1
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Wang Z, Deng S, Lv H, Fan Y, Zhang L, Wang F. Effect of WeChat-based continuous care intervention on the somatic function, depression, anxiety, social function and cognitive function for cancer patients: Meta-analysis of 18 RCTs. Nurs Open 2023; 10:6045-6057. [PMID: 37365734 PMCID: PMC10416022 DOI: 10.1002/nop2.1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 11/14/2022] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
AIM This meta-analysis systematically reviewed and identified the effects of WeChat-based continuous care (WCC) interventions on various outcomes in cancer patients. DESIGN Systematic review and meta-analysis. METHODS In this study, outcome measures included somatic function, anxiety, depression, social function, and cognitive function. The standardized mean differences and 95% CIs of pooled effect sizes were calculated using fixed- and random-effects models. NFail-safe and Begg's tests were performed to evaluate publication bias, and sensitivity analysis was performed to evaluate the robustness of the meta-analysis results. RESULTS The meta-analysis included 18 RCTs of moderate quality. WCC interventions significantly improved somatic function, depression, anxiety, social function, and cognitive function in cancer patients. There was no significant publication bias, and the sensitivity analysis indicated robust results. PATIENT OR PUBLIC CONTRIBUTION WCC interventions improved depression, anxiety, social function, and cognitive function in cancer patients.
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Affiliation(s)
- Zhuoxin Wang
- School of NursingBengbu Medical CollegeBengbuChina
- The Second People's Hospital of ChangzhiChangzhiShanxi ProvinceChina
| | | | - Hekai Lv
- School of Health ManagementBengbu Medical CollegeBengbuChina
| | - Yanyan Fan
- School of NursingBengbu Medical CollegeBengbuChina
| | - Li Zhang
- School of NursingBengbu Medical CollegeBengbuChina
| | - Fuzhi Wang
- School of Health ManagementBengbu Medical CollegeBengbuChina
- School of Public HealthPeking UniversityBeijingChina
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2
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M TE, MA RH, B GV, ME FF, V M, F P, P BP, C S, A N, C GP, M L. Clinical and economic impact of COVID-19 on people with obesity in a Spanish cohort during the first pandemic peak. Front Endocrinol (Lausanne) 2023; 14:1146517. [PMID: 37342262 PMCID: PMC10278591 DOI: 10.3389/fendo.2023.1146517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction COVID-19 and obesity relationship has been extensively studied since the COVID-19 outbreak, proving obesity is a risk factor. This study aims to broaden the available information about this association and to evaluate the economic impact of obesity and the COVID-19 disease combination. Methods This retrospective study analyzed a sample of 3,402 patients admitted to a Spanish hospital with available body mass index (BMI) data. Results The prevalence of obesity was 33.4%. Patients with obesity showed a higher risk of hospitalization (OR 95% ConfidenceInterval [CI]=1.46; [1.24-1.73]; p < 0.001), which increased with the obesity degree (I: OR [95% CI]=1.28 [1.06-1.55], p =0.010; II: OR [95% CI]=1.58 [1.16-2.15], p =0.004; III: OR [95% CI] =2.09 [1.31-3.34], p =0.002). Patients with type III obesity had a significantly higher risk of intensive care unit (ICU) admission (OR [95% CI]= 3.30 [1.67-6.53]; p = 0.001) and invasive mechanical ventilation (IMV) need (OR [95% CI]= 3.98 [2.00-7.94]; p<0.001). The average cost per patient was remarkably higher in patients with obesity (p = 0.007), reaching an excess cost of 28.41% in the study cohort and rising to 56.5% in patients < 70 years. The average cost per patient increased significantly with the degree of obesity (p = 0.007). Discussion In conclusion, our results suggest a strong association between obesity and adverse COVID-19 outcomes and higher expenditures in patients with both conditions.
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Affiliation(s)
- Torrego-Ellacuría M
- Innovation Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Rubio-Herrera MA
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - González López-Valcárcel B
- Department of Quantitative Methods for Economics and Management, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fuentes-Ferrer ME
- Department of Preventive Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Martín V
- Department of Market Access and Public Affairs, Novo Nordisk Pharma, Sociedad Anónima (SA.), Madrid, Spain
| | - Poyato F
- Department of Clinical, Medical and Regulatory, Novo Nordisk Pharma, Sociedad Anònima (SA.), Madrid, Spain
| | - Barber-Pérez P
- Department of Quantitative Methods for Economics and Management, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Santucci C
- Department of Quantitative Methods for Economics and Management, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Nuñez A
- Department of Critical Care, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - González-Pérez C
- Innovation Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Hospital Pharmacy, Hospital Clínico San Carlos, Instituto de Investigaciòn Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Luaces M
- Innovation Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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3
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Khairy Y, Naghibi D, Moosavi A, Sardareh M, Azami-Aghdash S. Prevalence of hypertension and associated risks in hospitalized patients with COVID-19: a meta-analysis of meta-analyses with 1468 studies and 1,281,510 patients. Syst Rev 2022; 11:242. [PMID: 36397129 PMCID: PMC9672558 DOI: 10.1186/s13643-022-02111-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Since the COVID-19 outbreak, preliminary research has shown that some risk-associated conditions increase death and severe complications of the disease, hypertension being one of them. Thus, numerous meta-analyses have been conducted to explore this issue. Therefore, this umbrella review aims to perform a meta-analysis of the meta-analyses to estimate the prevalence and associated risks of hypertension in patients with COVID-19. METHODS PubMed, Scopus, Web of Knowledge, Embase, and Cochrane databases were searched for the published meta-analyses up to January 1, 2022. Google Scholar, citation check, reference check, and Grey literature were also manually searched. A random-effect model approach was used for analysis. RESULTS The overall death rate was estimated at 12%. Hypertension was present in 25% of the patients as a comorbid disease. The overall RR for death, disease severity, and the possibility of ICU admission were estimated at 1.79 [1.68-1.89 with 95% CI], 1.74 [1.66-1.83 with 95% CI], and 1.91 [1.48-2.34 with 95% CI], respectively. The meta-regression results showed that being "male" significantly increases the risk of disease severity and ICU admission. CONCLUSIONS The results indicated that hypertension is a common comorbid disease in hospitalized patients with COVID-19, which significantly increases mortality risk, the severity of the disease, and the probability of ICU admission. SYSTEMATIC REVIEW REGISTRATION This study has been registered in PROSPERO (CRD42021231844).
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Affiliation(s)
- Yousof Khairy
- Center for the Development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Deniz Naghibi
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Ahmad Moosavi
- Department of Health and Community Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Mehran Sardareh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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4
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Mal P, Mukherjee T, Upadhyay AK, Mohanty S, Pattnaik AK. Connecting the dots between inflammatory cascades of obesity and COVID-19 in light of mortal consequences-a review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:57040-57053. [PMID: 35731430 PMCID: PMC9213647 DOI: 10.1007/s11356-022-21461-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Obesity is a term that has recently been referred to describe a condition in which a person has become a diseased vessel. Obesity's internal pathology is too mysterious as it has a close resemblance with fatal diseases pathology. Obesity and coronavirus disease 2019 (COVID-19) are simultaneous epidemics declared by many organizations after observing their rampage in the recent world. Oxidative stress, cytokine storm, interleukin, and their contribution to the internal adipocyte environment implicated in the cascades of inflammatory pathology are portrayed here. Major determinants like angiotensin-converting enzyme 2 (ACE2) and renin-angiotensin-aldosterone system (RAAS) axis are highly sensitive molecular factors. Data from various countries suggested a clinical overview of how greater body mass index (BMI) is related to greater COVID-19 risk. It also gives insight into how obese individuals are obligately getting admitted and combating COVID-19 in intensive care unit including children less than 13 years of age under ultimate therapeutic options. There are numerous studies currently taking place for finding a cure for obesity which are mainly focused on natural resources and novel therapies like photobiomodulation (PBM) consisting of laser treatment, infrared treatment, etc. as current pharmacological treatments are reported to have fatal adverse effects. Finally, it is discussed how attenuating obesity will be a solution for future combat strategy. This review gives light on the areas of coagulation, inflammatory parameters, cardiometabolic complications, endothelial dysfunctions, immunological infirmity due to COVID-19 in obese individuals. A conceptual outline about correlation between the inflammatory pathophysiological steps triggering the aggravation of fatal consequences has been drawn in this review.
