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Emamjomeh A, Mohammadifard N, Abbasi M, Askari M, Taheri M, Javanbakht S, Ahmadian M, Sayyah M, Mahmoudi S, Heidari K, Sarrafzadegan N. Association of obesity and the clinical course of hospitalised COVID-19 survivors. Clin Obes 2024; 14:e12663. [PMID: 38689477 DOI: 10.1111/cob.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 05/02/2024]
Abstract
Obesity is a risk factor for chronic inflammation and severe pulmonary infections. This study aimed to assess the association between obesity and the clinical courses of hospitalised COVID-19 survivors. This cross-sectional study used the Isfahan COVID Cohort (ICC) baseline data. The ICC is an ongoing, 5-year prospective, longitudinal cohort study conducted on hospitalised COVID-19 survivors in affiliated hospitals of the Medical University of Isfahan (MUI), Iran. Patients aged 19 and over throughout Isfahan County were recruited using a consecutive sampling method 1 month after discharge. Demographic and basic characteristics, symptoms and clinical features of these patients were collected and analysed. A total of 3843 hospitalised patients with COVID-19 were included in this study. Regarding the body mass index classification in the general obesity group, the patients with overweight and obesity had more extended hospitalisation and a higher frequency of low O2 saturation compared to the normal weight patients, and the highest frequency of low O2 saturation and more extended hospitalisation was observed in patients with obesity (5.9 ± 3.8 vs. 6.8 ± 5.4 vs. 7.1 ± 5.3, respectively; p = .001 and 59% vs. 64.5% vs. 65.5%; p < .001). Furthermore, individuals with abdominal obesity had a significantly longer duration of hospitalisation compared to the non-abdominal obesity group (6.3 ± 4.6 vs. 7.0 ± 5.3; p < .001). In the fully adjusted model, a significant association was observed between abdominal obesity and an increased occurrence of low oxygen saturation compared to general obesity (odds ratio: 1.25, 95% confidence interval: 1.03-1.44). Obesity was associated with more extended hospitalisation and hypoxia in patients with COVID-19. However, no significant relationship was found between obesity and other clinical courses.
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Affiliation(s)
- Ali Emamjomeh
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Abbasi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mozhde Askari
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Taheri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahel Javanbakht
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahshid Ahmadian
- Noncommunicable Control Department, Vice Chancellery of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maedeh Sayyah
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Mahmoudi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamal Heidari
- Department of Community Oral Health, School of Dentistry, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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de Paula Silva-Lalucci MP, Marques DCDS, Valdés-Badilla P, Andreato LV, Magnani Branco BH. Obesity as a Risk Factor for Complications and Mortality in Individuals with SARS-CoV-2: A Systematic Review. Nutrients 2024; 16:543. [PMID: 38398867 PMCID: PMC10892776 DOI: 10.3390/nu16040543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
This systematic review aimed to analyze the available studies that identified overweight and/or obesity as a risk factor for mortality, use of respiratory support, and changes in biochemical markers in adults hospitalized with SARS-CoV-2. The PubMed, Web of Science, and Scopus databases were searched using PRISMA guidelines until January 2024. The protocol was registered with PROSPERO (code: CRD42024501551). Of the 473 articles, only 8 met the inclusion criteria (e.g., adult individuals aged 18 or over diagnosed with COVID-19 individuals with overweight and/or obesity). In addition, the Downs and Black tool was used to assess the quality of the studies. The studies analyzed totaled 9782 adults hospitalized for COVID-19, indicating that overweight and obesity are present in more than half of adults. Diseases such as diabetes mellitus and hypertension are more prevalent in adults with obesity. The systematic review also highlighted that a higher incidence of respiratory support is related to a higher incidence of hospitalization in intensive care units and that adults with overweight and obesity have a higher risk of mortality from COVID-19. Biochemical markers such as procalcitinin, C-reactive protein, and interleukin-6 are associated with the severity of COVID-19 infection. This systematic review exposed overweight and/or obesity as a risk factor for worse COVID-19 disease, as well as for the need for intensive care, respiratory support, mortality, and changes in essential blood markers.
