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Saito M, Uchino H, Iwata Y, Fuchigami A, Sato G, Yoshikawa F, Miyagi M, Miyazaki T, Urita Y, Aoki K, Ishii Y, Tateda K, Hirose T. Glucose Tolerance and the Risk Factors for Transmission in Japanese SARS-CoV-2/WA-1/2020 Epicenter: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:2547-2554. [PMID: 38915899 PMCID: PMC11195674 DOI: 10.2147/dmso.s450230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
Purpose The severe pathogenic ancient-type COVID-19, SARS-CoV-2/WA-1/2020 was the predominant gene variant in early 2020 in Japan, however, its transmissibility was uncertain. The period before the public commenced using any personal protective equipment (PPE) was evaluating to describe the transmissibility of the SARS-CoV-2/WA-1/2020. We analyzed the secondary attack rate (SAR) among close contacts and the risk factor for SAR. Methods This retrospective cohort study included a total of 539 patients who were anticipated for the SARS-CoV-2/WA-1/2020 infection at Toho University Medical Center Omori Hospital from February to May 2020. We selected 54 patients with 1) exclude other pathogens infection, 2) include "Three Cs" condition: crowded places between distance< 6 feet, closed spaces indoor and close contact settings involving contact >15min with a person tested positive for SARS-CoV-2/WA-1/2020 without PPE. We evaluated alternative infection risks: the body mass index (BMI) and diabetes (DM) status (non-DM, pre-DM, and DM) as demographic determinants of transmissibility and infectivity of SARS-CoV2/WA-1/2020 cases during the incubation period. Results The calculated SAR was 79.3%. BMI was significantly associated with the PCR positivity rate, which was significant in the univariate (CI 95%, 1.02-1.51; P = 0.03) and multivariate (CI 95%, 1.02-1.60; P = 0.03) analyses. Comparing the different BMI groups, the highest BMI group (25.5-35.8 kg/m2) had an elevated risk of SAR compared to the lowest BMI group (14.0-22.8 kg/m2), with an odds ratio of 1.41 (95% CI, 1.02-1.59; P = 0.03). There were no significant differences in the risk of SAR among different DM statuses. Conclusion The transmissibility of SARS-CoV2/WA-1/2020 was high (79.3%) among household members without PPE who had "Three Cs" exposure. Although pre-DM and established DM did not confer a risk for transmissibility, higher BMI was associated with an increased risk of SAR. Trial Registration UMIN Clinical Trials Registry, UMIN0000 50905.
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Affiliation(s)
- Manabu Saito
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Hiroshi Uchino
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Yoko Iwata
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Ayako Fuchigami
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Genki Sato
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Fukumi Yoshikawa
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Masahiko Miyagi
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Taito Miyazaki
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - Yoshihisa Urita
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Takahisa Hirose
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
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Murvai GF, Ghitea TC, Cavalu S. Comparing Metabolic Preconditioning and Diabetes As Risk Factors in Knee Arthroplasty Complications. Cureus 2024; 16:e56634. [PMID: 38646213 PMCID: PMC11032089 DOI: 10.7759/cureus.56634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Advanced osteoarthritis of the knee joint severely affects the patient's mobility, compounded by pre-existing comorbidities such as metabolic preconditioning (such as obesity, dyslipidemia, hyperuricemia, and insulin resistance syndrome) and both type I and type II diabetes. The success of total knee arthroplasty is influenced by knowledge and management of risk factors. The present study aims to evaluate differences in the evolution of risk factors such as obesity, injuries, and sedentary lifestyle, distinguishing those with metabolic preconditions and diabetes. The objectives of our study include (1) investigating the prevalence of obesity among patients, highlighting their proportion in the five categories of body weight; (2) analyzing statistically significant differences between research groups in terms of weight status and physical activity; (3) evaluating postoperative evolution based on the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and without NSAIDs (N-NSAIDs), with an emphasis on overweight patients and those with diabetes; and (4) examining changes in metabolic preconditioning and the incidence of postoperative injury depending on the administration of anti-inflammatory drugs. MATERIALS AND METHODS A cohort involving 730 patients diagnosed with gonarthrosis was divided into two groups according to the administration of anti-inflammatory drugs in the first seven postoperative days: N-NSAIDs group (394 patients, 55.3%) and respectively NSAIDs group (319 patients, 44.7%). The prospective, observational study was conducted in terms of risk factors and complications that occurred upon treatment administration in relation to each type of intervention and implant used. The outcomes were assessed in terms of the influence on quality of life, the data being collected and interpreted for the entire cohort, and for each study year individually. RESULTS The results indicate that almost 69% of them were overweight, while only 31% had a normal weight. Significant differences in weight status were observed between research groups, highlighting the association between obesity and metabolic preconditions or diabetes. Physical activity was absent in a significant proportion, having a notable impact on postoperative evolution, especially in the group without metabolic precondition. Administration of anti-inflammatory drugs influenced postoperative outcomes, with significant differences in overweight and diabetic patients. CONCLUSIONS The findings suggest the need to manage body weight, promote physical activity, and personalize postoperative treatments, given the complex interactions between obesity, metabolic preconditions, and the administration of NSAIDs.