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Affiliation(s)
- Payel Mal
- Division of Pharmacology, Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India
| | - Tuhin Mukherjee
- Division of Pharmacology, Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India
| | - Abhay K Upadhyay
- Division of Pharmacology, Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India
| | - Satyajit Mohanty
- Division of Pharmacology, Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India
| | - Ashok K Pattnaik
- Division of Pharmacology, Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India.
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5
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Orozco-Beltrán D, Merino-Torres JF, Pérez A, Cebrián-Cuenca AM, Párraga-Martínez I, Ávila-Lachica L, Rojo-Martínez G, Pomares-Gómez FJ, Álvarez-Guisasola F, Sánchez-Molla M, Gutiérrez F, Ortega FJ, Mata-Cases M, Carretero-Anibarro E, Vilaseca JM, Quesada JA. Diabetes Does Not Increase the Risk of Hospitalization Due to COVID-19 in Patients Aged 50 Years or Older in Primary Care-APHOSDIAB-COVID-19 Multicenter Study. J Clin Med 2022; 11:2092. [PMID: 35456185 PMCID: PMC9025638 DOI: 10.3390/jcm11082092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to identify clinical, analytical, and sociodemographic variables associated with the need for hospital admission in people over 50 years infected with SARS-CoV-2 and to assess whether diabetes mellitus conditions the risk of hospitalization. A multicenter case-control study analyzing electronic medical records in patients with COVID-19 from 1 March 2020 to 30 April 2021 was conducted. We included 790 patients: 295 cases admitted to the hospital and 495 controls. Under half (n = 386, 48.8%) were women, and 8.5% were active smokers. The main comorbidities were hypertension (50.5%), dyslipidemia, obesity, and diabetes (37.5%). Multivariable logistic regression showed that hospital admission was associated with age above 65 years (OR from 2.45 to 3.89, ascending with age group); male sex (OR 2.15, 95% CI 1.47-3.15), fever (OR 4.31, 95% CI 2.87-6.47), cough (OR 1.89, 95% CI 1.28-2.80), asthenia/malaise (OR 2.04, 95% CI 1.38-3.03), dyspnea (4.69, 95% CI 3.00-7.33), confusion (OR 8.87, 95% CI 1.68-46.78), and a history of hypertension (OR 1.61, 95% CI 1.08-2.41) or immunosuppression (OR 4.97, 95% CI 1.45-17.09). Diabetes was not associated with increased risk of hospital admission (OR 1.18, 95% CI 0.80-1.72; p = 0.38). Diabetes did not increase the risk of hospital admission in people over 50 years old, but advanced age, male sex, fever, cough, asthenia, dyspnea/confusion, and hypertension or immunosuppression did.
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Affiliation(s)
- Domingo Orozco-Beltrán
- Health Center Cabo Huertas, Consejeria de Sanidad Univesal y Salud Pública, 03540 Alicante, Spain;
- Spanish Diabetes Society, 28002 Madrid, Spain;
- Clinical Medice Department, University Miguel Hernández, 03550 Alicante, Spain; (F.G.); (J.A.Q.)
| | - Juan Francisco Merino-Torres
- Endocrinology and Nutrition Service, University of Valencia, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
| | - Antonio Pérez
- Spanish Diabetes Society, 28002 Madrid, Spain;
- Medicine Department, Autonoums University of Barcelona, 08193 Barcelona, Spain
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), 20029 Madrid, Spain
- Hospital Santa Creu i Sant Pau, Servicio Catalán de Salud, 08041 Barcelona, Spain
| | - Ana M. Cebrián-Cuenca
- Primary Care and Prediabetes Group of the Spanish Diabetes Society, 30201 Cartagena, Spain;
- Health Center Cartagena Casco, Servicio Murciano de Salud, 30201 Cartagena, Spain
- Primary Care Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Ignacio Párraga-Martínez
- Spanish Society of Family and Community Medicine (semFyC), 28004 Madrid, Spain; (I.P.-M.); (F.Á.-G.)
- Health Center Zone VIII, Servicio de Salud Castilla la Mancha, 02006 Albacete, Spain
| | - Luis Ávila-Lachica
- Secretario GAPP-SED, Grupo DM-semFyC, 28004 Madrid, Spain;
- Consultorio de Almáchar, UGC Vélez Norte, 29718 Malaga, Spain
| | - Gemma Rojo-Martínez
- Spanish Diabetes Society, 28002 Madrid, Spain;
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), 20029 Madrid, Spain
- Biomedical Research Institute (IBIMA), Endocrinology and Nutrition Clinical Management Unit, Malaga Regional University Hospital, 29010 Malaga, Spain
| | - Francisco J. Pomares-Gómez
- Diabetes Mellitus Plan of the Valencian Community, University Hospital San Juan de Alicante, 03550 Alicante, Spain;
| | - Fernando Álvarez-Guisasola
- Spanish Society of Family and Community Medicine (semFyC), 28004 Madrid, Spain; (I.P.-M.); (F.Á.-G.)
- Health Center Ribera de Órbigo, Consejería de Salud Castilla León, 24280 León, Spain
| | | | - Felix Gutiérrez
- Clinical Medice Department, University Miguel Hernández, 03550 Alicante, Spain; (F.G.); (J.A.Q.)
- Internal Medicine, Elche General University Hospital, 03203 Elche, Spain
- CIBER Infectious Diseases, 28029 Madrid, Spain
| | - Francisco J. Ortega
- Health Center Campos-Lampreana, Conserjería de Salud Castilla y León, 49137 Zamora, Spain;
| | - Manel Mata-Cases
- Primary Care Center La Mina, Sant Adrià de Besòs, Servicio Catalán de Salud, 08930 Barcelona, Spain;
- Group DAP-Cat, Research Support Unit, Jordi Gol University Institute for Primary Healthcare Research, CIBERDEM, 08036 Barcelona, Spain
| | | | | | - Jose A. Quesada
- Clinical Medice Department, University Miguel Hernández, 03550 Alicante, Spain; (F.G.); (J.A.Q.)
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6
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Evaluating Possible Mechanisms Linking Obesity to COVID-19: a Narrative Review. Obes Surg 2022; 32:1689-1700. [PMID: 35113309 PMCID: PMC8811344 DOI: 10.1007/s11695-022-05933-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 01/05/2023]
Abstract
Currently, pneumonia caused by the coronavirus disease 2019 (COVID-19) is a pandemic. To date, there is no specific antiviral treatment for the disease, and universal access to the vaccine is a serious challenge. Some observational studies have shown that COVID-19 is more common in countries with a high prevalence of obesity and that people with COVID-19 have a higher body mass index. In these studies, obesity increased the risk of disease, as well as its severity and mortality. This study aimed to review the mechanisms that link obesity to COVID-19.
