Dietary mineral intakes predict Coronavirus-disease 2019 (COVID-19) incidence and hospitalization in older adults

BACKGROUND

The aim of this study was to determine the association between dietary mineral intake and Coronavirus-disease 2019 (COVID-19) infection and its associated hospitalization.

METHODS

This cohort study utilized the MASHAD study population, which comprised individuals aged 35-65. Upon recruitment in 2007, dietary intake was documented using a validated 65-item food frequency questionnaire (FFQ). Data on COVID-19 PCR test results was collected from all relevant medical centers in Mashhad between February 2020 and June 2022. The regression model included dietary minerals and employed the backward variable selection method, along with advanced data analysis techniques.

RESULTS

The final analysis involved 1957 participants, including 193 COVID-19-positive patients. The mean age was 49.71 and 50.28 years in the COVID-19-positive and negative groups, respectively (p = 0.12). Dietary intakes of magnesium, iron, and potassium were notably lower in COVID-19-positive patients (P < 0.05). Following adjustments for age and sex, dietary iron remained significantly associated with COVID-19 incidence (OR = 0.94, 95% CI: 0.90-0.98). Furthermore, a statistically significant relationship was observed between dietary zinc and hospitalization due to COVID-19 (OR = 0.69, 95% CI: 0.51-0.93). In dynamical system models, intakes of calcium, zinc, and iron below the cut-offs of 1138, 9.7, and 8.17 mg/day, respectively, were linked to an increased risk of COVID-19 incidence.

CONCLUSION

Higher dietary iron and zinc intake are associated with decreased risk of COVID-19 infection and hospitalization, respectively.

Role of SARS-COV-2 and ACE2 in the pathophysiology of peripheral vascular diseases

The occurrence of a novel coronavirus known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), created a serious challenge worldwide. SARS-CoV-2 has high infectivity, the ability to be transmitted even during the asymptomatic phase, and relatively low virulence, which has resulted in rapid transmission. SARS-CoV-2 can invade epithelial cells, hence, many patients infected with SARS-CoV-2 have suffered from vascular diseases (VDs) in addition to pulmonary manifestations. Accordingly, SARS-CoV-2 may can worsen the clinical condition of the patients with pre-existing VDs. Endothelial cells express angiotensin-converting enzyme 2 (ACE2). ACE2 is a biological enzyme that converts angiotensin (Ang)- 2 to Ang-(1-7). SARS-CoV-2 uses ACE2 as a cell receptor for viral entry. Thus, the SARS-CoV-2 virus promotes downregulation of ACE2, Ang-(1-7), and anti-inflammatory cytokines, as well as, an increase in Ang-2, resulting in pro-inflammatory cytokines. SARS-CoV-2 infection can cause hypertension, and endothelial damage, which can lead to intravascular thrombosis. In this review, we have concentrated on the effect of SARS-CoV-2 in peripheral vascular diseases (PVDs) and ACE2 as an enzyme in Renin-angiotensin aldosterone system (RAAS). A comprehensive search was performed on PubMed, Google Scholar, Scopus, using related keywords. Articles focusing on ("SARS-CoV-2", OR "COVID-19"), AND ("Vascular disease", OR "Peripheral vascular disease", OR interested disease name) with regard to MeSH terms, were selected. According to the studies, it is supposed that vascular diseases may increase susceptibility to severe SARS-CoV-2 infection due to increased thrombotic burden and endothelial dysfunction. Understanding SARS-CoV-2 infection mechanism and vascular system pathogenesis is crucial for effective management and treatment in pre-existing vascular diseases.

Attitudes of medical students toward psychiatry in Eastern Mediterranean Region: A systematic review

BACKGROUND

Psychiatry is facing one of the highest levels of shortages among medical specialties. Stigma toward psychiatry plays an influential role in medical students' decision to choose psychiatry as a career and has been reported to be prevalent in different parts of the world, particularly in low/middle-income countries.

OBJECTIVE

To systematically review the Eastern Mediterranean Region (EMR) medical students' attitudes toward psychiatry, to assess whether their attitudes are stigmatized or not, and the factors affecting their attitudes.

METHOD

PubMed, Scopus, Web of Science, and PsychInfo (PsycARTICLES) were searched using a combination of main terms "stigma," "psychiatry," "medical students," and the name of Eastern Mediterranean countries. Cross-sectional studies assessing the attitudes of EMR medical students toward psychiatry were included in this review.

RESULTS

Ten studies were eligible to be included in the result synthesis. These were from Pakistan (n = 3), Iran (n = 2), Saudi Arabia (n = 1), Lebanon (n = 1), Egypt (n = 1), Bahrain (n = 1), and Oman (n = 1). Most studies reported a combination of both positive and negative attitudes among medical students; however, the overall attitude was positive. Factors affecting medical students' attitude toward psychiatry included poor psychological well-being, having a friend with a psychiatric illness, involving in a romantic relationship with someone suffering from mental illness, young age, frequency of exposure to psychiatry clerkship/teaching, and quality of psychiatry clerkship. Nevertheless, the final positive or negative outcome of these factors on students' attitudes remained controversial.

CONCLUSION

Considering the lack of sufficient data from most EMR countries, we need to exercise caution in interpreting the results of this review. Nevertheless, our review indicates that psychiatry is not stigmatized among EMR medical students, and they have generally positive attitudes toward it. The findings of studies evaluating influencing factors are contradictory and demand further exploration.