted HR, 0.40; 95% CI, 0.18-0.86; P = .02). CONCLUSIONS AND RELEVANCE This cohort study found that, among patients with obesity, substantial weight loss achieved with surgery was associated with improved outcomes of COVID-19 infection. The findings suggest that obesity can be a modifiable risk factor for the severity of COVID-19 infection.
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Affiliation(s)
- Ali Aminian
- Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Chao Tu
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Alex Milinovich
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kathy E. Wolski
- Cleveland Clinic Coordinating Center for Clinical Research, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Michael W. Kattan
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steven E. Nissen
- Cleveland Clinic Coordinating Center for Clinical Research, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
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22
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El-Ghitany EM, Hashish MH, Farag S, Omran EA, Farghaly AG, Azzam NFAEM. Determinants of the Development of SARS-CoV-2 Anti-Spike Immune-Response after Vaccination among Healthcare Workers in Egypt. Vaccines (Basel) 2022; 10:174. [PMID: 35214633 PMCID: PMC8878288 DOI: 10.3390/vaccines10020174] [Citation(s) in RCA: 6] [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: 12/20/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Understanding the factors affecting humoral immune response to COVID-19 vaccines among healthcare workers (HCWs) is essential to predict their level of protection. Vaccination elicits antibodies against SARS-CoV-2 spike protein (anti-S). AIM To investigate the factors associated with the presence of SARS-CoV-2 anti-S antibodies among vaccinated HCWs. METHODS This cross-sectional study included 143 vaccinated HCWs, with or without a history of previous COVID-19 infection (clinically, radiologically, or by laboratory results) from different departments. Socio-demographic, clinical, as well as vaccine-related data, were recorded. Serum samples were collected and tested for SARS-CoV-2 spike antibodies. RESULTS Vaccination provoked an immunogenic response, where the overall anti-S positivity was 83.9% (95% CI: 77.8-90.0%). The response was not affected either by the age or gender of HCWs. Out of the 143 HCWs, 46 (32.1%; 95% CI: 24.4-39.9%) reported a previous history of COVID-19 infection, and seropositivity was significantly higher among them (p = 0.002), and it was associated with the frequency of infection (p = 0.044) and duration since diagnosis of COVID-19 infection (p = 0.065). They had higher median anti-S titers (111.8 RU/mL) than those without infection (39.8 RU/mL). Higher seropositivity was observed with Oxford/AstraZeneca vaccine (AZD1222) (88.9%; 95% CI: 83.1-95.0%) than Sinopharm (BBIBP-CorV) (67.7%; 95% CI: 50.3-85.2%), and with receiving two doses of vaccine (92.3%; 95% CI: 87.1-97.5%). CONCLUSIONS Antibody positivity was significantly affected by the previous history of COVID-19 infection, type of vaccine, the number of doses received, and duration since vaccination.
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Affiliation(s)
- Engy Mohamed El-Ghitany
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt;
| | - Mona H. Hashish
- Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt; (M.H.H.); (E.A.O.); (N.F.A.E.-M.A.)
| | - Shehata Farag
- Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt;
| | - Eman A. Omran
- Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt; (M.H.H.); (E.A.O.); (N.F.A.E.-M.A.)
| | - Azza Galal Farghaly
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt;
| | - Nashwa Fawzy Abd El-Moez Azzam
- Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt; (M.H.H.); (E.A.O.); (N.F.A.E.-M.A.)
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23
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Sawadogo W, Tsegaye M, Gizaw A, Adera T. Overweight and obesity as risk factors for COVID-19-associated hospitalisations and death: systematic review and meta-analysis. BMJ NUTRITION, PREVENTION & HEALTH 2022; 5:10-18. [PMID: 35814718 PMCID: PMC8783972 DOI: 10.1136/bmjnph-2021-000375] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
ObjectiveTo quantify the current weight of evidence of the association between overweight and obesity as risk factors for COVID-19-related hospitalisations (including hospital admission, intensive care unit admission, invasive mechanical ventilation) and death, and to assess the magnitude of the association and the potential dose–response relationships.DesignPubMed, Embase, Cochrane, Web of Sciences, WHO COVID-19 database and Google Scholar were used to identify articles published up to 20 July 2021. Peer-reviewed studies reporting adjusted estimates of the association between overweight or obesity and COVID-19 outcomes were included. Three authors reviewed the articles and agreed. The quality of eligible studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Random-effects meta-analysis was used to estimate the combined effects.ResultsA total of 208 studies with 3 550 997 participants from over 32 countries were included in this meta-analysis. Being overweight was associated with an increased risk of COVID-19-related hospitalisations (OR 1.19, 95% CI 1.12 to 1.28, n=21 studies), but not death (OR 1.02, 95% CI 0.92 to 1.13, n=21). However, patients with obesity were at increased risk of both COVID-19-related hospitalisations (OR 1.72, 95% CI 1.62 to 1.84, n=58) and death (OR 1.25, 95% CI 1.19 to 1.32, n=77). Similarly, patients with extreme obesity were at increased risk of COVID-19-related hospitalisations (OR 2.53, 95% CI 1.67 to 3.84, n=12) and death (OR 2.06, 95% CI 1.76 to 3.00, n=19). There was a linear dose–response relationship between these obesity categories and COVID-19 outcomes, but the strength of the association has decreased over time.ConclusionBeing overweight increases the risk of COVID-19-related hospitalisations but not death, while obesity and extreme obesity increase the risk of both COVID-19-related hospitalisations and death. These findings suggest that prompt access to COVID-19 care, prioritisation for COVID-19 vaccination and other preventive measures are warranted for this vulnerable group.
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Affiliation(s)
- Wendemi Sawadogo
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Medhin Tsegaye
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Andinet Gizaw
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Tilahun Adera
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
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24
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Kara Z, Akçin R, Demir AN, Dinç HÖ, Kocazeybek B, Yumuk VD. Risk Factors Influencing Seroconversion after Inactive SARS-CoV-2 Vaccination in People Living with Obesity. Obes Facts 2022; 15:648-654. [PMID: 35921804 PMCID: PMC9669952 DOI: 10.1159/000525555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to investigate the antibody titers against SARS-CoV-2 spike antigens and the risk factors affecting antibody levels in people living with obesity (PwO) after inactive SARS-CoV-2 vaccine (CoronaVac) administration. METHODS 169 consecutive patients with obesity who visited the Center for Obesity Management at Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty Hospitals, between May and August 2021, were invited to the study. The nonobese control group was recruited from 191 subjects who visited the Cerrahpaşa Hospitals Vaccination Unit. The study group and the nonobese control group have already received two doses of inactive SARS-CoV-2 vaccine. The SARS-CoV-2 IgG nucleocapsid antibody test was administered to patients and control subjects to discover those who had prior SARS-CoV-2 infection. Forty-one patients who had prior infection and received two doses of vaccine were also included in the study as a subgroup. Blood samples were taken on the 3rd to 4th week after the second vaccination. SARS-CoV-2 IgG antibody titers were determined by quantitative serological methods. RESULTS Antibody titers against SARS-CoV-2 spike antigen of individuals with BMI ≥30.0 kg/m2 were significantly lower than those with BMI <30 kg/m2 (p = 0.001) in the study group. Moreover, the antibody titers in people with BMI ≥30.0 kg/m2 were significantly lower than in those having a BMI <30.0 kg/m2 in the subgroup (p = 0.03). Age (p = 0.03), BMI (p = 0.006), and hypertension (p = 0.03) were found to be independent risk factors for antibody response in PwO. Women with non-prior SARS-CoV-2 infection showed a significantly higher antibody response then men (p = 0.001). CONCLUSION SARS-CoV-2-Immunoglobulin G antibody levels against inactive (CoronaVac) vaccine were found to be lower in PwO compared to nonobese individuals. Antibody titers may be measured, and booster doses should be delivered accordingly in PwO for optimal protection.