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7
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Elrayess MA, Cyprian FS, Abdallah AM, Emara MM, Diboun I, Anwardeen N, Schuchardt S, Yassine HM. Metabolic Signatures of Type 2 Diabetes Mellitus and Hypertension in COVID-19 Patients With Different Disease Severity. Front Med (Lausanne) 2022; 8:788687. [PMID: 35083246 PMCID: PMC8784560 DOI: 10.3389/fmed.2021.788687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/15/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Increased COVID-19 disease severity is higher among patients with type 2 diabetes mellitus and hypertension. However, the metabolic pathways underlying this association are not fully characterized. This study aims to identify the metabolic signature associated with increased COVID-19 severity in patients with diabetes mellitus and hypertension. Methods: One hundred and fifteen COVID-19 patients were divided based on disease severity, diabetes status, and hypertension status. Targeted metabolomics of serum samples from all patients was performed using tandem mass spectrometry followed by multivariate and univariate models. Results: Reduced levels of various triacylglycerols were observed with increased disease severity in the diabetic patients, including those containing palmitic (C16:0), docosapentaenoic (C22:5, DPA), and docosahexaenoic (C22:6, DHA) acids (FDR < 0.01). Functional enrichment analysis revealed triacylglycerols as the pathway exhibiting the most significant changes in severe COVID-19 in diabetic patients (FDR = 7.1 × 10-27). Similarly, reduced levels of various triacylglycerols were also observed in hypertensive patients corresponding with increased disease severity, including those containing palmitic, oleic (C18:1), and docosahexaenoic acids. Functional enrichment analysis revealed long-chain polyunsaturated fatty acids (n-3 and n-6) as the pathway exhibiting the most significant changes with increased disease severity in hypertensive patients (FDR = 0.07). Conclusions: Reduced levels of triacylglycerols containing specific long-chain unsaturated, monounsaturated, and polyunsaturated fatty acids are associated with increased COVID-19 severity in diabetic and hypertensive patients, offering potential novel diagnostic and therapeutic targets.
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Affiliation(s)
| | - Farhan S Cyprian
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Abdallah M Abdallah
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
| | - Mohamed M Emara
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
| | - Ilhame Diboun
- College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | | | - Sven Schuchardt
- Department of Bio- and Environmental Analytics, Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany
| | - Hadi M Yassine
- Biomedical Research Center (BRC), Qatar University, Doha, Qatar.,College of Health Sciences, Qatar University, Doha, Qatar
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8
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Dubé L, Silveira PP, Nielsen DE, Moore S, Paquet C, Cisneros-Franco JM, Kemp G, Knauper B, Ma Y, Khan M, Bartlett-Esquilant G, Evans AC, Fellows LK, Armony JL, Spreng RN, Nie JY, Brown ST, Northoff G, Bzdok D. From Precision Medicine to Precision Convergence for Multilevel Resilience-The Aging Brain and Its Social Isolation. Front Public Health 2022; 10:720117. [PMID: 35865245 PMCID: PMC9294141 DOI: 10.3389/fpubh.2022.720117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laurette Dubé
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Patricia P Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Daiva E Nielsen
- Faculty of Agricultural and Environmental Sciences, School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Spencer Moore
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Catherine Paquet
- Faculté des Sciences de l'Administration, Université Laval, Quebec City, QC, Canada
| | - J Miguel Cisneros-Franco
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Gina Kemp
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada.,Centre for Research in Neuroscience, The Research Institute of McGill University Health Center, Montreal, QC, Canada
| | - Bärbel Knauper
- Department of Psychology, Faculty of Arts, McGill University, Montreal, QC, Canada
| | - Yu Ma
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Mehmood Khan
- Life Biosciences Chief Executive Officer (CEO), Boston, MA, United States.,Council on Competitiveness (Chairman of the Board), Washington, DC, United States
| | | | - Alan C Evans
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Laboratory of Brain and Cognition, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Lesley K Fellows
- Laboratory of Brain and Cognition, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.,Chronic Mental Illness Service, Montreal Neurological Institute, Montreal, QC, Canada
| | - Jorge L Armony
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - R Nathan Spreng
- Laboratory of Brain and Cognition, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada.,Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada.,McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada
| | - Jian-Yun Nie
- Department of Computer Science and Operations Research, University of Montreal, Montreal, QC, Canada
| | - Shawn T Brown
- Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Georg Northoff
- Chronic Mental Illness Service, Montreal Neurological Institute, Montreal, QC, Canada.,Faculty of Medicine, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Danilo Bzdok
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre (BIC), Montreal Neurological Institute (MNI), McGill University, Montreal, QC, Canada.,Mila-Quebec Artificial Intelligence Institute, Montreal, QC, Canada
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9
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Reyes C, Pistillo A, Fernández-Bertolín S, Recalde M, Roel E, Puente D, Sena AG, Blacketer C, Lai L, Alshammari TM, Ahmed WUR, Alser O, Alghoul H, Areia C, Dawoud D, Prats-Uribe A, Valveny N, de Maeztu G, Sorlí Redó L, Martinez Roldan J, Lopez Montesinos I, Schilling LM, Golozar A, Reich C, Posada JD, Shah N, You SC, Lynch KE, DuVall SL, Matheny ME, Nyberg F, Ostropolets A, Hripcsak G, Rijnbeek PR, Suchard MA, Ryan P, Kostka K, Duarte-Salles T. Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: a multinational cohort study. BMJ Open 2021; 11:e057632. [PMID: 34937726 PMCID: PMC8704062 DOI: 10.1136/bmjopen-2021-057632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To characterise patients with and without prevalent hypertension and COVID-19 and to assess adverse outcomes in both inpatients and outpatients. DESIGN AND SETTING This is a retrospective cohort study using 15 healthcare databases (primary and secondary electronic healthcare records, insurance and national claims data) from the USA, Europe and South Korea, standardised to the Observational Medical Outcomes Partnership common data model. Data were gathered from 1 March to 31 October 2020. PARTICIPANTS Two non-mutually exclusive cohorts were defined: (1) individuals diagnosed with COVID-19 (diagnosed cohort) and (2) individuals hospitalised with COVID-19 (hospitalised cohort), and stratified by hypertension status. Follow-up was from COVID-19 diagnosis/hospitalisation to death, end of the study period or 30 days. OUTCOMES Demographics, comorbidities and 30-day outcomes (hospitalisation and death for the 'diagnosed' cohort and adverse events and death for the 'hospitalised' cohort) were reported. RESULTS We identified 2 851 035 diagnosed and 563 708 hospitalised patients with COVID-19. Hypertension was more prevalent in the latter (ranging across databases from 17.4% (95% CI 17.2 to 17.6) to 61.4% (95% CI 61.0 to 61.8) and from 25.6% (95% CI 24.6 to 26.6) to 85.9% (95% CI 85.2 to 86.6)). Patients in both cohorts with hypertension were predominantly >50 years old and female. Patients with hypertension were frequently diagnosed with obesity, heart disease, dyslipidaemia and diabetes. Compared with patients without hypertension, patients with hypertension in the COVID-19 diagnosed cohort had more hospitalisations (ranging from 1.3% (95% CI 0.4 to 2.2) to 41.1% (95% CI 39.5 to 42.7) vs from 1.4% (95% CI 0.9 to 1.9) to 15.9% (95% CI 14.9 to 16.9)) and increased mortality (ranging from 0.3% (95% CI 0.1 to 0.5) to 18.5% (95% CI 15.7 to 21.3) vs from 0.2% (95% CI 0.2 to 0.2) to 11.8% (95% CI 10.8 to 12.8)). Patients in the COVID-19 hospitalised cohort with hypertension were more likely to have acute respiratory distress syndrome (ranging from 0.1% (95% CI 0.0 to 0.2) to 65.6% (95% CI 62.5 to 68.7) vs from 0.1% (95% CI 0.0 to 0.2) to 54.7% (95% CI 50.5 to 58.9)), arrhythmia (ranging from 0.5% (95% CI 0.3 to 0.7) to 45.8% (95% CI 42.6 to 49.0) vs from 0.4% (95% CI 0.3 to 0.5) to 36.8% (95% CI 32.7 to 40.9)) and increased mortality (ranging from 1.8% (95% CI 0.4 to 3.2) to 25.1% (95% CI 23.0 to 27.2) vs from 0.7% (95% CI 0.5 to 0.9) to 10.9% (95% CI 10.4 to 11.4)) than patients without hypertension. CONCLUSIONS COVID-19 patients with hypertension were more likely to suffer severe outcomes, hospitalisations and deaths compared with those without hypertension.