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Affiliation(s)
- Gelu F Murvai
- Surgery Department, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | | | - Simona Cavalu
- Therapeutics Department, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
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Honchar O, Ashcheulova T. Short-term echocardiographic follow-up after hospitalization for COVID-19: a focus on early post-acute changes. Front Cardiovasc Med 2023; 10:1250656. [PMID: 38075959 PMCID: PMC10703357 DOI: 10.3389/fcvm.2023.1250656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/06/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Impaired physical functional status is one of the typical long-term sequelae of COVID-19 infection that significantly affects the quality of life and work capacity. Minor changes in cardiac structure and function that are unable to cause the manifestation of overt heart failure may remain undetected in COVID-19 convalescents, at the same time potentially contributing to the persistence of symptoms and development of long COVID syndrome. PURPOSE To study the typical features and short-term dynamics of cardiac remodeling and possible signs of cardiac dysfunction following hospitalization for COVID-19. METHODS This is a combined cross-sectional and longitudinal cohort study in which 176 hospitalized patients (93 female and 83 male, mean age 53.4 ± 13.6 years) with COVID-19 infection underwent comprehensive transthoracic echocardiography pre-discharge (22.6 ± 7.1 days from the onset of symptoms) with repeated evaluation after 1 month. The control group included 88 age-, sex-, height- and weight-matched healthy individuals, with a subset of those (n = 53) matched to the subset of non-hypertensive study participants (n = 106). RESULTS Concentric left ventricular geometry was revealed in 59% of participants, including 43% of non-hypertensive subjects; predominantly Grade I diastolic dysfunction was found in 35 and 25% of patients, respectively. Other findings were naturally following from described phenotype of the left venticle and included a mild increase in the absolute and relative wall thickness (0.45 ± 0.07 vs. 0.39 ± 0.04, p < 0.001), worsening of diastolic indices (e' velocity 9.2 ± 2.2 vs. 11.3 ± 2.6 cm/s, p < 0.001, E/e' ratio 7.5 ± 1.8 vs. 6.8 ± 1.7, p = 0.002) and global longitudinal strain (17.5 ± 2.4 vs. 18.6 ± 2.2, p < 0.001). No significant improvement was found on re-evaluation at 1 month. CONCLUSIONS Hospitalized patients recovering from COVID-19 were characterized by a high prevalence of left ventricular concentric remodeling, predominantly Grade I diastolic dysfunction, and a mild decrease in the longitudinal systolic function. These changes were less frequent but still prevalent in the non-hypertensive subgroup and largely persisted throughout the 1-month follow-up.
