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Stefanis C, Tsigalou C, Bezirtzoglou I, Mitropoulou G, Voidarou C, Stavropoulou E. The dynamic linkage between covid-19 and nutrition: a review from a probiotics perspective using machine learning and bibliometric analysis. Front Nutr 2025; 12:1575130. [PMID: 40416372 PMCID: PMC12098087 DOI: 10.3389/fnut.2025.1575130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2025] [Accepted: 04/15/2025] [Indexed: 05/27/2025] Open
Abstract
Introduction The pandemic crisis is now a memorable milestone in the history of science, not only for the impacts on the population's health but also for the effort of the medical community to find immediate solutions amid the pandemic so that appropriate therapeutic means can be provided. Diet and nutrition could not fail to be studied in the context of combating the side effects of COVID-19. This study attempts to detect the relationship between dietary patterns and the disease of COVID-19 and emphasizes research on probiotics by mapping the knowledge produced during the pandemic until 2024. Methods In addition to bibliometrics, a machine-learning framework, ASReview, was used to structure the literature search. With this method, 2,309 articles were collected from the PubMed database, with 599 constituting inputs into bibliometric software and further analysis. Results Food choices, dietary patterns, vitamins and their role (vitamin D), obesity, and probiotics were keywords that attracted global research attention. Dietary supplements also constituted a field of study regarding the evolution of the disease and the impact they could have after the first pandemic wave. Discussion Probiotics were considered an adjunct therapeutic intervention not only during the period before the development of vaccines but also alongside other therapeutic solutions. Whether used preventively or during the treatment phase, probiotics were studied to combat COVID-19 due to their potential role in immunomodulation and ability to regulate gut microbiota during respiratory infections.
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Affiliation(s)
- Christos Stefanis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Tsigalou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Gregoria Mitropoulou
- Laboratory of Applied Microbiology and Biotechnology, Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Elisavet Stavropoulou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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2
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Morais TO, de Medeiros GCBS, de Medeiros KS, Mendes TGDM, Leite-Lais L, Lopes MMGD. Severity of COVID-19 in hospitalized pediatric patients with obesity: A systematic review. J Pediatr Gastroenterol Nutr 2025; 80:783-791. [PMID: 39945077 DOI: 10.1002/jpn3.70017] [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: 05/09/2024] [Revised: 01/21/2025] [Accepted: 01/21/2025] [Indexed: 05/13/2025]
Abstract
This review is intended to evaluate the severity of Coronavirus Disease 2019 (COVID-19) in hospitalized pediatric patients with obesity. The increased risk of hospitalization in pediatric patients with obesity highlights the need for a thorough investigation into the impact of COVID-19 in this vulnerable population, given the significant public health challenges obesity presents in this age group. The review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A systematic search was conducted in the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), LILACS (scientific health information from Latin America and the Caribbean countries), Web of Science, Embase, and Scopus databases for relevant articles published between December 2019 and November 2021. Observational studies (cross-sectional and cohort) involving pediatric patients with obesity who tested positive for COVID-19, were hospitalized, and had outcomes related to disease severity parameters such as intensive care unit (ICU) admission, length of ICU stay, and mechanical ventilation) were included. The quality of evidence from the included studies was assessed using the Newcastle‒Ottawa Scale. Extracted data included the author, year, country, study design, aim, population, outcomes/severity, and primary results. Eight studies were included in the review. A narrative synthesis was conducted to qualitatively summarize the findings, highlighting that obesity is a potential aggravating factor in the clinical presentation of COVID-19 among hospitalized pediatric patients. The findings revealed a positive association between the pediatric population with obesity and COVID-19 severity, particularly among adolescents, who were at greater risk of developing severe illness. This association was also evident in higher rates of ICU admission and increased use of mechanical ventilation.
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Affiliation(s)
| | | | - Kleyton S de Medeiros
- Institute of Education, Research, and Innovation; League Against Cancer, Natal, Brazil
| | - Thayanne G de Medeiros Mendes
- Postgraduate Program in Sciences Applied to Women's Health, Center of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lucia Leite-Lais
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Márcia M G D Lopes
- Department of Nutrition and Postgraduate Program in Sciences Applied to Women's Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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3
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Adilović M. COVID-19 related complications. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2025; 213:259-314. [PMID: 40246346 DOI: 10.1016/bs.pmbts.2025.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2025]
Abstract
The COVID-19 pandemic has significantly impacted global healthcare systems, revealed vulnerabilities and prompted a re-evaluation of medical practices. Acute complications from the virus, including cardiovascular and neurological issues, have underscored the necessity for timely medical interventions. Advances in diagnostic methods and personalized therapies have been pivotal in mitigating severe outcomes. Additionally, Long COVID has emerged as a complex challenge, affecting various body systems and leading to respiratory, cardiovascular, neurological, psychological, and musculoskeletal problems. This broad spectrum of complications highlights the importance of multidisciplinary management approaches that prioritize therapy, rehabilitation, and patient-centered care. Vulnerable populations such as paediatric patients, pregnant women, and immunocompromised individuals face unique risks and complications, necessitating continuous monitoring and tailored management strategies to reduce morbidity and mortality associated with COVID-19.