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Affiliation(s)
- Marielle Priscila de Paula Silva-Lalucci
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology, and Innovation, Maringá 87050-390, Paraná, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Paraná, Brazil
| | - Déborah Cristina de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology, and Innovation, Maringá 87050-390, Paraná, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Paraná, Brazil
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Leonardo Vidal Andreato
- Higher School of Health Sciences, State University of Amazonas, Manaus 69065-001, Amazonas, Brazil;
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology, and Innovation, Maringá 87050-390, Paraná, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Paraná, Brazil
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Ren J, Hao Y, Nan L, Wang Y, Yang H. Peripheral artery disease independently associated with significantly higher risk for COVID-19 mortality: Evidence based on adjusted effect estimates. Vascular 2023; 31:1262-1264. [PMID: 35739076 PMCID: PMC9234371 DOI: 10.1177/17085381221111226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/05/2022] [Accepted: 06/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the influence of peripheral artery disease (PAD) on the risk of mortality among coronavirus disease 2019 (COVID-19) patients based on adjusted effect estimates. METHODS Systematic searches were performed through electronic databases. A random-effect model was applied to calculate the pooled effect and corresponding 95% confidence interval (CI). Inconsistency index (I2) was used to evaluate the heterogeneity across studies. Sensitivity analysis, subgroup analysis, and Begg's test were all implemented. RESULTS On the basis of 16 eligible studies with 142,832 COVID-19 patients, the meta-analysis showed that PAD significantly increased the risk for mortality among COVID-19 patients (pooled effect = 1.29, 95% CI: 1.10-1.51). The significant association was also observed in the subgroup analysis stratified by hospitalized patients, mean age ≥ 60 years, Europe and North America. Sensitivity analysis verified the robustness of our findings. Begg's test (P = 0.15) showed there was no potential publication bias. CONCLUSIONS COVID-19 patients with PAD may have a greater risk of mortality. Clinicians and nursing staff are supposed to identify and monitor these high-risk patients in a timely manner and provide appropriate clinical treatment for them.
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Affiliation(s)
- Jiahao Ren
- Department of Epidemiology, School
of Public Health, Zhengzhou University, China
| | - Yuqing Hao
- International College of Zhengzhou
University, China
| | - Lan Nan
- Yusuf Hamied Department of
Chemistry, University of Cambridge, UK
| | - Yadong Wang
- Department of Toxicology, Henan Center for Disease Control and
Prevention, China
| | - Haiyan Yang
- Department of Epidemiology, School
of Public Health, Zhengzhou University, China
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Kubiliute I, Vitkauskaite M, Urboniene J, Svetikas L, Zablockiene B, Jancoriene L. Clinical characteristics and predictors for in-hospital mortality in adult COVID-19 patients: A retrospective single center cohort study in Vilnius, Lithuania. PLoS One 2023; 18:e0290656. [PMID: 37624796 PMCID: PMC10456157 DOI: 10.1371/journal.pone.0290656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The COVID-19 infection had spread worldwide causing many deaths. Mortality rates and patients' characteristics varied within and between countries, making it important to understand the peculiarities of different populations. The aim of this study was to identify the main predictors associated with in-hospital mortality due to COVID-19 in Vilnius, Lithuania. MATERIALS AND METHODS This was a retrospective observational cohort study conducted at Vilnius