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Affiliation(s)
- Zehra Kara
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey
- *Zehra Kara,
| | - Rüveyda Akçin
- Department of Medical Microbiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Ahmet Numan Demir
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Harika Öykü Dinç
- Department of Medical Microbiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Bezmialem Vakıf University, Istanbul, Turkey
| | - Bekir Kocazeybek
- Department of Medical Microbiology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Volkan Demirhan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
- European Association for the Study of Obesity-Collaborating Center for Obesity Management, Istanbul, Turkey
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25
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Nicolau J, Ayala L, Sanchís P, Rodríguez I, Romano A, Dotres K, Pujol A, Masmiquel L. The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection. Clin Nutr ESPEN 2021; 46:434-438. [PMID: 34857231 PMCID: PMC8463107 DOI: 10.1016/j.clnesp.2021.09.722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 01/08/2023]
Abstract
Background and aims The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19. Methods This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl. Results 11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5). Conclusions The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.
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Affiliation(s)
- Joana Nicolau
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain.
| | - Luisa Ayala
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Pilar Sanchís
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Irene Rodríguez
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Andrea Romano
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Keyla Dotres
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Antelm Pujol
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Lluís Masmiquel
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
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26
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Alfaro S, Autrey C, Sen-Crowe B, Elkbuli A. Obesity implications on SARS-CoV-2 infections' prevalence, hospitalizations, critical care needs, fatalities & vaccination rates: A public health crisis. Ann Med Surg (Lond) 2021; 72:103096. [PMID: 34868578 PMCID: PMC8631047 DOI: 10.1016/j.amsu.2021.103096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Sophie Alfaro
- A.T. Still University School of Osteopathic Medicine, Arizona, USA
| | - Cody Autrey
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Brendon Sen-Crowe
- NOVA Southeastern University, Dr. Kiran.C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
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27
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Oduro-Mensah D, Oduro-Mensah E, Quashie P, Awandare G, Okine L. Explaining the unexpected COVID-19 trends and potential impact across Africa. F1000Res 2021; 10:1177. [PMID: 36605410 PMCID: PMC9763772 DOI: 10.12688/f1000research.74363.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/03/2023] Open
Abstract
Official COVID-19 case counts and mortality rates across Africa are lower than had been anticipated. Research reports, however, indicate far higher exposure rates than the official counts in some countries. Particularly in Western and Central Africa, where mortality rates are disproportionately lower than the rest of the continent, this occurrence may be due to immune response adaptations resulting from (1) frequent exposure to certain pro-inflammatory pathogens, and (2) a prevalence of low-grade inflammation coupled with peculiar modifications to the immune response based on one's immunobiography. We suggest that the two factors lead to a situation where post infection, there is a rapid ramp-up of innate immune responses, enough to induce effective defense and protection against plethora pathogens. Alongside current efforts at procuring and distributing vaccines, we draw attention to the need for work towards appreciating the impact of the apparently widespread, asymptomatic SARS-CoV-2 infections on Africa's populations vis a vis systemic inflammation status and long-term consequences for public health.
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Affiliation(s)
- Daniel Oduro-Mensah
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Peter Quashie
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, LG 581, Ghana
| | - Gordon Awandare
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Laud Okine
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
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28
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Oduro-Mensah D, Oduro-Mensah E, Quashie P, Awandare G, Okine L. Explaining the unexpected COVID-19 trends and potential impact across Africa. F1000Res 2021; 10:1177. [PMID: 36605410 PMCID: PMC9763772 DOI: 10.12688/f1000research.74363.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Official COVID-19 case counts and mortality rates across Africa are lower than had been anticipated. Research reports, however, indicate far higher exposure rates than the official counts in some countries. Particularly in Western and Central Africa, where mortality rates are disproportionately lower than the rest of the continent, this occurrence may be due to immune response adaptations resulting from (1) frequent exposure to certain pro-inflammatory pathogens, and (2) a prevalence of low-grade inflammation coupled with peculiar modifications to the immune response based on one's immunobiography. We suggest that the two factors lead to a situation where post infection, there is a rapid ramp-up of innate immune responses, enough to induce effective defense and protection against plethora pathogens. Alongside current efforts at procuring and distributing vaccines, we draw attention to the need for work towards appreciating the impact of the apparently widespread, asymptomatic SARS-CoV-2 infections on Africa's populations vis a vis systemic inflammation status and long-term consequences for public health.
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Affiliation(s)
- Daniel Oduro-Mensah
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Peter Quashie
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, LG 581, Ghana
| | - Gordon Awandare
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Laud Okine
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
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29
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Uysal EB, Gümüş S, Bektöre B, Bozkurt H, Gözalan A. Evaluation of antibody response after COVID-19 vaccination of healthcare workers. J Med Virol 2021; 94:1060-1066. [PMID: 34704620 PMCID: PMC8661654 DOI: 10.1002/jmv.27420] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/01/2021] [Accepted: 10/25/2021] [Indexed: 12/26/2022]
Abstract
The common goal of all vaccines developed against COVID‐19, although they have been designed with different methods, is to develop an effective immunity and antibody response against SARS‐CoV‐2. However, the postvaccination immune response and antibody levels differ between individuals. This study examined the relationship between postvaccine seropositivity rates, age, gender, smoking, and body mass index (BMI), and antibody titers. A total of 314 healthcare workers (HCW) who were not previously infected with COVID‐19 and who had received two doses of CoronaVac inactivated vaccine participated in the study. Seropositivity against the receptor‐binding domain (RBD) of the SARS‐CoV‐2 spike protein was measured from the participants 4 weeks after the second dose of vaccine using the electrochemiluminescence (ECLIA) method. In addition, the antibody developed against the nucleocapsid protein (NCP) was evaluated and compared using Elecsys Anti‐SARS‐CoV‐2 kit. One hundred and eighty‐one of the participants were female (57.6%) with a median age of 39 (interquartile range [IQR], 10) and 133 (42.4%) were male with a median age of 41 (IQR, 11). 99.6% of the volunteers developed seropositivity 4 weeks after the second dose of vaccine. It was also observed that the rate of RBD protein antibody titer was >250 U/ml in smokers, which is quite low compared to nonsmokers (p = 0.032), and that high RBD antibody titers were proportionally lower in obese participants, according to BMI values, compared to those with normal BMI (49.5% and 9.9%). It was observed that seropositivity developed in almost all participants after the CoronaVac vaccine. However, it was determined that the antibody titer measured varied depending on factors such as smoking, BMI, and duration.