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Affiliation(s)
- Muhamed Adilović
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnička cesta, Sarajevo, Bosnia and Herzegovina.
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Jackson DA, Beccia AL, Raffoul A, Sarda V, Chavarro JE, Hart JE, Austin SB. Racial/ethnic inequities in potentially harmful supplement use: Results of a prospective US cohort during the COVID-19 pandemic. Public Health 2025; 240:104-111. [PMID: 39893757 PMCID: PMC11967280 DOI: 10.1016/j.puhe.2024.12.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 12/09/2024] [Accepted: 12/24/2024] [Indexed: 02/04/2025]
Abstract
OBJECTIVES To quantify racial/ethnic inequities in the use of harmful supplements sold with claims to aid in immune boosting, energy boosting, cleansing/detoxing, and weight loss throughout the first year of the COVID-19 pandemic. STUDY DESIGN Prospective cohort study using longitudinal data (April/May 2020-April 2021) drawn from the US-based COVID-19 Substudy (N = 55,098), embedded in the Nurses' Health Studies 2 and 3 and the Growing Up Today Study. METHODS Modified Poisson models were fit to estimate sociodemographic-adjusted risk ratios (aRRs) and 95 % confidence intervals (CIs) of supplement use by racialized identity. We estimated the contribution of social stressors in driving racial/ethnic inequities in use of immune, energy, cleanse/detox, and weight-loss supplements. RESULTS Non-Hispanic Black participants had up to two times higher risk of supplement use compared to Non-Hispanic White participants. Living in a county with a high COVID-19 mortality rate was associated with a slightly elevated risk of immune supplement use, and experiencing chronic high discrimination was associated with an elevated use of all supplement types. CONCLUSIONS There were stark racial/ethnic inequities in use of harmful supplements throughout the first year of the COVID-19 pandemic.
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Affiliation(s)
- Destiny A Jackson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Ariel L Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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5
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Feldman C, Anderson R. Smoking, Alcohol Use, Diabetes Mellitus, and Metabolic Syndrome as Risk Factors for Community-Acquired Pneumonia. Clin Chest Med 2025; 46:93-104. [PMID: 39890295 DOI: 10.1016/j.ccm.2024.10.007] [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] [Indexed: 02/03/2025]
Abstract
Community-acquired pneumonia (CAP) continues to be a cause of significant morbidity and mortality worldwide. Much recent attention in this area of research has been focused on host factors associated with the infection. This article will discuss 4 diverse, yet often coexistent conditions, namely, smoking, excessive alcohol use, diabetes mellitus, and metabolic syndrome. While all these conditions can be considered to be largely associated with lifestyle factors, they represent important risk factors for CAP. All can lead to acquired host immune suppression that underlies their risk for the development of severe CAP.
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Affiliation(s)
- Charles Feldman
- Department of Internal Medicine, University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa.
| | - Ronald Anderson
- Department of Immunology, School of Medicine, University of Pretoria, PO Box 667, Pretoria 0001, South Africa
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Chun KH, Kim HJ, Kang DR, Kim JY, Kim W, Jeong YW, Han SH, Koh KK. Sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome: a comparative study of 2018-2019 and 2020-2021. Korean J Intern Med 2025; 40:262-274. [PMID: 40102710 PMCID: PMC11938662 DOI: 10.3904/kjim.2024.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 10/15/2024] [Accepted: 11/20/2024] [Indexed: 03/20/2025] Open
Abstract
BACKGROUND/AIMS The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS Data from the KNHANES VII (2018) and VIII (2019-2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome. RESULTS The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females. CONCLUSION The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.