University Hospital Santaros Clinics, Lithuania. The study included SARS-CoV-2 positive patients aged over 18 years and hospitalized between March 2020 and May 2021. Depersonalized data were retrieved from electronic medical records. The predictive values of laboratory parameters were evaluated using ROC analysis. Multivariable binary logistic regression was performed to reveal predictors of in-hospital mortality due to COVID-19. RESULTS Among 2794 patients, 54.4% were male, the age median was 59 years (IQR 48-70), 47.4% had at least one comorbidity. The most common comorbidities were arterial hypertension (36.9%) and diabetes mellitus (13.7%). Overall, 12.7% of patients died. Multivariable regression revealed that age (OR 1.04, 95%CI 1.02-1.06), congestive heart failure (OR 3.06, 95%CI 1.96-4.77), obesity (OR 3.90, 95%CI 2.12-7.16), COPD (OR 2.92, 95%CI 1.12-7.60), previous stroke (OR 5.80, 95%CI 2.07-16.21), urea >7.01 mmol/l (OR 2.32, 95%CI 1.47-3.67), AST/ALT >1.49 (OR 1.54, 95%CI 1.08-2.21), LDH >452.5 U/l (OR 2.60, 95%CI 1.74-3.88), CRP >92.68 mg/l (OR 1.58, 95%CI 1.06-2.35), IL-6 >69.55 ng/l (OR 1.62, 95%CI 1.10-2.40), and troponin I >18.95 ng/l (OR 2.04, 95%CI 1.38-3.02), were associated with increased risk for in-hospital mortality in COVID-19 patients. CONCLUSIONS Age, congestive heart failure, obesity, COPD, prior stroke, and increased concentration of urea, LDH, CRP, IL-6, troponin I, ALT to AST ratio were identified to be the predictors for in-hospital mortality of COVID-19 patients.
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Affiliation(s)
- Ieva Kubiliute
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Jurgita Urboniene
- Center of Infectious Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | - Linas Svetikas
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Birute Zablockiene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Syrimi N, Sourri F, Giannakopoulou MC, Karamanis D, Pantousas A, Georgota P, Rokka E, Vladeni Z, Tsiantoula E, Soukara E, Lavda N, Gkaragkanis D, Zisaki A, Vakalidis P, Goula V, Loupou E, Palaiodimos L, Hatzigeorgiou D. Humoral and Cellular Response and Associated Variables Nine Months following BNT162b2 Vaccination in Healthcare Workers. J Clin Med 2023; 12:jcm12093172. [PMID: 37176612 PMCID: PMC10179201 DOI: 10.3390/jcm12093172] [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: 03/03/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
In this study, we aimed to illustrate the trajectory of humoral and cellular immunity nine months after primary vaccination with the BNT162b2 mRNA vaccine among 189 healthcare workers (HCWs). Additionally, we endeavored to identify correlations between immunity parameters and a number of common variables and comorbidities. A total of 189 healthcare workers (HCWs), vaccinated against COVID-19, were finally included in the study. All of the subjects had received two doses of the BNT162b2 vaccine; had undergone antibody tests one, four and nine months post-vaccination; and had completed a medical questionnaire. Further samples taken at nine months were tested for cellular immunity. No participants had evidence of COVID-19 infection pre- or post-vaccination. An anti-S1 receptor binding domain (RBD) antibody assay was used to assess humoral response, and cellular immunity was estimated with an INF-γ release assay (IGRA). Statistical analysis was performed using STATA. We report a statistically significant antibody drop over time. Being above the age of 40 or a smoker reduces the rise of antibodies by 37% and 28%, respectively. More than half of the participants did not demonstrate T-cell activation at nine months. Female gender and antibody levels at four months predispose detection of cellular immunity at nine months post-immunization. This study furthers the qualitative, quantitative, and temporal understanding of the immune response to the BNT162b2 mRNA vaccine and the effect of correlated factors.