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Affiliation(s)
- Carlen Reyes
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Sergio Fernández-Bertolín
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Elena Roel
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Diana Puente
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Anthony G Sena
- Janssen Research and Development Titusville, Titusville, New Jersey, USA
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Clair Blacketer
- Janssen Research and Development Titusville, Titusville, New Jersey, USA
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lana Lai
- School of Medical Sciences, The University of Manchester, Manchester, UK
| | | | - Waheed-Ui-Rahman Ahmed
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Center, Oxford, UK
- College of Medicine and Health, University of Exeter, St Luke's Campus, Exeter, UK
| | - Osaid Alser
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Carlos Areia
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Dalia Dawoud
- National Institute for Health and Care Excellence (NICE), London, UK
- Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Albert Prats-Uribe
- Center for Statistics in Medicine, NDORMS, University of Oxford, Botnar Research Center, Nuffield Orthopaedic Center, Oxford, UK
| | | | | | - Luisa Sorlí Redó
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Department of Infectious Diseases, Hospital del Mar, Institut Hospital del Mar d'Investigació Mèdica (IMIM), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Jordi Martinez Roldan
- Director of Innovation and Digital Transformation, Hospital del Mar, Barcelona, Spain
| | - Inmaculada Lopez Montesinos
- Department of Infectious Diseases, Hospital del Mar, Institut Hospital del Mar d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Lisa M Schilling
- University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Asieh Golozar
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | | | - Jose D Posada
- Stanford University School of Medicine, Stanford, California, USA
| | - Nigam Shah
- Stanford University School of Medicine, Stanford, California, USA
| | - Seng Chan You
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Department of Internal Medicine, The University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Scott L DuVall
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Department of Internal Medicine, The University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Michael E Matheny
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Department of Internal Medicine, The University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Ostropolets
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
- Medical Informatics Services, New York-Presbyterial Hospital, New York, NY, USA
| | - Peter R Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marc A Suchard
- Department of Biostatistics, Fielding School of Publich Health, University of California, Los Angeles, California, USA
| | - Patrick Ryan
- Janssen Research and Development Titusville, Titusville, New Jersey, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Kristin Kostka
- Real-World Solutions, IQVIA, Cambridge, Massachusetts, USA
- The OHDSI Center at the Roux Institute, Northeastern University, Portland, ME, USA
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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Abstract
Diabetes mellitus (DM) is one of the most common comorbid conditions in persons with COVID-19 and a risk factor for poor prognosis. The reasons why COVID-19 is more severe in persons with DM are currently unknown although the scarce data available on patients with DM hospitalized because of COVID-19 show that glycemic control is inadequate. The fact that patients with COVID-19 are usually cared for by health professionals with limited experience in the management of diabetes and the need to prevent exposure to the virus may also be obstacles to glycemic control in patients with COVID-19. Effective clinical care should consider various aspects, including screening for the disease in at-risk persons, education, and monitoring of control and complications. We examine the effect of COVID-19 on DM in terms of glycemic control and the restrictions arising from the pandemic and assess management of diabetes and drug therapy in various scenarios, taking into account factors such as physical exercise, diet, blood glucose monitoring, and pharmacological treatment. Specific attention is given to patients who have been admitted to hospital and critically ill patients. Finally, we consider the role of telemedicine in the management of DM patients with COVID-19 during the pandemic and in the future.
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11
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Rizvi AA, Janez A, Rizzo M. Cardiometabolic Alterations in the Interplay of COVID-19 and Diabetes: Current Knowledge and Future Avenues. Int J Mol Sci 2021; 22:ijms222212311. [PMID: 34830193 PMCID: PMC8619040 DOI: 10.3390/ijms222212311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 01/13/2023] Open
Affiliation(s)
- Ali A. Rizvi
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA;
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of South Carolina, Columbia, SC 29208, USA
| | - Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center Ljubljana, 1000 Ljubljana, Slovenia;
| | - Manfredi Rizzo
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of South Carolina, Columbia, SC 29208, USA
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), School of Medicine, University of Palermo, 90100 Palermo, Italy
- Correspondence:
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12
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Factors Associated with SARS-CoV-2 Infection Risk among Healthcare Workers of an Italian University Hospital. Healthcare (Basel) 2021; 9:healthcare9111495. [PMID: 34828540 PMCID: PMC8622462 DOI: 10.3390/healthcare9111495] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 02/07/2023] Open
Abstract
We report the results of a study on the cumulative incidence of SARS-CoV-2 infections in about 6000 workers of the University Hospital of Modena, Northern Italy, in the period March 2020–January 2021, and the relations with some individual and occupational factors. Overall, in healthcare workers (HCW) the cumulative incidence of COVID-19 during the period was 13.8%. Results confirm the role of overweight and obesity as significant risk factors for SARS-CoV-2 infection. Chronic respiratory diseases, including asthma, also proved to be significantly associated with the infection rate. Considering occupational factors, the COVID-19 risk was about threefold (OR: 2.7; 95% CI 1.7–4.5) greater in nurses and nurse aides than in non-HCW, and about double (OR: 1.9; 95% CI 1.2–3.2) in physicians. Interestingly, an association was also observed between infection risk and nightshifts at work (OR: 1.8; 95% CI 1.4–2.3), significantly related to the total number of shifts in the whole eleven-month period. Even if the vaccination campaign has now greatly modified the scenario of SARS-CoV-2 infections among HCW, the results of this study can be useful for further development of health and policy strategies to mitigate the occupational risk related to the new variants of coronavirus, and therefore the evolution of the pandemic.
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13
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Surma S, Banach M, Lewek J. COVID-19 and lipids. The role of lipid disorders and statin use in the prognosis of patients with SARS-CoV-2 infection. Lipids Health Dis 2021; 20:141. [PMID: 34689776 PMCID: PMC8542506 DOI: 10.1186/s12944-021-01563-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
The global coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 coronavirus started in March 2020. The conclusions from numerous studies indicate that people with comorbidities, such as arterial hypertension, diabetes, obesity, underlying cardiovascular disease, are particularly vulnerable to the severe course of COVID-19. The available data also suggest that patients with dyslipidemia, the most common risk factor of cardiovascular diseases, are also at greater risk of severe course of COVID-19. On the other hand, it has been shown that COVID-19 infection has an influence on lipid profile leading to dyslipidemia, which might require appropriate treatment. Owing to antiviral, anti-inflammatory, immunomodulatory, and cardioprotective activity, statin therapy has been considered as valuable tool to improve COVID-19 outcomes. Numerous observational studies have shown potential beneficial effects of lipid-lowering treatment on the course of COVID-19 with significant improved prognosis and reduced mortality.