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Affiliation(s)
- Elif B Uysal
- Department of Medical Microbiology, Alanya Alaaddin Keykubat University, School of Medicine, Alanya, Antalya, Turkey
| | - Sibel Gümüş
- Department of Medical Microbiology, Alanya Alaaddin Keykubat University, School of Medicine, Alanya, Antalya, Turkey
| | - Bayhan Bektöre
- Alanya Alaaddin Keykubat University, Education and Research Hospital, Alanya, Antalya, Turkey
| | - Hale Bozkurt
- Alanya Alaaddin Keykubat University, Education and Research Hospital, Alanya, Antalya, Turkey
| | - Ayşegül Gözalan
- Department of Medical Microbiology, Alanya Alaaddin Keykubat University, School of Medicine, Alanya, Antalya, Turkey
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Bretón I, de Hollanda A, Vilarrasa N, Rubio Herrera MA, Lecube A, Salvador J, García-Luna PP, Tinahones FJ, Sánchez Santos R, Gómez Huelgas R, Carretero Gómez J, Moizé V, Polo García J, Tranche Iparraguirre S, Fernández-Pro Ledesma A, Escalada J. Obesity and COVID-19. A necessary position statement. ENDOCRINOL DIAB NUTR 2021; 68:573-576. [PMID: 34872641 PMCID: PMC8598951 DOI: 10.1016/j.endien.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 04/24/2023]
Affiliation(s)
- Irene Bretón
- Servicio de Endocrinología y Nutrición, Hospital Universitario Gregorio Marañón, IiSGM, Facultad de Medicina, Universidad Complutense, Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, Spain.
| | - Ana de Hollanda
- Servicio de Endocrinología y Nutrición, Hospital Clínic Barcelona Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBEROBN, Coordinadora electa GOSEEN, Sociedad Española de Endocrinología y Nutrición, (SEEN), Barcelona, Spain
| | - Nuria Vilarrasa
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Bellvitge-IDIBELL, CIBERDEM, Coordinadora GOSEEN, Sociedad Española de Endocrinología y Nutrición (SEEN), Barcelona, Spain
| | - Miguel A Rubio Herrera
- Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos, IDISSC, Facultad de Medicina, Universidad Complutense, Vicepresidente, Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, Spain
| | - Albert Lecube
- Servicio de Endocrinología y Nutrición, Hospital Universitari Arnau de Vilanova de Lleida, Grupo de Obesidad, Diabetes y Metabolismo (ODIM), Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida (UdL), CIBERDEM, Vicepresidente, Sociedad Española para el Estudio de la Obesidad, SEEDO, Lleida, Spain
| | - Javier Salvador
- Profesor Emérito de Endocrinología, Universidad de Navarra, Pamplona, CIBEROBN, Instituto Carlos III, Madrid, Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
| | - Pedro Pablo García-Luna
- Unidad de Nutrición, UGEN, Hospital Universitario Virgen del Rocío, Sociedad Española de Endocrinología y Nutrición (SEEN), Sevilla, Spain
| | - Francisco J Tinahones
- Servicio Endocrinología y Nutrición, Hospital Virgen de la Victoria Málaga, Universidad de Málaga, CIBEROBN, Presidente, Sociedad Española para el Estudio de la Obesidad (SEEDO), Málaga, Spain
| | - Raquel Sánchez Santos
- Complejo Hospitalario Universitario de Vigo, Instituto de Investigación Galicia Sur, Presidente de la Sociedad Española de Cirugía de la Obesidad (SECO), Galicia, Spain
| | - Ricardo Gómez Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Sociedad Española de Medicina Interna (SEMI), Málaga, Spain
| | - Juana Carretero Gómez
- Servicio de Medicina Interna, Hospital Comarcal de Zafra, Vicepresidente, Sociedad Española de Medicina Interna (SEMI), Zafra, Badajoz, Spain
| | - Violeta Moizé
- Unidad Funcional de Obesidad, Hospital Clínic Barcelona, Presidenta, Sociedad Española de Dietética y Nutrición (SEDYN), Barcelona, Spain
| | - José Polo García
- Centro de Salud Casar de Cáceres, Presidente, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Casar de Cáceres, Cáceres, Spain
| | - Salvador Tranche Iparraguirre
- Centro de Salud El Cristo, Servicio de Salud del Principado de Asturias (SESPA), Presidente, Sociedad Española de Medicina Familiar y Comunitaria, (semFYC), Oviedo, Asturias, Spain
| | | | - Javier Escalada
- Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Grupo de Nefrología Clínica, Presidente, Sociedad Española de Endocrinología y Nutrición (SEEN), Pamplona, Navarra, Spain
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Nather K, Bolger F, DiModica L, Fletcher‐Louis M, Salvador J, Pattou F, Panton UH, Cancino A. The impact of COVID-19 on obesity services across Europe: A physician survey. Clin Obes 2021; 11:e12474. [PMID: 34254445 PMCID: PMC8420525 DOI: 10.1111/cob.12474] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/13/2021] [Accepted: 06/01/2021] [Indexed: 12/14/2022]
Abstract
Obesity is a risk factor for severe complications from coronavirus disease 2019 (COVID-19). During the COVID-19 pandemic in Spring 2020, many clinics and obesity centers across Europe were required to close. This study aimed to determine the impact of COVID-19 on the provision of obesity services across 10 European countries via a survey of physicians (n = 102) specializing in treating persons with obesity (PwO). In total, 62-95 out of 102 physicians reported that COVID-19 affected obesity-related services, with cancellations/suspensions ranging from 50% to 100% across the 10 countries. Approximately 75% of cancellations/suspensions were provider- rather than patient-initiated. A median increase of 20%-25% in waiting times was reported for most services across the countries. When services resume, 87 out of 100 physicians consider factors influencing down-stream patient outcomes as the most relevant factors for prioritizing interventional treatment. Responses showed that 65 out of 102 and 36 out of 102 physicians believed it (highly) likely that a change in treatment guidance will occur to prioritize earlier interventional treatment for the management of PwO, by either using bariatric surgery or pharmacotherapy, respectively. Results from this study provide important learnings, such as opportunities for, and discrepancies in, the provision of alternative care in light of services cancellations or delays, which may be important for the future management of obesity, especially during future waves of COVID-19 or other infectious pandemics.