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Affiliation(s)
- Natalia Syrimi
- Paediatric Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Flora Sourri
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Maria-Christina Giannakopoulou
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
| | - Dimitrios Karamanis
- Department of Health Informatics, Rutgers School of Health Professions, 65 Bergen St., Newark, NJ 07107, USA
- Department of Economics, University of Piraeus, Karaoli and Dimitriou 80, 18534 Piraeus, Greece
| | - Asterios Pantousas
- Department of Electrical and Computer Engineering, Democritus University of Thrace, 69100 Komotini, Greece
| | - Persefoni Georgota
- Immunology Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Eleni Rokka
- Oncology Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Zoe Vladeni
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Euaggelia Tsiantoula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evangelia Soukara
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Nikoletta Lavda
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Dimitrios Gkaragkanis
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Aikaterini Zisaki
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Panagiotis Vakalidis
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Vasiliki Goula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evdokia Loupou
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Dimitrios Hatzigeorgiou
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
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Mehta A, Kharawala A, Nagraj S, Apple SJ, Barzallo D, Al Deen Alhuarrat M, Moya CJB, Vikash S, Zoumpourlis P, Xesfingi S, Varrias D, Demirhan YE, Palaiodimos L, Karamanis D. Invasive Mechanical Ventilation and Death Was More Likely in Patients with Lower LDL Cholesterol Levels during COVID-19 Hospitalization: A Retrospective Propensity-Matched Cohort Study. JOURNAL OF RESPIRATION 2023. [DOI: 10.3390/jor3020005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Hyperlipidemia has been associated with worse outcomes in patients with Coronavirus disease 2019 (COVID-19). However, lower LDL-C (low-density lipoprotein cholesterol) levels have been associated with increased COVID-19 severity and mortality. We conducted a retrospective observational study of patients with COVID-19 admitted to New York City Health and Hospitals from 1 March 2020 to 31 October 2020, comparing pre-COVID-19 LDL-C levels or LDL-C levels obtained during COVID-19 hospitalization, with the need for invasive mechanical ventilation and death. Propensity score matching was performed using logistic regression models, and standardized mean differences were calculated. A total of 3020 patients (median age 61 years; 36% women) were included. In the matched cohort, on multivariate logistic regression analysis, LDL was inversely associated with in-hospital death (OR: 0.99, 95% CI: 0.986–0.999, p = 0.036). As a categorical variable, LDL > 70 mg/dL was associated with 47% lower likelihood of invasive mechanical ventilation (OR: 0.53, 95% CI: 0.29–0.95, p = 0.034). No significant association between pre-COVID-19 LDL and death or invasive mechanical ventilation was found (OR: 1.00, 95% CI 0.99–1.01, p = 0.833). Low LDL-C level measured during COVID-19 was associated with a higher likelihood of invasive mechanical ventilation and in-hospital death. A similar association was not found between pre-COVID-19 LDL-C and these outcomes. LDL-C levels obtained during COVID-19 are likely not reflective of the baseline lipid profile.
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Affiliation(s)
- Adhya Mehta
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Amrin Kharawala
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Sanjana Nagraj
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Samuel J. Apple
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Diego Barzallo
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Majd Al Deen Alhuarrat
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Cesar Joel Benites Moya
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Sindhu Vikash
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Panagiotis Zoumpourlis
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Sophia Xesfingi
- National Documentation Center, Zefirou 56, 17564 Paleo Faliro, Greece
| | - Dimitrios Varrias
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Yunus Emre Demirhan
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
| | - Leonidas Palaiodimos
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, New York City Health + Hospitals, 1400 Pelham Parkway S, Bronx, NY 10461, USA
- CUNY School of Medicine, New York, NY 10031, USA
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, 18534 Piraeus, Greece
- Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA
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7
