Increased Metabolic Burden Among Blacks: A Putative Mechanism for Disparate COVID-19 Outcomes

Characteristics of Older Adults with Alzheimer's Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

We aim to investigate the relationships between the population characteristics of patients with Alzheimer's Disease (AD) and their Healthcare Utilization (HU) during the COVID-19 pandemic. Electronic health records (EHRs) were utilized. The study sample comprised those with ICD-10 codes G30.0, G30.1, G30.8, and G30.9 between 1 January 2020 and 31 December 2021. Pearson's correlation and multiple regression were used. The analysis utilized 1537 patient records with an average age of 82.20 years (SD = 7.71); 62.3% were female. Patients had an average of 1.64 hospitalizations (SD = 1.18) with an average length of stay (ALOS) of 7.45 days (SD = 9.13). Discharge dispositions were primarily home (55.1%) and nursing facilities (32.4%). Among patients with multiple hospitalizations, a negative correlation was observed between age and both ALOS (r = -0.1264, p = 0.0030) and number of hospitalizations (r = -0.1499, p = 0.0004). Predictors of longer ALOS included male gender (p = 0.0227), divorced or widowed (p = 0.0056), and the use of Medicare Advantage and other private insurance (p = 0.0178). Male gender (p = 0.0050) and Black race (p = 0.0069) were associated with a higher hospitalization frequency. We recommend future studies including the co-morbidities of AD patients, larger samples, and longitudinal data.

Novel nutraceutical supplements with yeast β-glucan, prebiotics, minerals, and Silybum marianum (silymarin) ameliorate obesity-related metabolic and clinical parameters: A double-blind randomized trial

Purpose

It is known that obesity has a multifactorial etiology that involves genetic and environmental factors. The WHO estimates the worldwide prevalence of 1.9 billion overweight adults and more than 650 million people with obesity. These alarming data highlight the high and growing prevalence of obesity and represent a risk factor for the development and aggravation of other chronic diseases, such as nonalcoholic fatty liver disease (NAFLD) that is frequently considered the hepatic outcome of type 2 diabetes. The use of non-pharmacological therapies such as food supplements, nutraceuticals, and natural integrative therapies has grown as an alternative tool for obesity-related diseases compared to conventional medications. However, it is a still little explored research field and lacks scientific evidence of therapeutic effectiveness. Considering this, the aim is to evaluate whether a new nutraceutical supplement composition can improve and supply essential mineral nutrients, providing an improvement of obesity-related metabolic and endocrine parameters.

Methods

Sedentary volunteers (women and men) with body mass index (BMI) ≤34.9 kg/m2 were divided into two groups: Novel Nutraceutical Supplement_(S) (n = 30) and Novel Nutraceutical Supplement (n = 29), differing in the absence (S) or presence of silymarin, respectively. Volunteers were instructed to take two capsules in the morning and two capsules in the evening. No nutritional intervention was performed during the study period. The data (anthropometrics and anamneses) and harvest blood (biochemistry and hormonal exams) were collected at three different time points: baseline time [day 0 (T0)], day 90 (T90), and day 180 (T180) post-supplementation.

Results

In the anthropometric analysis, the waist circumference in middle abdomen (WC-mid) and waist circumference in iliac crest (WC-IC) were reduced. Also, the waist-to-height ratio (WHt R) and waist-to-hip ratio (WHR) seem to slightly decrease alongside the supplementation period with both nutraceutical supplements tested as well as transaminase enzyme ratio [aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR)], a known as a biomarker of NAFLD, and endocrine hormones cortisol and thyroid-stimulating hormone (TSH) at 90 and 180 days post-supplementation.

Conclusions

In a condition associated with sedentary and no nutritional intervention, the new nutraceutical supplement composition demonstrated the ability to be a strong and newfangled tool to improve important biomarkers associated with obesity and its comorbidities.

Sleepless in COVID-19: racial disparities during the pandemic as a consequence of structural inequity

STUDY OBJECTIVES

Insomnia has been on the rise during the 2019 coronavirus disease (COVID-19) pandemic, which may disproportionately affect racial minorities. This study characterized racial disparities in insomnia during the pandemic and evaluated mechanisms for such disparities.

METHODS

Participants included 196 adults (48 Black) from a 2016-2017 clinical trial of insomnia treatment who were reevaluated in April 2020. Race was evaluated as a predictor of change in insomnia, impact of COVID-19, and COVID-19 stress. Mediation models using the PRODCLIN method evaluated the extent to which: (1) COVID-19 impact accounted for Black-White disparities in change in insomnia, and (2) COVID-19 stress accounted for associations between discrimination and change in insomnia.

RESULTS

Increases in insomnia symptoms during COVID-19 were greater in Black compared to White participants, with 4.3 times the odds of severe insomnia (Insomnia Severity Index ≥ 22). Symptom severity was associated with pre-pandemic experiences of discrimination. Black participants were also disproportionately impacted by COVID-19, with twice the odds of irreparable loss of income/employment and four times the rate of COVID-19 diagnoses in their sociofamilial network compared to White participants. The disproportionate impact of COVID-19 accounted for 69.2% of the relationship between race and change in insomnia severity, and COVID-19 related stress accounted for 66.5% of the relationship between prior history of racial discrimination and change in insomnia severity.