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Affiliation(s)
| | | | | | | | - Javier Salvador
- Department of Endocrinology & NutritionClínica Universidad de NavarraPamplonaSpain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN)Instituto de Salud Carlos IIIMadridSpain
| | - François Pattou
- Univ Lille, CHU de Lille, InsermLille Pasteur Institute, Integrated Obesity CenterLilleFrance
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Westheim AJF, Bitorina AV, Theys J, Shiri-Sverdlov R. COVID-19 infection, progression, and vaccination: Focus on obesity and related metabolic disturbances. Obes Rev 2021; 22:e13313. [PMID: 34269511 PMCID: PMC8420274 DOI: 10.1111/obr.13313] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
Coronaviruses are constantly circulating in humans, causing common colds and mild respiratory infections. In contrast, infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for coronavirus disease-2019 (COVID-19), can cause additional severe complications, particularly in patients with obesity and associated metabolic disturbances. Obesity is a principal causative factor in the development of the metabolic syndrome; a series of physiological, biochemical, clinical, and metabolic factors that increase the risk of obesity-associated diseases. "Metabolically unhealthy" obesity is, in addition to metabolic disturbances, also associated with immunological disturbances. As such, patients with obesity are more prone to develop serious complications from infections, including those from SARS-CoV-2. In this review, we first describe how obesity and related metabolic disturbances increase the risk of SARS-CoV-2 infection. Then, mechanisms contributing to COVID-19 complications and poor prognosis in these patients are discussed. Finally, we discuss how obesity potentially reduces long-term COVID-19 vaccination efficacy. Despite encouraging COVID-19 vaccination results in patients with obesity and related metabolic disturbances in the short-term, it is becoming increasingly evident that long-term COVID-19 vaccination efficacy should be closely monitored in this vulnerable group.
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Affiliation(s)
- Annemarie J F Westheim
- Department of Precision Medicine, GROW-Research School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Albert V Bitorina
- Department of Molecular Genetics, NUTRIM-School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jan Theys
- Department of Precision Medicine, GROW-Research School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ronit Shiri-Sverdlov
- Department of Molecular Genetics, NUTRIM-School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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Landecho MF, Marin-Oto M, Recalde-Zamacona B, Bilbao I, Frühbeck G. Obesity as an adipose tissue dysfunction disease and a risk factor for infections - Covid-19 as a case study. Eur J Intern Med 2021; 91:3-9. [PMID: 33858724 PMCID: PMC8017564 DOI: 10.1016/j.ejim.2021.03.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/20/2021] [Accepted: 03/25/2021] [Indexed: 12/13/2022]
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV2) disease (COVID-19) is a novel threat that hampers life expectancy especially in obese individuals. Though this association is clinically relevant, the underlying mechanisms are not fully elucidated. SARS CoV2 enters host cells via the Angiotensin Converting Enzyme 2 receptor, that is also expressed in adipose tissue. Moreover, adipose tissue is also a source of many proinflammatory mediators and adipokines that might enhance the characteristic COVID-19 cytokine storm due to a chronic low-grade inflammatory preconditioning. Further obesity-dependent thoracic mechanical constraints may also incise negatively into the prognosis of obese subjects with COVID-19. This review summarizes the current body of knowledge on the obesity-dependent circumstances triggering an increased risk for COVID-19 severity, and their clinical relevance.
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Affiliation(s)
- M F Landecho
- Internal Medicine Department, General Health Check-up Unit, Clínica Universidad de Navarra. Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain; COVID-19 department, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain;.
| | - M Marin-Oto
- COVID-19 department, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain;; Pulmonary Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain
| | - B Recalde-Zamacona
- COVID-19 department, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain;; Pulmonary Medicine Department, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain
| | - I Bilbao
- Internal Medicine Department, General Health Check-up Unit, Clínica Universidad de Navarra. Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain; COVID-19 department, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008 Pamplona, Navarra, Spain
| | - Gema Frühbeck
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Navarra, Spain; Metabolic Research Laboratory, Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Pamplona, Spain.
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Chetboun M, Raverdy V, Labreuche J, Simonnet A, Wallet F, Caussy C, Antonelli M, Artigas A, Goma G, Meziani F, Helms J, Mylonakis E, Levy MM, Kalligeros M, Latronico N, Piva S, Cerf C, Neuville M, Klouche K, Larcher R, Tamion F, Occhiali E, Snacken M, Preiser J, Kontar L, Riviere A, Silva S, Sarton B, Krouchi R, Dubar V, Palaiodimos L, Karamanis D, Perche J, L'Her E, Busetto L, Dicker D, Lev S, Duhamel A, Jourdain M, Pattou F. BMI and pneumonia outcomes in critically ill covid-19 patients: An international multicenter study. Obesity (Silver Spring) 2021; 29:1477-1486. [PMID: 33966355 PMCID: PMC8242742 DOI: 10.1002/oby.23223] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Previous studies have unveiled a relationship between the severity of coronavirus disease 2019 (COVID-19) pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension, hyperlipidemia, and current smoking status) in critically ill patients with COVID-19. METHODS Patients admitted to intensive care units for COVID-19 in 21 centers (in Europe, Israel, and the United States) were enrolled in this study between February 19, 2020, and May 19, 2020. Primary and secondary outcomes were the need for invasive mechanical ventilation (IMV) and 28-day mortality, respectively. RESULTS A total of 1,461 patients were enrolled; the median (interquartile range) age was 64 years (40.9-72.0); 73.2% of patients were male; the median BMI was 28.1 kg/m2 (25.4-32.3); a total of 1,080 patients (73.9%) required IMV; and the 28-day mortality estimate was 36.1% (95% CI: 33.0-39.5). An adjusted mixed logistic regression model showed a significant linear relationship between BMI and IMV: odds ratio = 1.27 (95% CI: 1.12-1.45) per 5 kg/m2 . An adjusted Cox proportional hazards regression model showed a significant association between BMI and mortality, which was increased only in obesity class III (≥40; hazard ratio = 1.68 [95% CI: 1.06-2.64]). CONCLUSIONS In critically ill COVID-19 patients, a linear association between BMI and the need for IMV, independent of other metabolic risk factors, and a nonlinear association between BMI and mortality risk were observed.