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Vassilopoulou E, Bumbacea RS, Pappa AK, Papadopoulos AN, Bumbacea D. Obesity and Infection: What Have We Learned From the COVID-19 Pandemic. Front Nutr 2022; 9:931313. [PMID: 35938136 PMCID: PMC9353573 DOI: 10.3389/fnut.2022.931313] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/14/2022] [Indexed: 01/14/2023] Open
Abstract
Objective The critical role played by the nutritional status in the complications, duration of hospitalization and mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) has emerged from several research studies in diverse populations. Obesity has been associated with an increased risk of serious complications, as the adipose tissue appears to have significant effects on the immune response. The aim of this narrative review was to investigate the relationship between COVID-19 and obesity. Methods We performed a review of papers in the English language derived from PubMed, Science Direct, and Web of Science. The primary outcomes investigated were the severity of the disease, admission to the intensive care unit (ICU), need for intubation, and mortality. Results and Conclusion Review of 44 eligible studies from 18 countries around the world revealed evidence that obesity increases the risk of severe COVID-19 complications, ICU admission, intubation and mortality. Patients with a higher body mass index (BMI) appear to be more vulnerable to SARS-CoV-2 infection, with more severe illness requiring admission to ICU and intubation, and to have higher mortality. A healthy body weight should be targeted as a long-term prevention measure against acute complications of infection, and in the event of COVID-19, overweight and obese patients should be monitored closely.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Roxana Silvia Bumbacea
- Allergy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Allergy Department, Nephrology Hospital Dr Carol Davila, Bucharest, Romania
| | | | - Athanasios N. Papadopoulos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Dragos Bumbacea
- Department of Cardio-Thoracic Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pneumology and Acute Respiratory Care, Elias Emergency University Hospital, Bucharest, Romania
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8
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Moll-Bernardes R, Fortier SC, Sousa AS, Lopes RD, Vera N, Conde L, Feldman A, Arruda G, Cabral-Castro M, Albuquerque DC, Paula TC, Furquim T, Loures VA, Giusti K, Oliveira N, Macedo A, Barros e Silva P, De Luca F, Kotsugai M, Domiciano R, Silva FA, Santos MF, Souza OF, Bozza FA, Luiz RR, Medei E. NKG2A Expression among CD8 Cells Is Associated with COVID-19 Progression in Hypertensive Patients: Insights from the BRACE CORONA Randomized Trial. J Clin Med 2022; 11:jcm11133713. [PMID: 35806995 PMCID: PMC9267446 DOI: 10.3390/jcm11133713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular comorbidities and immune-response dysregulation are associated with COVID-19 severity. We aimed to explore the key immune cell profile and understand its association with disease progression in 156 patients with hypertension that were hospitalized due to COVID-19. The primary outcome was progression to severe disease. The probability of progression to severe disease was estimated using a logistic regression model that included clinical variables and immune cell subsets associated with the primary outcome. Obesity; diabetes; oxygen saturation; lung involvement on computed tomography (CT) examination; the C-reactive protein concentration; total lymphocyte count; proportions of CD4+ and CD8+ T cells; CD4/CD8 ratio; CD8+ HLA-DR MFI; and CD8+ NKG2A MFI on admission were all associated with progression to severe COVID-19. This study demonstrated that increased CD8+ NKG2A MFI at hospital admission, in combination with some clinical variables, is associated with a high risk of COVID-19 progression in hypertensive patients. These findings reinforce the hypothesis of the functional exhaustion of T cells with the increased expression of NKG2A in patients with severe COVID-19, elucidating how severe acute respiratory syndrome coronavirus 2 infection may break down the innate antiviral immune response at an early stage of the disease, with future potential therapeutic implications.
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Affiliation(s)
- Renata Moll-Bernardes
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
| | - Sérgio C. Fortier
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Pathological Anatomy Laboratory, Rede D’Or São Luiz, São Paulo 04321-120, Brazil
| | - Andréa S. Sousa
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Renato D. Lopes
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA
- Brazilian Clinical Research Institute, São Paulo 01404-000, Brazil;
| | - Narendra Vera
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (N.V.); (L.C.)
| | - Luciana Conde
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (N.V.); (L.C.)