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Affiliation(s)
- Stanisław Surma
- Faculty of Medicial Sciences in Katowice, Medical University of Silesia in Katowice, Poland; Medyków 18, 40-752 Katowice, Poland
- Club of Young Hypertensiologists, Polish Society of Hypertension, Warsaw, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Rzgowska 281/289, 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338 Lodz, Poland
| | - Joanna Lewek
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Rzgowska 281/289, 93-338 Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338 Lodz, Poland
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14
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Mahamat-Saleh Y, Fiolet T, Rebeaud ME, Mulot M, Guihur A, El Fatouhi D, Laouali N, Peiffer-Smadja N, Aune D, Severi G. Diabetes, hypertension, body mass index, smoking and COVID-19-related mortality: a systematic review and meta-analysis of observational studies. BMJ Open 2021; 11:e052777. [PMID: 34697120 PMCID: PMC8557249 DOI: 10.1136/bmjopen-2021-052777] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/07/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES We conducted a systematic literature review and meta-analysis of observational studies to investigate the association between diabetes, hypertension, body mass index (BMI) or smoking with the risk of death in patients with COVID-19 and to estimate the proportion of deaths attributable to these conditions. METHODS Relevant observational studies were identified by searches in the PubMed, Cochrane library and Embase databases through 14 November 2020. Random-effects models were used to estimate summary relative risks (SRRs) and 95% CIs. Certainty of evidence was assessed using the Cochrane methods and the Grading of Recommendations, Assessment, Development and Evaluations framework. RESULTS A total of 186 studies representing 210 447 deaths among 1 304 587 patients with COVID-19 were included in this analysis. The SRR for death in patients with COVID-19 was 1.54 (95% CI 1.44 to 1.64, I2=92%, n=145, low certainty) for diabetes and 1.42 (95% CI 1.30 to 1.54, I2=90%, n=127, low certainty) for hypertension compared with patients without each of these comorbidities. Regarding obesity, the SSR was 1.45 (95% CI 1.31 to 1.61, I2=91%, n=54, high certainty) for patients with BMI ≥30 kg/m2 compared with those with BMI <30 kg/m2 and 1.12 (95% CI 1.07 to 1.17, I2=68%, n=25) per 5 kg/m2 increase in BMI. There was evidence of a J-shaped non-linear dose-response relationship between BMI and mortality from COVID-19, with the nadir of the curve at a BMI of around 22-24, and a 1.5-2-fold increase in COVID-19 mortality with extreme obesity (BMI of 40-45). The SRR was 1.28 (95% CI 1.17 to 1.40, I2=74%, n=28, low certainty) for ever, 1.29 (95% CI 1.03 to 1.62, I2=84%, n=19) for current and 1.25 (95% CI 1.11 to 1.42, I2=75%, n=14) for former smokers compared with never smokers. The absolute risk of COVID-19 death was increased by 14%, 11%, 12% and 7% for diabetes, hypertension, obesity and smoking, respectively. The proportion of deaths attributable to diabetes, hypertension, obesity and smoking was 8%, 7%, 11% and 2%, respectively. CONCLUSION Our findings suggest that diabetes, hypertension, obesity and smoking were associated with higher COVID-19 mortality, contributing to nearly 30% of COVID-19 deaths. TRIAL REGISTRATION NUMBER CRD42020218115.
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Affiliation(s)
- Yahya Mahamat-Saleh
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, F-94805, Villejuif, France
| | - Thibault Fiolet
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, F-94805, Villejuif, France
| | - Mathieu Edouard Rebeaud
- Department of Plant Molecular Biology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Matthieu Mulot
- Laboratory of Soil Biodiversity, Faculty of Science, University of Neuchatel, Neuchâtel, Switzerland
| | - Anthony Guihur
- Department of Plant Molecular Biology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Douae El Fatouhi
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, F-94805, Villejuif, France
| | - Nasser Laouali
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, F-94805, Villejuif, France
| | - Nathan Peiffer-Smadja
- Universite de Paris, IAME, INSERM, Paris, France
- National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
- Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gianluca Severi
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP, F-94805, Villejuif, France
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
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15
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Sen S, Chakraborty R, Kalita P, Pathak MP. Diabetes mellitus and COVID-19: Understanding the association in light of current evidence. World J Clin Cases 2021; 9:8327-8339. [PMID: 34754842 PMCID: PMC8554438 DOI: 10.12998/wjcc.v9.i28.8327] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/12/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have posed a problematic healthcare situation worldwide since December 2019. Diabetes mellitus is associated with an increased risk and severity of coronavirus disease 2019 (COVID-19). While interacting with various other risk factors, high blood sugar was found to reduce immunity and increase the replication of SARS-CoV-2. Oxidative stress and the release of pro-inflammatory cytokines are greater in diabetic individuals than in healthy people, worsening the outcome of SARS-CoV-2 infection in diabetics. Increased expression of furin and angiotensin converting enzyme 2 (ACE-2) receptor in the hyperglycemic environment may promote the entry of SARS-CoV-2 in the host cell. COVID-19 infection primarily modulates immune and inflammatory responses, and may cause a cytokine storm, resulting in possible lethal outcomes in diabetics. An experimental report suggests that ACE expressed in the pancreas and the SARS-CoV-2 virus invariably destroy β-cells which contain ACE-2 receptors and results in acute diabetes. Moreover, COVID-19 also causes hyperglycemia in an individual with diabetes which may be related to insulin resistance and destruction of β-cells during SARS-CoV-2 infection. Early observations also suggest a correlation between oral hypoglycemic agents and the risk of COVID-19. This review focused on the possible cause and mechanism involved in SARS-CoV-2 infection in diabetics and the role of antidiabetic drugs in COVID-19.
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Affiliation(s)
- Saikat Sen
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati 781026, Assam, India
| | - Raja Chakraborty
- Department of Pharmaceutical Technology, School of Medical Sciences, ADAMAS University, Kolkata 700 126, West Bengal, India
| | - Pratap Kalita
- Department of Pharmacy, Pratiksha Institute of Pharmaceutical Sciences, Guwahati 781026, Assam, India
| | - Manash Pratim Pathak
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati 781026, Assam, India
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Sahin M, Haymana C, Demirci I, Tasci I, Rıfat E, Unluturk U, Satman I, Demir T, Cakal E, Ata N, Ertugrul D, Salman S, Sahin I, Dagdelen S, Celik O, Caglayan M, Atmaca A, Sonmez A. The clinical outcomes of COVID-19 infection in patients with a history of thyroid cancer: A nationwide study. Clin Endocrinol (Oxf) 2021; 95:628-637. [PMID: 33872399 PMCID: PMC8251412 DOI: 10.1111/cen.14486] [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: 02/18/2021] [Revised: 04/03/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There are scarce published data in differentiated thyroid cancer patients about new coronavirus disease 2019 (COVID-19) disease outcomes and mortality. Here, we evaluated COVID-19 infection outcomes and mortality in thyroid cancer patients with COVID-19 infection. DESIGN AND METHODS We included a cohort of patients with thyroid cancer with PCR-confirmed COVID-19 disease from 11 March to 30 May 2020 from the Turkish Ministry of Health database in our nationwide, retrospective study. We compared the mortality and morbidity of COVID patients with or without thyroid cancer. Univariate and multivariate analyses were used to assess the independent factors for mortality, length of hospital stay and intensive care unit (ICU) admission and mechanical ventilation. We also analysed the effect of radioiodine treatment on severity and death rate of COVID-19 disease. RESULTS We evaluated 388 COVID-19 patients with thyroid cancer [median age: 54 years, interquartile range (IQR) 18 years, males: 23%] and age and gender-matched 388 COVID-19 patients without thyroid cancer. Patients with thyroid cancer had a similar mortality ratio compared with the non-cancer group. Among patients with thyroid cancer, age, presence of diabetes mellitus, asthma/COPD, heart failure, chronic kidney disease, prior coronary artery disease, RAS blocker usage and low lymphocyte count were associated with mortality. Radioactive iodine (RAI) treatment and cumulative radioactive iodine dosage did not negatively affect the severity and mortality of COVID-19 disease in our patient group. CONCLUSIONS Our study indicated that history of thyroid cancer did not have an increased risk of mortality or morbidity in COVID-19 disease. Besides, RAI therapy history and doses of radioactive iodine did not affect mortality or outcome.