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Page-Wilson G, Arakawa R, Nemeth S, Bell F, Girvin Z, Tuohy MC, Lauring M, Laferrère B, Reyes-Soffer G, Natarajan K, Chen R, Kurlansky P, Korner J. Obesity is independently associated with septic shock, renal complications, and mortality in a multiracial patient cohort hospitalized with COVID-19. PLoS One 2021; 16:e0255811. [PMID: 34383798 PMCID: PMC8360607 DOI: 10.1371/journal.pone.0255811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/25/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Obesity has emerged as a risk factor for severe coronavirus disease 2019 (COVID-19) infection. To inform treatment considerations the relationship between obesity and COVID-19 complications and the influence of race, ethnicity, and socioeconomic factors deserves continued attention. OBJECTIVE To determine if obesity is an independent risk factor for severe COVID-19 complications and mortality and examine the relationship between BMI, race, ethnicity, distressed community index and COVID-19 complications and mortality. METHODS A retrospective cohort study of 1,019 SARS-CoV-2 positive adult admitted to an academic medical center (n = 928) and its affiliated community hospital (n-91) in New York City from March 1 to April 18, 2020. RESULTS Median age was 64 years (IQR 52-75), 58.7% were men, 23.0% were Black, and 52.8% were Hispanic. The prevalence of overweight and obesity was 75.2%; median BMI was 28.5 kg/m2 (25.1-33.0). Over the study period 23.7% patients died, 27.3% required invasive mechanical ventilation, 22.7% developed septic shock, and 9.1% required renal replacement therapy (RRT). In the multivariable logistic regression model, BMI was associated with complications including intubation (Odds Ratio [OR]1.03, 95% Confidence Interval [CI]1.01-1.05), septic shock (OR 1.04, CI 1.01-1.06), and RRT (OR1.07, CI 1.04-1.10), and mortality (OR 1.04, CI 1.01-1.06). The odds of death were highest among those with BMI ≥ 40 kg/m2 (OR 2.05, CI 1.04-4.04). Mortality did not differ by race, ethnicity, or socioeconomic distress score, though Black and Asian patients were more likely to require RRT. CONCLUSIONS AND RELEVANCE Severe complications of COVID-19 and death are more likely in patients with obesity, independent of age and comorbidities. While race, ethnicity, and socioeconomic status did not impact COVID-19 related mortality, Black and Asian patients were more likely to require RRT. The presence of obesity, and in some instances race, should inform resource allocation and risk stratification in patients hospitalized with COVID-19.
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Affiliation(s)
- Gabrielle Page-Wilson
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- * E-mail:
| | - Rachel Arakawa
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Division of Endocrinology, Diabetes, and Bone disease, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Samantha Nemeth
- Columbia HeartSource, Center for Innovation and Outcomes Research, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Fletcher Bell
- Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Zachary Girvin
- Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Mary-Claire Tuohy
- Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Max Lauring
- Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Blandine Laferrère
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Gissette Reyes-Soffer
- Division of Preventive Medicine and Nutrition, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Karthik Natarajan
- Department of Biomedical Informatics, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - RuiJun Chen
- Department of Biomedical Informatics, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Translational Data Science and Informatics, Geisinger Health, New York, New York, United States of America
| | - Paul Kurlansky
- Columbia HeartSource, Center for Innovation and Outcomes Research, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Judith Korner
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
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Moll-Bernardes R, de Sousa AS, Macedo AVS, Lopes RD, Vera N, Maia LCR, Feldman A, Arruda GDAS, Castro MJC, Pimentel-Coelho PM, de Albuquerque DC, de Paula TC, Furquim TAB, Loures VA, Giusti KGD, de Oliveira NM, De Luca FA, Kotsugai MDM, Domiciano RAM, Santos MF, de Souza OF, Bozza FA, Luiz RR, Medei E. IL-10 and IL-12 (P70) Levels Predict the Risk of Covid-19 Progression in Hypertensive Patients: Insights From the BRACE-CORONA Trial. Front Cardiovasc Med 2021; 8:702507. [PMID: 34386533 PMCID: PMC8353079 DOI: 10.3389/fcvm.2021.702507] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Cardiovascular comorbidities such as hypertension and inflammatory response dysregulation are associated with worse COVID-19 prognoses. Different cytokines have been proposed to play vital pathophysiological roles in COVID-19 progression, but appropriate prognostic biomarkers remain lacking. We hypothesized that the combination of immunological and clinical variables at admission could predict the clinical progression of COVID-19 in hypertensive patients. Methods: The levels of biomarkers, including C-reactive protein, lymphocytes, monocytes, and a panel of 29 cytokines, were measured in blood samples from 167 hypertensive patients included in the BRACE-CORONA trial. The primary outcome was the highest score during hospitalization on the modified WHO Ordinal Scale for Clinical Improvement. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and biomarkers associated significantly with the primary outcome. Results: During hospitalization, 13 (7.8%) patients showed progression to more severe forms of COVID-19, including three deaths. Obesity, diabetes, oxygen saturation, lung involvement on computed tomography examination, the C-reactive protein level, levels of 15 cytokines, and lymphopenia on admission were associated with progression to severe COVID-19. Elevated levels of interleukin-10 and interleukin-12 (p70) combined with two or three of the abovementioned clinical comorbidities were associated strongly with progression to severe COVID-19. The risk of progression to severe disease reached 97.5% in the presence of the five variables included in our model. Conclusions: This study demonstrated that interleukin-10 and interleukin-12 (p70) levels, in combination with clinical variables, at hospital admission are key biomarkers associated with an increased risk of disease progression in hypertensive patients with COVID-19.
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Affiliation(s)
| | - Andrea Silvestre de Sousa
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ariane V S Macedo
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Hospital São Luiz Jabaquara, São Paulo, Brazil.,Santa Casa de São Paulo, São Paulo, Brazil
| | - Renato D Lopes
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, United States.,Brazilian Clinical Research Institute, São Paulo, Brazil
| | - Narendra Vera
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana C R Maia
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - André Feldman
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Hospital São Luiz Anália Franco, São Paulo, Brazil
| | | | - Mauro J C Castro
- Instituto de Microbiologia Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro M Pimentel-Coelho
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Denílson C de Albuquerque
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Cardiology Department, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | | | | | | | - Olga Ferreira de Souza
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Hospital Copa Star, Rio de Janeiro, Brazil
| | - Fernando A Bozza
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Institute for Studies in Public Health-IESC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Emiliano Medei
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,National Center for Structural Biology and Bioimaging, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Haavik H, Niazi IK, Kumari N, Amjad I, Duehr J, Holt K. The Potential Mechanisms of High-Velocity, Low-Amplitude, Controlled Vertebral Thrusts on Neuroimmune Function: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:536. [PMID: 34071880 PMCID: PMC8226758 DOI: 10.3390/medicina57060536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022]
Abstract
The current COVID-19 pandemic has necessitated the need to find healthcare solutions that boost or support immunity. There is some evidence that high-velocity, low-amplitude (HVLA) controlled vertebral thrusts have the potential to modulate immune mediators. However, the mechanisms of the link between HVLA controlled vertebral thrusts and neuroimmune function and the associated potential clinical implications are less clear. This review aims to elucidate the underlying mechanisms that can explain the HVLA controlled vertebral thrust--neuroimmune link and discuss what this link implies for clinical practice and future research needs. A search for relevant articles published up until April 2021 was undertaken. Twenty-three published papers were found that explored the impact of HVLA controlled vertebral thrusts on neuroimmune markers, of which eighteen found a significant effect. These basic science studies show that HVLA controlled vertebral thrust influence the levels of immune mediators in the body, including neuropeptides, inflammatory markers, and endocrine markers. This narravtive review discusses the most likely mechanisms for how HVLA controlled vertebral thrusts could impact these immune markers. The mechanisms are most likely due to the known changes in proprioceptive processing that occur within the central nervous system (CNS), in particular within the prefrontal cortex, following HVLA spinal thrusts. The prefrontal cortex is involved in the regulation of the autonomic nervous system, the hypothalamic-pituitary-adrenal axis and the immune system. Bi-directional neuro-immune interactions are affected by emotional or pain-related stress. Stress-induced sympathetic nervous system activity also alters vertebral motor control. Therefore, there are biologically plausible direct and indirect mechanisms that link HVLA controlled vertebral thrusts to the immune system, suggesting HVLA controlled vertebral thrusts have the potential to modulate immune function. However, it is not yet known whether HVLA controlled vertebral thrusts have a clinically relevant impact on immunity. Further research is needed to explore the clinical impact of HVLA controlled vertebral thrusts on immune function.