| | - André Feldman
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Anália Franco Hospital, São Paulo 03313-001, Brazil
| | - Guilherme Arruda
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz São Caetano Hospital, São Caetano do Sul 09531-205, Brazil
| | - Mauro Cabral-Castro
- Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil;
| | - Denílson C. Albuquerque
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Cardiology Department, Rio de Janeiro State University, Rio de Janeiro 20551-030, Brazil
| | - Thiago C. Paula
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Jabaquara Hospital, São Paulo 04321-120, Brazil
| | - Thyago Furquim
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Sino Brasileiro Hospital, Osasco 06016-050, Brazil
| | - Vitor A. Loures
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Anália Franco Hospital, São Paulo 03313-001, Brazil
| | - Karla Giusti
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Villa Lobos Hospital, São Paulo 03184-020, Brazil
| | - Nathália Oliveira
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Villa Lobos Hospital, São Paulo 03184-020, Brazil
| | - Ariane Macedo
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Jabaquara Hospital, São Paulo 04321-120, Brazil
- Santa Casa of São Paulo, São Paulo 01221-010, Brazil
| | | | - Fábio De Luca
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Morumbi Hospital, São Paulo 05605-050, Brazil
| | - Marisol Kotsugai
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Morumbi Hospital, São Paulo 05605-050, Brazil
| | - Rafael Domiciano
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- São Luiz Anália Franco Hospital, São Paulo 03313-001, Brazil
| | - Flávia A. Silva
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Pathological Anatomy Laboratory, Rede D’Or São Luiz, São Paulo 04321-120, Brazil
| | - Mayara F. Santos
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
| | - Olga F. Souza
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Copa Star Hospital, Rio de Janeiro 22031-012, Brazil
| | - Fernando A. Bozza
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Ronir R. Luiz
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Public Health Studies Institute—IESC, Federal University of Rio de Janeiro, Rio de Janeiro 21941-592, Brazil
| | - Emiliano Medei
- D’Or Institute for Research and Education, Rio de Janeiro 22281-100, Brazil; (R.M.-B.); (S.C.F.); (A.S.S.); (R.D.L.); (A.F.); (G.A.); (D.C.A.); (T.C.P.); (T.F.); (V.A.L.); (K.G.); (N.O.); (A.M.); (F.D.L.); (M.K.); (R.D.); (F.A.S.); (M.F.S.); (O.F.S.); (F.A.B.); (R.R.L.)
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-170, Brazil; (N.V.); (L.C.)
- National Center for Structural Biology and Bioimaging, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
- Correspondence: ; Tel.: +55-21-3938-0370
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9
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Citu IM, Citu C, Margan MM, Craina M, Neamtu R, Gorun OM, Burlea B, Bratosin F, Rosca O, Grigoras ML, Motoc A, Malita D, Neagoe O, Gorun F. Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection. Nutrients 2022; 14:nu14071445. [PMID: 35406057 PMCID: PMC9003126 DOI: 10.3390/nu14071445] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting as a cofactor for immunoglobulin production and other processes required for T and B cell activity. Considering magnesium as a recommended dietary supplement during pregnancy and the possible role of magnesium deficiency in COVID-19 and its complications, the current study sought to determine the effect of magnesium and magnesium-containing nutritional supplements on the immune response following SARS-CoV-2 infection in pregnant women, as well as to observe differences in pregnancy outcomes based on the supplements taken during pregnancy. The study followed a cross-sectional design, where patients with a history of SARS-CoV-2 infection during their pregnancy were surveyed for their preferences in nutritional supplementation and their profile compared with existing records from the institutional database. A cohort of 448 pregnant women with COVID-19 during 22 months of the pandemic was assembled, out of which 13.6% took a magnesium-only supplement, and 16.5% supplemented their diet with a combination of calcium, magnesium, and zinc. Around 60% of patients in the no-supplementation group had the SARS-CoV-2 anti-RBD lower than 500 U/mL, compared with 50% in those who took magnesium-based supplements. A quantity of magnesium >450 mg in the taken supplements determined higher levels of antibody titers after COVID-19. Low magnesium dosage (<450 mg) was an independent risk factor for a weak immune response (OR-1.25, p-value = 0.003). The observed findings suggest supplementing the nutritional intake of pregnant women with magnesium-based supplements to determine higher levels of SARS-CoV-2 anti-RBD antibodies, although causality remains unclear.
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Affiliation(s)
- Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
- Correspondence: ; Tel.: +40-(722)-322-877
| | - Madalin-Marius Margan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Oana Maria Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Bogdan Burlea
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Ovidiu Rosca
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Mirela Loredana Grigoras
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Daniel Malita
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Octavian Neagoe
- First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
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