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Affiliation(s)
- Mustafa Sahin
- Department of Endocrinology and MetabolismAnkara UniversityAnkaraTurkey
| | - Cem Haymana
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesGulhane Training and Research HospitalAnkaraTurkey
| | - Ibrahim Demirci
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesGulhane Training and Research HospitalAnkaraTurkey
| | - Ilker Tasci
- Department of Internal MedicineGulhane Faculty of Medicine and Gulhane Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
| | - Emral Rıfat
- Department of Endocrinology and MetabolismAnkara UniversityAnkaraTurkey
| | - Ugur Unluturk
- Department of Endocrinology and MetabolismFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Ilhan Satman
- Department of Endocrinology and MetabolismFaculty of MedicineIstanbul UniversityIstanbulTurkey
- Institute of Public Health and Chronic DiseasesThe Health Institutes of TurkeyIstanbulTurkey
| | - Tevfik Demir
- Department of Endocrinology and MetabolismFaculty of MedicineDokuz Eylul UniversityAnkaraTurkey
| | - Erman Cakal
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesDiskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
| | - Naim Ata
- Department of Strategy DevelopmentMinistry of HealthAnkaraTurkey
| | - Derun Ertugrul
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesKecioren Training and Research HospitalAnkaraTurkey
| | - Serpil Salman
- Department of Endocrinology and MetabolismMedica ClinicIstanbulTurkey
| | - Ibrahim Sahin
- Department of Endocrinology and MetabolismFaculty of MedicineInonu UniversityMalatyaTurkey
| | - Selcuk Dagdelen
- Department of Endocrinology and MetabolismFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Osman Celik
- Ministry of HealthPublic Hospitals General DirectorateRepublic of TurkeyAnkaraTurkey
| | | | - Aysegul Atmaca
- Department of Endocrinology and MetabolismFaculty of MedicineOndokuz Mayis UniversitySamsunTurkey
| | - Alper Sonmez
- Department of Endocrinology and MetabolismGulhane Faculty of Medicine and Gulhane Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
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Vahedian-Azimi A, Mohammadi SM, Banach M, Beni FH, Guest PC, Al-Rasadi K, Jamialahmadi T, Sahebkar A. Improved COVID-19 Outcomes following Statin Therapy: An Updated Systematic Review and Meta-analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1901772. [PMID: 34568488 PMCID: PMC8463212 DOI: 10.1155/2021/1901772] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although vaccine rollout for COVID-19 has been effective in some countries, there is still an urgent need to reduce disease transmission and severity. We recently carried out a meta-analysis and found that pre- and in-hospital use of statins may improve COVID-19 mortality outcomes. Here, we provide an updated meta-analysis in an attempt to validate these results and increase the statistical power of these potentially important findings. METHODS The meta-analysis investigated the effect of observational and randomized clinical studies on intensive care unit (ICU) admission, tracheal intubation, and death outcomes in COVID-19 cases involving statin treatment, by searching the scientific literature up to April 23, 2021. Statistical analysis and random effect modeling were performed to assess the combined effects of the updated and previous findings on the outcome measures. Findings. The updated literature search led to the identification of 23 additional studies on statin use in COVID-19 patients. Analysis of the combined studies (n = 47; 3,238,508 subjects) showed no significant effect of statin treatment on ICU admission and all-cause mortality but a significant reduction in tracheal intubation (OR = 0.73, 95% CI: 0.54-0.99, p = 0.04, n = 10 studies). The further analysis showed that death outcomes were significantly reduced in the patients who received statins during hospitalization (OR = 0.54, 95% CI: 0.50-0.58, p < 0.001, n = 7 studies), with no such effect of statin therapy before hospital admission (OR = 1.06, 95% CI = 0.82-1.37, p = 0.670, n = 29 studies). CONCLUSION Taken together, this updated meta-analysis extends and confirms the findings of our previous study, suggesting that in-hospital statin use leads to significant reduction of all-cause mortality in COVID-19 cases. Considering these results, statin therapy during hospitalization, while indicated, should be recommended.
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Affiliation(s)
- Amir Vahedian-Azimi
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyede Momeneh Mohammadi
- Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz (MUL), Poland
- Cardiovascular Research Centre, University of Zielona-Gora, Zielona-Gora, Poland
| | - Farshad Heidari Beni
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Paul C. Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - 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
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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18
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Ando W, Horii T, Uematsu T, Hanaki H, Atsuda K, Otori K. Impact of overlapping risks of type 2 diabetes and obesity on coronavirus disease severity in the United States. Sci Rep 2021; 11:17968. [PMID: 34504112 PMCID: PMC8429758 DOI: 10.1038/s41598-021-96720-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/12/2021] [Indexed: 12/30/2022] Open
Abstract
The impact of overlapping risk factors on coronavirus disease (COVID-19) severity is unclear. To evaluate the impact of type 2 diabetes (T2D) and obesity on COVID-19 severity, we conducted a cohort study with 28,095 anonymized COVID-19 patients using data from the COVID-19 Research Database from January 1, 2020 to November 30, 2020. The mean age was 50.8 ± 17.5 years, and 11,802 (42%) patients were male. Data on age, race, sex, T2D complications, antidiabetic medication prescription, and body mass index ≥ 30 kg/m2 (obesity) were analysed using Cox proportional hazard models, with hospitalization risk and critical care within 30 days of COVID-19 diagnosis as the main outcomes. The risk scores were 0–4 for age ≥ 65 years, male sex, T2D, and obesity. Among the participants, 11,294 (61.9%) had obesity, and 4445 (15.8%) had T2D. T2D, obesity, and male sex were significantly associated with COVID-19 hospitalization risk. Regarding hospitalization risk scores, compared with those for hospitalization risk score 0 and critical care risk score 0, hazard ratios [95% confidence intervals] were 19.034 [10.470–34.600] and 55.803 [12.761–244.015] (P < 0.001) (P < 0.001), respectively, for risk score 4. Complications from diabetes and obesity increased hospitalization and critical care risks for COVID-19 patients.
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Affiliation(s)
- Wataru Ando
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan.
| | - Takeshi Horii
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara City, Kanagawa, 252-0375, Japan
| | - Takayuki Uematsu
- Biomedical Laboratory, Division of Biomedical Research, Kitasato University Medical Center, 6-100 Arai, Kitamoto City, Saitama, 364-8501, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8641, Japan
| | - Koichiro Atsuda
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara City, Kanagawa, 252-0375, Japan
| | - Katsuya Otori
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
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19
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Gregg EW, Sophiea MK, Weldegiorgis M. Diabetes and COVID-19: Population Impact 18 Months Into the Pandemic. Diabetes Care 2021; 44:1916-1923. [PMID: 34244333 DOI: 10.2337/dci21-0001] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 02/03/2023]
Abstract
Eighteen months into the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) pandemic, epidemiologic studies indicate that diabetes is a central contributor to severe COVID-19 morbidity, and, conversely, COVID-19 has had a devastating effect on the population with diabetes. In this literature synthesis, we summarize the relationship of diabetes to COVID-19-related morbidity and mortality, discuss the predictors of severe adverse outcomes and implications of the overall pandemic, and critique the current status of and identify needs for epidemiologic studies for the next phase of the pandemic. Case series show that ∼30-40% of people with COVID-19-related hospitalization, severe morbidity requiring intensive care, and/or death have type 2 or type 1 diabetes. Among hospitalized individuals with diabetes, ∼21-43% required intensive care and case fatality is ∼25%. Risk of severe morbidity and mortality is 100-250% higher among people with diabetes than those without, even after adjustment for sociodemographic factors and comorbid conditions. Impact on the general population with diabetes has been similarly dire, as overall mortality rates were 50% higher than historical trends, a net increase more than twice that of the general population. Of the excess deaths, ∼75-80% are not officially attributed to COVID-19, which raises unanswered questions about missed attribution or collateral impact. Many predictors of poor outcomes have been identified, particularly comorbid conditions (chronic kidney disease, coronary heart disease, and heart failure), concurrent obesity, and acute and chronic poor HbA1c control, that point to the potential to reduce severe morbidity and mortality in its next stages. However, response to the continuing pandemic will benefit from population-wide studies with broader examination of the risks of exposure, infection, and hospitalization, for which few data currently exist. The indirect impact of the pandemic's effects on health services, health behaviors, disease management, care, control, and complications has not been well quantified; determining this impact will be essential to lessen the future impact. Expanding epidemiologic studies of the relationship of diabetes to COVID-19 beyond few high-income countries will also be essential to limit the burden in low- and middle-income countries where 80% of individuals with diabetes reside and where the COVID-19 pandemic has been so damaging.