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Affiliation(s)
- Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; (H.H.); (N.K.); (I.A.); (J.D.)
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; (H.H.); (N.K.); (I.A.); (J.D.)
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 0627, New Zealand
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Nitika Kumari
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; (H.H.); (N.K.); (I.A.); (J.D.)
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 0627, New Zealand
| | - Imran Amjad
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; (H.H.); (N.K.); (I.A.); (J.D.)
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad 46000, Pakistan
| | - Jenna Duehr
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; (H.H.); (N.K.); (I.A.); (J.D.)
| | - Kelly Holt
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; (H.H.); (N.K.); (I.A.); (J.D.)
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38
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Spolidoro GCI, Azzolino D, Shamir R, Cesari M, Agostoni C. Joint Effort towards Preventing Nutritional Deficiencies at the Extremes of Life during COVID-19. Nutrients 2021; 13:1616. [PMID: 34065864 PMCID: PMC8150599 DOI: 10.3390/nu13051616] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 (Coronavirus disease 2019) pandemic is posing a threat to communities and healthcare systems worldwide. Malnutrition, in all its forms, may negatively impact the susceptibility and severity of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection in both children and older adults. Both undernutrition and obesity have been evoked as conditions associated with a higher susceptibility to the infection and poor prognosis. In turn, the COVID-19 infection may worsen the nutritional status through highly catabolic conditions, exposing individuals to the risk of malnutrition, muscle wasting, and nutritional deficiencies. Accordingly, the relationship between malnutrition and COVID-19 is likely to be bidirectional. Furthermore, the modification of nutritional behaviors and physical activity, required to limit the spread of the virus, are posing a challenge to health at both the extremes of life. Thus far, even the most advanced healthcare systems have failed to address the alarming consequences of malnutrition posed by this pandemic. If not properly addressed, we may run the risk that new and old generations will experience the consequences of COVID-19 related malnutrition.
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Affiliation(s)
- Giulia C. I. Spolidoro
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
| | - Domenico Azzolino
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy
| | - Raanan Shamir
- Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Institute of Gastroenterology, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (G.C.I.S.); (D.A.); (M.C.)
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Bayram Deger V. Eating Behavior Changes of People with Obesity During the COVID-19 Pandemic. Diabetes Metab Syndr Obes 2021; 14:1987-1997. [PMID: 33976559 PMCID: PMC8104982 DOI: 10.2147/dmso.s305782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/13/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The precautions taken during the pandemic period may cause stress-related eating behavior disorders. It was aimed to test this hypothesis, and the study was carried out to examine pandemic measures the effect of on the nutritional, depression and stress conditions of people with obesity. METHODS The individuals who participated in the study were people with obesity who received follow-up dietary therapy in a private hospital. Three separate scales were applied to the individuals, which measured the desire to overeating request, depression status and stress-fighting status. RESULTS This study was conducted on 368 individuals. Women had lower values of BMI (28.57±3.89 kg/cm2) than men (30.64±2.87 kg/cm2). When the scores of the excessive eating request scale mean scores before and during the pandemic were examined, it was seen that the scores of the individuals increased during the pandemic. In the multivariate regression model, it was seen that the increase of stress and BMI increased the FCQ score (p<0.001). Multiple regression models were created by taking into account the criteria that caused the score increase. Each variable can predict the FCQ score separately. The predictor significance order of variants on FCQ score β values is as follows: the Patient Health Questionnaire-9 (PHQ-9) (β=0.774), before pandemic FCQ (β=0.601), the Perceived Stress Scale (PSS) (β=-0.268), before pandemic BMIa (β=-0.223), during pandemic BMIb (β=0.073), and age (β=-0.013). CONCLUSION COVID-19 pandemic, making applications such as quarantine in pandemic processes has successful results in being able to combat its. However, undesirable conditions such as stress can have serious negative consequences on other health measurements. It was observed in the results of this study that excessive eating food desire developed in people with obesity.
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Affiliation(s)
- Vasfiye Bayram Deger
- Faculty of Health Sciences, Department of Nursing (Public Health and Nutrition), Mardin Artuklu Unıversıty, Mardin, Turkey
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Bretón I, de Hollanda A, Vilarrasa N, Rubio Herrera MA, Lecube A, Salvador J, García-Luna PP, Tinahones FJ, Sánchez Santos R, Gómez Huelgas R, Carretero Gómez J, Moizé V, Polo García J, Tranche Iparraguirre S, Fernández-Pro Ledesma A, Escalada J. Obesity and COVID-19. A necessary position statement. ENDOCRINOL DIAB NUTR 2021; 68:S2530-0164(21)00085-9. [PMID: 33875395 PMCID: PMC8009039 DOI: 10.1016/j.endinu.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Irene Bretón
- Servicio de Endocrinología y Nutrición, Hospital Universitario Gregorio Marañón. IiSGM. Facultad de Medicina, Universidad Complutense. Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, España.