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Ortiz-Guzmán JE, Mollà-Casanova S, Serra-Añó P, Arias-Mutis ÓJ, Calvo C, Bizy A, Alberola A, Chorro FJ, Zarzoso M. Short-Term Heart Rate Variability in Metabolic Syndrome: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6051. [PMID: 37762990 PMCID: PMC10532399 DOI: 10.3390/jcm12186051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Our aim was to determine the differences in short-term heart rate variability (HRV) between patients with metabolic syndrome (MS) and healthy controls. METHODS We searched electronic databases for primary works with short-term HRV recordings (≤30 min) that made comparisons between individuals with MS versus healthy controls. This systematic review and meta-analysis (MA) was performed according to PRISMA guidelines and registered at PROSPERO (CRD42022358975). RESULTS Twenty-eight articles were included in the qualitative synthesis and nineteen met the criteria for the MA. Patients with MS showed decreased SDNN (-0.36 [-0.44, -0.28], p < 0.001), rMSSD (-7.59 [-9.98, -5.19], p < 0.001), HF (-0.36 [-0.51, -0.20], p < 0.00001) and LF (-0.24 [-0.38, -0.1], p = 0.001). In subsequent subanalyses, we found a decrease in SDNN (-0.99 (-1.45, -0.52], p < 0.001), rMSSD (-10.18 [-16.85, -3.52], p < 0.01) and HF (-1.04 [-1.97, -0.1] p < 0.05) in women. In men, only LF showed a significant lower value (-0.26 [-0.5, -0.02], p < 0.05). We could not perform MA for non-linear variables. CONCLUSIONS Patients with MS showed changes in time-domain analyses, with lower values in SDNN and rMSSD. Regarding frequency-domain analyses, MS patients showed a decrease in HF and LF When sex was used as a grouping variable, the MA was only possible in one of both sexes (men or women) in rMSSD and LF/HF. Lastly, when data for both men and women were available, subanalyses showed a different behavior compared to mixed analyses for SDNN, HF and LF, which might point towards a different impact of MS in men and women.
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Affiliation(s)
- Johan E. Ortiz-Guzmán
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Sara Mollà-Casanova
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Pilar Serra-Añó
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- UBIC Research Group, Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain
| | - Óscar J. Arias-Mutis
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
| | - Conrado Calvo
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
- CSIC-UPV, Instrumentation for Molecular Imaging Technologies Research Institute (I3M), Universitat Politècnica de València, 46022 Valencia, Spain
| | - Alexandra Bizy
- CEU Cardenal Herrera, Department of Biomedical Sciences, Street Lluís Vives 1, 46115 Valencia, Spain; (Ó.J.A.-M.); (A.B.)
| | - Antonio Alberola
- Department of Physiology, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain; (J.E.O.-G.); (C.C.); (A.A.)
| | - Francisco J. Chorro
- Health Research Institute—Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA) Valencia, Street Menéndez y Pelayo 4, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
- Department of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Street Gascó Oliag 5, 46010 Valencia, Spain; (S.M.-C.); (P.S.-A.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV) Madrid, Av. Monforte de Lemos, 3–5, Pavilion 11, Floor 0, 28029 Madrid, Spain
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Connections between Diabetes Mellitus and Metabolic Syndrome and the Outcome of Cardiac Dysfunctions Diagnosed during the Recovery from COVID-19 in Patients without a Previous History of Cardiovascular Diseases. BIOLOGY 2023; 12:biology12030370. [PMID: 36979062 PMCID: PMC10044929 DOI: 10.3390/biology12030370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
(1) Background: Throughout the COVID-19 pandemic, it became obvious that individuals suffering with obesity, diabetes mellitus (T2DM), and metabolic syndrome (MS) frequently developed persisting cardiovascular complications, which were partially able to explain the onset of the long-COVID-19 syndrome. (2) Methods: Our aim was to document, by transthoracic echocardiography (TTE), the presence of cardiac alterations in 112 patients suffering from post-acute COVID-19 syndrome and T2DM, MS, and/or obesity, in comparison to 91 individuals without metabolic dysfunctions (MD); (3) Results: in patients with MD, TTE borderline/abnormal left (LVF) and/or right ventricular function (RVF), alongside diastolic dysfunction (DD), were more frequently evidenced, when compared to controls (p ˂ 0.001). Statistically significant associations between TTE parameters and the number of factors defining MS, the triglyceride-glucose (TyG) index, the severity of the SARS-CoV-2 infection, and the number of persisting symptoms (p ˂ 0.001) were noted. Significant predictive values for the initial C-reactive protein and TyG index levels, both for the initial and the 6-month follow-up levels of these TTE abnormalities (p ˂ 0.001), were highlighted by means of a multivariate regression analysis. (4) Conclusions: in diabetic patients with MS and/or obesity with comorbid post-acute COVID-19 syndrome, a comprehensive TTE delineates various cardiovascular alterations, when compared with controls. After 6 months, LVF and RVF appeared to normalize, however, the DD—although somewhat improved—did persist in approximately a quarter of patients with MD, possibly due to chronic myocardial changes.