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Affiliation(s)
- Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.
| | - Marisa K Sophiea
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
| | - Misghina Weldegiorgis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
- The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
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20
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Ulivieri FM, Banfi G, Camozzi V, Colao A, Formenti AM, Frara S, Lombardi G, Napoli N, Giustina A. Vitamin D in the Covid-19 era: a review with recommendations from a G.I.O.S.E.G. expert panel. Endocrine 2021; 72:597-603. [PMID: 33999367 PMCID: PMC8127472 DOI: 10.1007/s12020-021-02749-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/03/2021] [Indexed: 02/06/2023]
Abstract
Vitamin D (VITD) is a key hormone for bone health and has relevant extra-skeletal effects that might play a role in the prevention and treatment of COronaVIrus Disease 19 (COVID-19). Literature regarding this scenario is voluminous but controversial. Glucocorticoid Induced Osteoporosis Skeletal Endocrinology Group (G.I.O.S.E.G) has been present in the scientific debate about the use of VITD and has regularly interfaced national regulatory agencies to ensure appropriateness of its employment. Given the current pandemic and the questions on COVID-19 and VITD, G.I.O.S.E.G. appointed an expert panel to advise how to consider this issue best. The results of these deliberations are reported in the current recommendation paper.
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Affiliation(s)
- Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences (IEMS), San Raffaele Vita-Salute University, IRCCS San Raffaele Hospital, Via Olgettina 20, Milan, Italy.
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi, 4, Milan, Italy
- San Raffaele Vita-Salute University, Via Olgettina 20, Milan, Italy
| | - Valentina Camozzi
- Endocrinology Unit, Department of Internal Medicine (DIMED), Padua Hospital-University, Via Nicolò Giustiniani, 2, Padua, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University Federico II of Naples, Corso Umberto I, 40, Naples, Italy
| | - Anna Maria Formenti
- Institute of Endocrine and Metabolic Sciences (IEMS), San Raffaele Vita-Salute University, IRCCS San Raffaele Hospital, Via Olgettina 20, Milan, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences (IEMS), San Raffaele Vita-Salute University, IRCCS San Raffaele Hospital, Via Olgettina 20, Milan, Italy
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, Milan, Italy
- Department of Athletics Strength and Conditioning, Poznań University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznań, Poland
| | - Nicola Napoli
- Endocrinology and Metabolic Diseases, Campus Bio Medico University of Rome, Via Álvaro del Portillo, 200, Rome, Italy
| | - Andrea Giustina
- Institute of Endocrine and Metabolic Sciences (IEMS), San Raffaele Vita-Salute University, IRCCS San Raffaele Hospital, Via Olgettina 20, Milan, Italy
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21
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Flores-Silva FD, García-Grimshaw M, Valdés-Ferrer SI, Vigueras-Hernández AP, Domínguez-Moreno R, Tristán-Samaniego DP, Michel-Chávez A, González-Duarte A, Vega-Boada FA, Reyes-Melo I, Jiménez-Ruiz A, Chávez-Martínez OA, Rebolledo-García D, Marché-Fernández OA, Sánchez-Torres S, García-Ramos G, Cantú-Brito C, Chiquete E. Neurologic manifestations in hospitalized patients with COVID-19 in Mexico City. PLoS One 2021; 16:e0247433. [PMID: 33831042 PMCID: PMC8031187 DOI: 10.1371/journal.pone.0247433] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/05/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is a systemic entity that frequently implies neurologic features at presentation and complications during the disease course. We aimed to describe the characteristics and predictors for developing in-hospital neurologic manifestations in a large cohort of hospitalized patients with COVID-19 in Mexico City. METHODS We analyzed records from consecutive adult patients hospitalized from March 15 to June 30, 2020, with moderate to severe COVID-19 confirmed by reverse transcription real-time polymerase chain reaction (rtRT-PCR) for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurologic syndromes were actively searched by a standardized structured questionnaire and physical examination, confirmed by neuroimaging, neurophysiology of laboratory analyses, as applicable. RESULTS We studied 1,072 cases (65% men, mean age 53.2±13 years), 71 patients had pre-existing neurologic diseases (diabetic neuropathy: 17, epilepsy: 15, history of ischemic stroke: eight, migraine: six, multiple sclerosis: one, Parkinson disease: one), and 163 (15.2%) developed a new neurologic complication. Headache (41.7%), myalgia (38.5%), dysgeusia (8%), and anosmia (7%) were the most common neurologic symptoms at hospital presentation. Delirium (13.1%), objective limb weakness (5.1%), and delayed recovery of mental status after sedation withdrawal (2.5%), were the most common new neurologic syndromes. Age, headache at presentation, preexisting neurologic disease, invasive mechanical ventilation, and neutrophil/lymphocyte ratio ≥9 were independent predictors of new in-hospital neurologic complications. CONCLUSIONS Even after excluding initial clinical features and pre-existing comorbidities, new neurologic complications in hospitalized patients with COVID-19 are frequent and can be predicted from clinical information at hospital admission.
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Affiliation(s)
- Fernando Daniel Flores-Silva
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Miguel García-Grimshaw
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sergio Iván Valdés-Ferrer
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Center for Biomedical Science, Feinstein Institute for Medical Research, Manhasset, NY, United States of America
| | - Alma Poema Vigueras-Hernández
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rogelio Domínguez-Moreno
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Anaclara Michel-Chávez
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alejandra González-Duarte
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Felipe A. Vega-Boada
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Isael Reyes-Melo
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Amado Jiménez-Ruiz
- Stroke, Dementia & Heart Disease Laboratory, Western University, London, ON, Canada
| | - Oswaldo Alan Chávez-Martínez
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Daniel Rebolledo-García
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Osvaldo Alexis Marché-Fernández
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Samantha Sánchez-Torres
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Guillermo García-Ramos
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos Cantú-Brito
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Erwin Chiquete
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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22
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Satman I, Demirci I, Haymana C, Tasci I, Salman S, Ata N, Dagdelen S, Sahin I, Emral R, Cakal E, Atmaca A, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Arga KY, Caglayan M, Sonmez A. Unexpectedly lower mortality rates in COVID-19 patients with and without type 2 diabetes in Istanbul. Diabetes Res Clin Pract 2021; 174:108753. [PMID: 33741352 PMCID: PMC7963521 DOI: 10.1016/j.diabres.2021.108753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) is a risk factor for severe COVID-19. Our aim was to compare the clinical outcomes of patients with and without T2DM during the first hit of COVID-19 in Istanbul. METHODS A retrospective population-based study was conducted including all consecutive adult symptomatic COVID-19 cases. Patients were confirmed with rt-PCR; treated and monitored in accordance with standard protocols. The primary endpoints were hospitalization and 30-day mortality. RESULTS Of the 93,571 patients, 22.6% had T2DM, with older age and higher BMI. Propensity Score matched evaluation resulted in significantly higher rates of hospitalization (1.5-fold), 30-day mortality (1.6-fold), and pneumonia (1.4-fold). They revealed more severe laboratory deviations, comorbidities, and frequent drug usage than the Non-DM group. In T2DM age, pneumonia, hypertension, obesity, and insulin-based therapies were associated with an increased likelihood of hospitalization; whereas age, male gender, lymphopenia, obesity, and insulin treatment were considerably associated with higher odds of death. CONCLUSIONS COVID-19 patients with T2DM had worse clinical outcomes with higher hospitalization and 30-day mortality rates than those without diabetes. Compared to most territories of the world, COVID-19 mortality was much lower in Istanbul, which may be associated with accessible healthcare provision and the younger structure of the population.