| | - Ana de Hollanda
- Servicio de Endocrinología y Nutrición. Hospital Clínic Barcelona Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBEROBN. Coordinadora electa GOSEEN. Sociedad Española de Endocrinología y Nutrición, (SEEN), Barcelona, España
| | - Nuria Vilarrasa
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Bellvitge-IDIBELL. CIBERDEM. Coordinadora GOSEEN. Sociedad Española de Endocrinología y Nutrición (SEEN), Barcelona, España
| | - Miguel A Rubio Herrera
- Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos. IDISSC. Facultad de Medicina, Universidad Complutense. Vicepresidente, Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, España
| | - Albert Lecube
- Servicio de Endocrinología y Nutrición. Hospital Universitari Arnau de Vilanova de Lleida. Grupo de Obesidad, Diabetes y Metabolismo (ODIM). Institut de Recerca Biomèdica de Lleida (IRBLleida). Universitat de Lleida (UdL). CIBERDEM. Vicepresidente, Sociedad Española para el Estudio de la Obesidad, SEEDO, Lleida, España
| | - Javier Salvador
- Profesor Emérito de Endocrinología. Universidad de Navarra. Pamplona. CIBEROBN. Instituto Carlos III. Madrid. Sociedad Española de Endocrinología y Nutrición (SEEN), España
| | - Pedro Pablo García-Luna
- Unidad de Nutrición. UGEN. Hospital Universitario Virgen del Rocío. Sociedad Española de Endocrinología y Nutrición (SEEN), Sevilla, España
| | - Francisco J Tinahones
- Servicio Endocrinología y Nutrición, Hospital Virgen de la Victoria Málaga. Universidad de Málaga. Presidente, Sociedad Española para el Estudio de la Obesidad (SEEDO), Málaga, España
| | - Raquel Sánchez Santos
- Complejo Hospitalario Universitario de Vigo. Instituto de Investigación Galicia Sur. Presidente de la Sociedad Española de Cirugía de la Obesidad (SECO), Galicia, España
| | - Ricardo Gómez Huelgas
- Servicio de Medicina Interna. Hospital Regional Universitario de Málaga. Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Sociedad Española de Medicina Interna (SEMI), Málaga, España
| | - Juana Carretero Gómez
- Servicio de Medicina Interna. Hospital Comarcal de Zafra. Vicepresidente, Sociedad Española de Medicina Interna (SEMI), Zafra, Badajoz, España
| | - Violeta Moizé
- Unidad Funcional de Obesidad. Hospital Clínic Barcelona. Presidenta, Sociedad Española de Dietética y Nutrición (SEDYN), Barcelona, España
| | - José Polo García
- Centro de Salud Casar de Cáceres. Presidente, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Casar de Cáceres, Cáceres, España
| | - Salvador Tranche Iparraguirre
- Centro de Salud El Cristo. Servicio de Salud del Principado de Asturias (SESPA). Presidente, Sociedad Española de Medicina Familiar y Comunitaria, (semFYC), Oviedo, Asturias, España
| | | | - Javier Escalada
- Departamento de Endocrinología y Nutrición. Clínica Universidad de Navarra. Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII. Instituto de Investigación Sanitaria de Navarra (IdiSNA). Grupo de Nefrología Clínica. Presidente, Sociedad Española de Endocrinología y Nutrición (SEEN), Pamplona, Navarra, España
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Földi M, Farkas N, Kiss S, Dembrovszky F, Szakács Z, Balaskó M, Erőss B, Hegyi P, Szentesi A. Visceral Adiposity Elevates the Risk of Critical Condition in COVID-19: A Systematic Review and Meta-Analysis. Obesity (Silver Spring) 2021; 29:521-528. [PMID: 33263191 PMCID: PMC7753720 DOI: 10.1002/oby.23096] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE A higher BMI has become acknowledged as one of the important risk factors for developing critical condition in coronavirus disease 2019 (COVID-19). In addition to BMI, body composition, and particularly visceral adiposity, might be an even more accurate measure to stratify patients. Therefore, the aim of this study was to evaluate the association between the distributions of computed-tomography-quantified fat mass and critical condition of patients with COVID-19. METHODS A systematic search was conducted in five databases for studies published until November 17, 2020. In the meta-analysis, pooled mean difference (standardized mean difference [SMD]) of visceral fat area (VFA; in square centimeters) was calculated between patients in the intensive care unit and those in general ward and between patients with the requirement for invasive mechanical ventilation (IMV) and those without the IMV requirement. RESULTS The quantitative synthesis revealed that patients requiring intensive care had higher VFA values (SMD = 0.46, 95% CI: 0.20-0.71, P < 0.001) compared with patients on the general ward. Similarly, patients requiring IMV had higher VFA values (SMD = 0.38, 95% CI: 0.05-0.71, P = 0.026) compared with patients without the IMV requirement. CONCLUSIONS VFA values were found to be significantly higher in patients with critical condition. Therefore, abdominal adiposity seems to be a risk factor in COVID-19, and patients with central obesity might need special attention.
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Affiliation(s)
- Mária Földi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
| | - Nelli Farkas
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Institute of BioanalysisMedical SchoolUniversity of PécsPécsHungary
| | - Szabolcs Kiss
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
| | - Fanni Dembrovszky
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Zsolt Szakács
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Márta Balaskó
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Bálint Erőss
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
| | - Péter Hegyi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
| | - Andrea Szentesi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
- Szentágothai Research CentreUniversity of PécsPécsHungary
- Centre for Translational MedicineDepartment of MedicineUniversity of SzegedSzegedHungary
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Rubio Herrera MA, Bretón Lesmes I. Obesity in the COVID era: A global health challenge. ENDOCRINOL DIAB NUTR 2021; 68. [PMID: 33162383 PMCID: PMC8032558 DOI: 10.1016/j.endien.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Obesity is a chronic disease that leads to an increased risk of mortality and morbidity, and the impact of the COVID-19 pandemic may create a new health challenge. There is clear evidence showing that some biological and social factors associated with obesity involve an increased risk of COVID-19 infection, hospitalization, and greater severity compared to people with normal weight. Undoubtedly, obesity involves a low-grade proinflammatory state that produces a dysregulation of the immune system that compromises its ability to respond to respiratory infection by COVID-19 and so produces a worsening of the disease. In this review, the main epidemiological and pathophysiological data that associate obesity with COVID-19 are described.
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Affiliation(s)
- Miguel A Rubio Herrera
- Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos. IDISSC. Facultad de Medicina, Universidad Complutense, Madrid, España.
| | - Irene Bretón Lesmes
- Servicio de Endocrinología y Nutrición, Hospital Universitario Gregorio Marañón. Facultad de Medicina, Universidad Complutense, Madrid, España
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Rubio Herrera MA, Bretón Lesmes I. [Obesity in the COVID era: A global health challenge]. ENDOCRINOLOGIA, DIABETES Y NUTRICION 2021; 68:123-129. [PMID: 38620799 PMCID: PMC7577699 DOI: 10.1016/j.endinu.2020.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/02/2020] [Accepted: 10/02/2020] [Indexed: 01/08/2023]
Abstract
Obesity is a chronic disease that leads to an increased risk of mortality and morbidity, and the impact of the COVID-19 pandemic may create a new health challenge. There is clear evidence showing that some biological and social factors associated with obesity involve an increased risk of COVID-19 infection, hospitalization, and greater severity compared to people with normal weight. Undoubtedly, obesity involves a low-grade proinflammatory state that produces a dysregulation of the immune system that compromises its ability to respond to respiratory infection by COVID-19 and so produces a worsening of the disease. In this review, the main epidemiological and pathophysiological data that associate obesity with COVID-19 are described.
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Affiliation(s)
- Miguel A Rubio Herrera
- Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos. IDISSC. Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Irene Bretón Lesmes
- Servicio de Endocrinología y Nutrición, Hospital Universitario Gregorio Marañón. Facultad de Medicina, Universidad Complutense, Madrid, España
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Srivastava S, Rathor R, Singh S, Kumar B, Suryakumar G. Obesity: A Risk Factor for COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1352:195-210. [DOI: 10.1007/978-3-030-85109-5_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Sahin S, Sezer H, Cicek E, Yagız Ozogul Y, Yildirim M, Icli TB, Polat Korkmaz O, Durcan E, Sulu C, Somay K, Bekdemir B, Borekci S, Yazici D, Deyneli O, Ergonul O, Tabak F, Dikmen Y, Ozkaya HM, Gonen MS, Damci T, Ilkova H, Yumuk VD. The Role of Obesity in Predicting the Clinical Outcomes of COVID-19. Obes Facts 2021; 14:481-489. [PMID: 34352797 PMCID: PMC8450845 DOI: 10.1159/000517180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. METHODS We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. RESULTS There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). CONCLUSION COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.