CONCLUSIONS

Black-White disparities in insomnia severity during COVID-19 may be driven by structural inequities resulting in the disproportionate impact of COVID-19 on Black Americans. Results lend support for the minority stress model in the context of sleep health.

CLINICAL TRIAL REGISTRATION

Sleep to Prevent Evolving Affecting Disorders (SPREAD). NCT number: NCT02988375. https://clinicaltrials.gov/ct2/show/NCT02988375.

Engendering a Sense of Belonging to Support Student Well-Being during COVID-19: A Focus on Sustainable Development Goals 3 and 4

The COVID-19 pandemic has exposed a plethora of inequalities in South Africa. These inequalities have had a direct impact on the 2030 Agenda for Sustainable Development Goals (SDGs). SDG 3 (good health and well-being) and SDG 4 (quality education) were the focus of this article. This article investigated how students enrolled at a South African residential university perceived the impact of the COVID-19 pandemic on their well-being, their success in completing their studies and their future career prospects. A quantitative survey research design was followed. Data were collected by means of a questionnaire from 537 students in a South African university. Statistical Package for Social Sciences software version 27 was used to analyze the data. The results indicated direct influences on student well-being from concerns that arose from COVID-19 about future job concerns, degree completion, social support and belonging. The relationship between concerns about degree completion was moderated by a sense of belonging (social identification) but not by social support. The study has significant implications for how higher education institution governors and academics might consider reconceptualizing notions of student support, beyond the narrow, technical and basic curriculum support for degree completion, towards the affective and social as it relates to creating conditions for students to identify with and experience a profound sense of belonging.

Is Trikatu; an ayurvedic formulation effective for the management of flu-like illness? A narrative review

OBJECTIVES

The aim of this review is to summarise and appraise the findings of various studies on Trikatu.

CONTENT

COVID-19 or SARS-CoV-2 disease a pandemic principally contaminating the respiratory tract and bringing about Severe Acute Respiratory Syndrome is liable for significant mortality around the world. Far-fetched, there is no exact treatment accessible till today. Consequently, it is critical to discover the alternative methodology which can decrease the weight of illness. Trikatu powder recommended by authorities for the management of mild cases of COVID-19 is a conventional ayurvedic formulation containing three spices; Zingiber officinale, Piper nigrum, and Piper longum. A comprehensive search of the articles published since inception to 01/08/2020 on Trikatu was carried out. Major electronic medical databases such as Pub Med/MEDLINE and Cochrane Database of Systematic Reviews were used for the literature search.

SUMMARY

A total of 21 records were identified by electronic searches between since inception to 01/08/2020 of which 13 records were included for review. The reviewed articles highlight Trikatu as a safe, anti-inflammatory, and immune-modulatory property by suppression of the production of pro-inflammatory cytokines TNF-a, IL-1b, IL-6, IL-17, alteration in levels of circulating immune complexes, anti-dyslipidaemia agent by reduced triglycerides and LDL cholesterol and increased HDL cholesterol, enhancing bio-availability of co-drug by reducing the elimination half-life (t1/2β) and zero time intercept of the elimination phase.

OUTLOOK

The findings of this review seem to show Trikatu as a potential anti-inflammatory, anti-dyslipidaemia, and immune-modulatory ayurvedic formulation can be used for combating flu like illnesses and also in the management of COVID-19 as an adjuvant. However, rigorous double blind randomized controlled trials with larger sample size are warranted for better validation in such clinical conditions.

HIGHLIGHTS

– COVID-19 has affected the lives of millions worldwide and unfortunately no precise treatment available till today. – Trikatu an ayurvedic formulation suggested by various authorities in India. – Trikatu found to be a potential anti-inflammatory; anti-dyslipidaemia and immune-modulatory drug can be used for combating flu like illnesses.

Addressing psychological resilience during the coronavirus disease 2019 pandemic: a rapid review

PURPOSE OF REVIEW

The mental health toll on populations exposed to COVID-19 is alarming, and there is a need to address this with urgency. This current review provides insights on how individuals, communities, and specific populations, such as healthcare workers and patients are leveraging pre-COVID-19 and peri-COVID-19 factors to reinforce their psychological resilience during the global public health crisis.

RECENT FINDINGS

Examination of the extant literature indicated that populations around the world rely often on support from their loved-ones, closed significant others, outdoor and physical activities, and spirituality to cope with the COVID-19-related distress. Increased sense of meaning/purpose since the COVID-19 pandemic was also reported.

SUMMARY

A portion of publications provided intervention models to reinforce resilience among specific populations during the COVID-19 pandemic. Nevertheless, it is not convincing that some of these models can be applied universally. Additionally, it is important to note that in this category, translational data was scarce.