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Affiliation(s)
- Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey; The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey.
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey.
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey.
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey.
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey.
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey.
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Kazim Yalcin Arga
- The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey; Marmara University, Faculty of Engineering, Department of Bioengineering, Istanbul, Turkey.
| | | | - Alper Sonmez
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey; University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
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23
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Betti M, Bertolotti M, Ferrante D, Roveta A, Pelazza C, Giacchero F, Penpa S, Massarino C, Bolgeo T, Cassinari A, Mussa M, Chichino G, Maconi A. Baseline clinical characteristics and prognostic factors in hospitalized COVID-19 patients aged ≤ 65 years: A retrospective observational study. PLoS One 2021; 16:e0248829. [PMID: 33760885 PMCID: PMC7990225 DOI: 10.1371/journal.pone.0248829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Individual differences in susceptibility to SARS-CoV-2 infection, symptomatology and clinical manifestation of COVID-19 have thus far been observed but little is known about the prognostic factors of young patients. METHODS A retrospective observational study was conducted on 171 patients aged ≤ 65 years hospitalized in Alessandria's Hospital from 1st March to 30th April 2020 with laboratory confirmed COVID-19. Epidemiological data, symptoms at onset, clinical manifestations, Charlson Comorbidity Index, laboratory parameters, radiological findings and complications were considered. Patients were divided into two groups on the basis of COVID-19 severity. Multivariable logistic regression analysis was used to establish factors associated with the development of a moderate or severe disease. FINDINGS A total of 171 patients (89 with mild/moderate disease, 82 with severe/critical disease), of which 61% males and a mean age (± SD) of 53.6 (± 9.7) were included. The multivariable logistic model identified age (50-65 vs 18-49; OR = 3.23 CI95% 1.42-7.37), platelet count (per 100 units of increase OR = 0.61 CI95% 0.42-0.89), c-reactive protein (CPR) (per unit of increase OR = 1.12 CI95% 1.06-1.20) as risk factors for severe or critical disease. The multivariable logistic model showed a good discriminating capacity with a C-index value of 0.76. INTERPRETATION Patients aged ≥ 50 years with low platelet count and high CRP are more likely to develop severe or critical illness. These findings might contribute to improved clinical management.
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Affiliation(s)
- Marta Betti
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
- * E-mail:
| | - Marinella Bertolotti
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics, Department of Translational Medicine, University of “Piemonte Orientale” and Cancer Epidemiology, CPO Piemonte, Novara, Italy
| | - Annalisa Roveta
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Carolina Pelazza
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Fabio Giacchero
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Serena Penpa
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Costanza Massarino
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Tatiana Bolgeo
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Antonella Cassinari
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Marco Mussa
- Infectious Diseases Unit, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Guido Chichino
- Infectious Diseases Unit, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Antonio Maconi
- Infrastruttura Ricerca Formazione Innovazione, Dipartimento Attività Integrate Ricerca Innovazione, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
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Vahedian-Azimi A, Mohammadi SM, Heidari Beni F, Banach M, Guest PC, Jamialahmadi T, Sahebkar A. Improved COVID-19 ICU admission and mortality outcomes following treatment with statins: a systematic review and meta-analysis. Arch Med Sci 2021; 17:579-595. [PMID: 34025827 PMCID: PMC8130467 DOI: 10.5114/aoms/132950] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Approximately 1% of the world population has now been infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). With cases still rising and vaccines just beginning to rollout, we are still several months away from seeing reductions in daily case numbers, hospitalisations, and mortality. Therefore, there is a still an urgent need to control the disease spread by repurposing existing therapeutics. Owing to antiviral, anti-inflammatory, immunomodulatory, and cardioprotective actions, statin therapy has been considered as a plausible approach to improve COVID-19 outcomes. MATERIAL AND METHODS We carried out a meta-analysis to investigate the effect of statins on 3 COVID-19 outcomes: intensive care unit (ICU) admission, tracheal intubation, and death. We systematically searched the PubMed, Web of Science, Scopus, and ProQuest databases using keywords related to our aims up to November 2, 2020. All published observational studies and randomised clinical trials on COVID-19 and statins were retrieved. Statistical analysis with random effects modelling was performed using STATA16 software. RESULTS The final selected studies (n = 24 studies; 32,715 patients) showed significant reductions in ICU admission (OR = 0.78, 95% CI: 0.58-1.06; n = 10; I 2 = 58.5%) and death (OR = 0.70, 95% CI: 0.55-0.88; n = 21; I 2 = 82.5%) outcomes, with no significant effect on tracheal intubation (OR = 0.79; 95% CI: 0.57-1.11; n = 7; I 2= 89.0%). Furthermore, subgroup analysis suggested that death was reduced further by in-hospital application of stains (OR = 0.40, 95% CI: 0.22-0.73, n = 3; I 2 = 82.5%), compared with pre-hospital use (OR = 0.77, 95% CI: 0.60-0.98, n = 18; I 2 = 81.8%). CONCLUSIONS These findings call attention to the need for systematic clinical studies to assess both pre- and in-hospital use of statins as a potential means of reducing COVID-19 disease severity, particularly in terms of reduction of ICU admission and total mortality reduction.
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Affiliation(s)
- Amir Vahedian-Azimi
- Trauma Research Centre, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyede Momeneh Mohammadi
- Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Farshad Heidari Beni
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Paul C. Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Centre, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Biomedical Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Yuvanc E, Tuglu D, Ozan T, Kisa U, Balci M, Batislam E, Yilmaz E. Evaluation of pheniramine maleate and zofenopril in reducing renal damage induced by unilateral ureter obstruction. An experimental study. Arch Med Sci 2021; 17:812-817. [PMID: 34025852 PMCID: PMC8130462 DOI: 10.5114/aoms.2019.88320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/14/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Obstruction of the ureter may occur due to congenital, iatrogenic or other reasons. This can cause hydronephrosis in the early stage and can lead to cellular inflammation, necrosis and atrophy in the kidney tissue. The aim of this paper is to evaluate the protective effect of pheniramine maleate (PM) and zofenopril on renal damage caused by hydronephrosis due to unilateral partial ureter obstruction. MATERIAL AND METHODS Twenty-four female Sprague Dawley rats were divided into 4 groups. Group 1: sham group, group 2: partial unilateral ureteral obstruction (PUUO) group, group 3: PUUO + PM group, group 4: PUUO + zofenopril group. Paraoxonase (PON), total antioxidant status (TAS) and total oxidant status (TOS) of tissue and blood samples were measured and calculated. Tissue samples were evaluated histopathologically. RESULTS An increase in tissue TAS and a decrease in tissue TOS and OSI levels were detected in groups 3 and 4 compared to group 2 (both: p < 0.01). Tissue PON levels showed an increase in groups 3 and 4 compared to groups 1 and 2 (both: p < 0.01). Histopathological evaluation showed a decrease in interstitial inflammation and congestion in groups 3 and 4 compared to the control group (p < 0.001). The decrease was observed to be more significant in group 4 compared to group 3 (p < 0.01). CONCLUSIONS In our experimental study, we observed that PM and zofenopril reduce the oxidation and tissue damage caused by unilateral partial obstruction.
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Affiliation(s)
- Ercan Yuvanc
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Devrim Tuglu
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Tunc Ozan
- Department of Urology, Firat University School of Medicine, Elazig, Turkey
| | - Ucler Kisa
- Department of Biochemistry, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Mahi Balci
- Department of Pathology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Ertan Batislam
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
| | - Erdal Yilmaz
- Department of Urology, Kirikkale University School of Medicine, Kirikkale, Turkey
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