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Affiliation(s)
- Serdar Sahin
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Havva Sezer
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ebru Cicek
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Yeliz Yagız Ozogul
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Murat Yildirim
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Tevhide Betul Icli
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Ozge Polat Korkmaz
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Emre Durcan
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Cem Sulu
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Kayra Somay
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Bahar Bekdemir
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sermin Borekci
- Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Dilek Yazici
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Oguzhan Deyneli
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Onder Ergonul
- Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Yalim Dikmen
- Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Hande Mefkure Ozkaya
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Mustafa Sait Gonen
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
| | - Taner Damci
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Hasan Ilkova
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
| | - Volkan Demirhan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University − Cerrahpasa, Istanbul, Turkey
- European Association for the Study of Obesity − Collaborating Center for Obesity Management, Istanbul, Turkey
- *Volkan Demirhan Yumuk,
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Staub K, Matthes KL, Rühli F, Bender N. Clash of the pandemics - At least 150'000 adults in Switzerland suffer from obesity grades 2 or 3 and are thus at elevated risk for severe COVID-19. F1000Res 2020; 9:1413. [PMID: 33796278 PMCID: PMC7970431 DOI: 10.12688/f1000research.27819.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 01/27/2023] Open
Abstract
Background: Grade 2 and 3 obesity, alongside with other relevant risk factors, are substantially and independently associated with adverse outcomes of coronavirus disease 2019 (COVID-19). However, for Switzerland, due to the lack of synthesis studies, it is currently unknown how many people are affected by obesity at all. This knowledge may help to better estimate the relevance and size of this group at elevated risk, which could be incorporated into strategies to protect risk groups during the still unfolding COVID-19 pandemic. This study aimed to provide a first overall estimation of how many people in Switzerland are currently affected by grade 2 or 3 obesity. Methods: Five representative national population-based studies were accessed which were conducted between 2012 and 2017 and which include data on height and weight of adult men and women in Switzerland. Results: In Switzerland in 2012-2017, among the 11.20% adults who were obese (body mass index (BMI) ≥30.0kg/m2), 1.76% (95% CI 1.50-2.02) suffered from grade 2 obesity (BMI 35.0-39.9 kg/m2), and 0.58% (95% CI 0.50-0.66) from grade severe 3 obesity (BMI ≥40.0 kg/m2). Converted into estimated absolute population numbers, this corresponds to a total of approximately n=154,515 people who suffer from grade 2 or 3 obesity (n=116,216 and n=38,298, respectively). Conclusions: This risk group includes many younger people in Switzerland. The number of people with obesity-related risk becomes 3.8 to 13.6 times higher if grade 1 obesity and overweight people are also included in this risk group, for which there are arguments arising in the latest literature. In general, this large group at risk for severe COVID-19 should be given more attention and support. If it is confirmed that obesity plays a major role in severe COVID-19 courses, then every kilo of body weight that is not gained or that is lost in lockdown counts.
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Affiliation(s)
- Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health SSPH+, Zurich, Switzerland
| | - Katarina L. Matthes
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health SSPH+, Zurich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health SSPH+, Zurich, Switzerland
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Aminian A, Fathalizadeh A, Tu C, Butsch WS, Pantalone KM, Griebeler ML, Kashyap SR, Rosenthal RJ, Burguera B, Nissen SE. Association of prior metabolic and bariatric surgery with severity of coronavirus disease 2019 (COVID-19) in patients with obesity. Surg Obes Relat Dis 2020; 17:208-214. [PMID: 33243670 PMCID: PMC7682430 DOI: 10.1016/j.soard.2020.10.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 02/07/2023]
Abstract
Background Obesity is a risk factor for poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19). Objectives To investigate the relationship between prior metabolic surgery and the severity of COVID-19 in patients with severe obesity. Setting Cleveland Clinic Health System in the United States. Methods Among 4365 patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March 8, 2020 and July 22, 2020 in the Cleveland Clinic Health System, 33 patients were identified who had a prior history of metabolic surgery. The surgical patients were propensity matched 1:10 to nonsurgical patients to assemble a cohort of control patients (n = 330) with a body mass index (BMI) ≥ 40 kg/m2 at the time of SARS-CoV-2 testing. The primary endpoint was the rate of hospital admission. The exploratory endpoints included admission to the intensive care unit (ICU), need for mechanical ventilation and dialysis during index hospitalization, and mortality. After propensity score matching, outcomes were compared in univariate and multivariate regression models. Results The average BMI of the surgical group was 49.1 ± 8.8 kg/m2 before metabolic surgery and was down to 37.2 ± 7.1 at the time of SARS-CoV-2 testing, compared with the control group’s BMI of 46.7 ± 6.4 kg/m2. In the univariate analysis, 6 (18.2%) patients in the metabolic surgery group and 139 (42.1%) patients in the control group were admitted to the hospital (P = .013). In the multivariate analysis, a prior history of metabolic surgery was associated with a lower hospital admission rate compared with control patients with obesity (odds ratio, 0.31; 95% confidence interval, 0.11−0.88; P = .028). While none of the 4 exploratory outcomes occurred in the metabolic surgery group, 43 (13.0%) patients in the control group required ICU admission (P = .021), 22 (6.7%) required mechanical ventilation, 5 (1.5%) required dialysis, and 8 (2.4%) patients died. Conclusion Prior metabolic surgery with subsequent weight loss and improvement of metabolic abnormalities was associated with lower rates of hospital and ICU admission in patients with obesity who became infected with SARS-CoV-2. Confirmation of these findings will require larger studies. Is there an association between prior metabolic surgery and severity of COVID-19 in patients with obesity? In this matched cohort study of 363 patients with COVID-19 (including 33 patients who underwent metabolic surgery and 330 matched controls with obesity), metabolic surgery was significantly associated with near three times lower odds of hospital admission (odds ratio 0.31, P=0.028). While none of the 4 exploratory outcomes occurred in the metabolic surgery group, 43 (13.0%) patients in the control group required ICU admission (P=0.021), 22 (6.7%) required mechanical ventilation, 5 (1.5%) required dialysis, and 8 (2.4%) patients died. Among patients with obesity, metabolic surgery was significantly associated with a lower risk of hospital and intensive care unit admission.
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Affiliation(s)
- Ali Aminian
- Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio.
| | - Alisan Fathalizadeh
- Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Chao Tu
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - W Scott Butsch
- Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Kevin M Pantalone
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Marcio L Griebeler
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sangeeta R Kashyap
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Raul J Rosenthal
- Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Weston, Florida
| | - Bartolome Burguera
- Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steven E Nissen
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
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48
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Hauner H. The COVID-19 Pandemic: A Challenge for Obesity Research and Management. Obes Facts 2020; 13:453-454. [PMID: 32961534 PMCID: PMC7753016 DOI: 10.1159/000511186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hans Hauner
- Else Kröner-Fresenius Center for Nutritional Medicine, Technical University of Munich, Munich, Germany,
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