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Correspondence between Aortic and Arterial Stiffness, and Diastolic Dysfunction in Apparently Healthy Female Patients with Post-Acute COVID-19 Syndrome. Biomedicines 2023; 11:biomedicines11020492. [PMID: 36831027 PMCID: PMC9953636 DOI: 10.3390/biomedicines11020492] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
(1) Background: Abnormally increased arterial and aortic stiffness (AS and AoS), which are often associated with diastolic dysfunction (DD), represent common alterations in COVID-19. In this study, we aimed to assess, by transthoracic echocardiography (TTE) and pulse-wave velocity (PWV), the frequency of these dysfunctions in patients with post-acute COVID-19 syndrome and to highlight potential correlations between their severity and multiple clinical and laboratory parameters. (2) Methods: In total, 121 women were included in our study, all of whom were younger than 55 and had been diagnosed with post-COVID-19 syndrome. Of those women, 67 also had metabolic syndrome (MS) (group A), whereas the other 54 did not (group B); 40 age-matched healthy subjects were used as controls (group C). (3) Results: Patients in group A had worse values of indexes characterizing AS and AoS and had more frequent DD compared to those from group B and group C (p < 0.0001). The statistical analysis evidenced significant associations between these indexes and the time that had elapsed since COVID-19 diagnosis, the factors that characterize the severity of the acute disease and those that specify MS. Multivariate regression analysis identified the following as the main independent predictors for DD: values of the AoS index, the C-reactive protein, and the triglyceride-glucose index. (4) Conclusions: Altered AS, AoS, and DD are common in patients with post-COVID-19 syndrome, especially with concurrent MS, and these parameters are apparently associated not only with the severity and time elapsed since COVID-19 diagnosis but also with MS.
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Ogungbe O, Gilotra NA, Davidson PM, Farley JE, Dennison Himmelfarb CR, Post WS, Commodore-Mensah Y. Cardiac postacute sequelae symptoms of SARS-CoV-2 in community-dwelling adults: cross-sectional study. Open Heart 2022. [PMCID: PMC9445235 DOI: 10.1136/openhrt-2022-002084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To examine risk factors for cardiac-related postacute sequelae of SARS-CoV-2 infection (PASC) in community-dwelling adults after acute COVID-19 infection. Methods We performed a cross-sectional analysis among adults who tested positive for COVID-19. Outcomes were self-reported cardiac-related PASC. We conducted stepwise multivariable logistic regression to assess association between the risk factors (existing cardiovascular disease (CVD), pre-existing conditions, days since positive test, COVID-19 hospitalisation, age, sex, education, income) and cardiac-related PASC. Results In a sample of 442 persons, mean (SD) age was 45.4 (16.2) years, 71% were women, 13% were black, 46% had pre-existing conditions, 23% had cardiovascular (CV) risk factors and 4% had CVD. Prevalence of cardiac PASC was 43% and newly diagnosed cardiac conditions were 27%. The odds for cardiac-related PASC were higher among persons with underlying pre-existing conditions (adjusted OR (aOR): 2.00, 95% CI: 1.28 to 3.10) and among those who were hospitalised (aOR: 3.03, 95% CI: 1.58 to 5.83). Conclusions More than a third of persons with COVID-19 reported cardiac-related PASC symptoms. Underlying CVD, pre-existing diseases, age and COVID-19 hospitalisation are possible risk factors for cardiac-related PASC symptoms. COVID-19 may exacerbate CV risk factors and increase risk of complications.
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Affiliation(s)
| | - Nisha A Gilotra
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Jason E Farley
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- The Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Cheryl R Dennison Himmelfarb
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wendy S Post
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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