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Affiliation(s)
- Kyeong-Hyeon Chun
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang,
Korea
| | - Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri,
Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju,
Korea
| | - Jang Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju,
Korea
| | - Wonjin Kim
- Division of Endocrinology, Department of Internal Medicine, CHA University School of Medicine, Pocheon,
Korea
| | - Yong Whi Jeong
- Department of Medical Informatics and Biostatistics, Graduate School, Yonsei University, Wonju,
Korea
| | - Seung Hwan Han
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon,
Korea
| | - Kwang Kon Koh
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon,
Korea
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Li D, Chen Y, Zhu X, Yang Y, Li H, Zhao RC. A novel human specific lncRNA MEK6-AS1 regulates adipogenesis and fatty acid biosynthesis by stabilizing MEK6 mRNA. J Biomed Sci 2025; 32:6. [PMID: 39773638 PMCID: PMC11708274 DOI: 10.1186/s12929-024-01098-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 11/09/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Obesity is becoming one of the major non-communicable diseases with increasing incidence and risks that cannot be ignored. However effective and safe clinical treatment strategies still need to be deeply explored. Increased number and volume of adipocytes lead to overweight and obesity. The aim of our work is to identify lncRNAs that have important regulatory in differentiation of human mesenchymal stem cells (MSCs) into adipocytes, and to provide effective targets for clinical prevention and treatment of obesity and related metabolic disorders. METHODS We extracted primary MSCs from human adipose tissue, and conducted expression profile analysis of lncRNAs during adipogenic differentiation of MSCs to screen changed lncRNAs. Characteristics of lncRNA were revealed mainly by RACE and RNA FISH. Loss- and gain-of function experiments in vivo and in vitro were used to analyze effects of lncRNA. Targeted metabolomics was utilized to detect levels of free fatty acids. RNA pull-down, mRNA stability tests, etc. were employed to explore mechanisms of lncRNA. RESULTS Human-specific lncRNA, we named it MEK6-AS1, was the most up-regulated transcript during adipogenic differentiation of MSCs. MEK6-AS1 was highly expressed in adipose tissue samples from individuals with BMI ≥ 25 and positively correlated with adipogenic marker genes in these samples. Knocking down lncRNA inhibited expression of adipogenic differentiation markers and ectopic adipogenesis, reducing contents of various free fatty acids, as well as promoting osteogenic differentiation. Overexpression of lncRNA had the opposite effects to the above processes. We also found that MEK6-AS1 was elevated during hepatic steatosis organoid generation. Mechanistically, MEK6-AS1 worked partially through stabilization of MEK6 mRNA by NAT10. CONCLUSIONS We have identified a human-specific lncRNA (MEK6-AS1) with position information in the genomic database but has not been extensively reported. We demonstrated that MEK6-AS1 as a novel lncRNA involved in adipogenic differentiation and adipogenesis, fatty acid metabolism, and osteogenic differentiation. We found that MEK6-AS1 may exert its effect by enhancing MEK6 mRNA stability through NAT10. Our study may provide insights into implication of lncRNAs in stem cell biology and offer a new potential therapeutic target for the prevention and treatment of obesity and other related disease.
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Affiliation(s)
- Di Li
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Center for Excellence in Tissue Engineering, Chinese Academy of Medical Sciences, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Key Laboratory of New Drug Development and Clinical Trial of Stem Cell Therapy (BZ0381), Beijing, China
| | - Yunhua Chen
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Center for Excellence in Tissue Engineering, Chinese Academy of Medical Sciences, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Key Laboratory of New Drug Development and Clinical Trial of Stem Cell Therapy (BZ0381), Beijing, China
| | - Xingyu Zhu
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Center for Excellence in Tissue Engineering, Chinese Academy of Medical Sciences, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Key Laboratory of New Drug Development and Clinical Trial of Stem Cell Therapy (BZ0381), Beijing, China
| | - Yanlei Yang
- Clinical Biobank, Department Medical Research Central, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongling Li
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China.
- Center for Excellence in Tissue Engineering, Chinese Academy of Medical Sciences, Beijing, China.
- State Key Laboratory of Common Mechanism Research for Major Diseases, Chinese Academy of Medical Sciences, Beijing, China.
- Beijing Key Laboratory of New Drug Development and Clinical Trial of Stem Cell Therapy (BZ0381), Beijing, China.
| | - Robert Chunhua Zhao
- Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China.
- Center for Excellence in Tissue Engineering, Chinese Academy of Medical Sciences, Beijing, China.
- State Key Laboratory of Common Mechanism Research for Major Diseases, Chinese Academy of Medical Sciences, Beijing, China.
- Beijing Key Laboratory of New Drug Development and Clinical Trial of Stem Cell Therapy (BZ0381), Beijing, China.
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Yang X, Sima Y, Zhao J, Zhang J, Wang X, Zhang L. Risk and protective factors for coronavirus disease 2019 (COVID-19) in allergic rhinitis patients: a national survey in China. FRONTIERS IN ALLERGY 2024; 5:1479493. [PMID: 39720613 PMCID: PMC11666529 DOI: 10.3389/falgy.2024.1479493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 11/18/2024] [Indexed: 12/26/2024] Open
Abstract
Background Several epidemiological studies have shown that allergic rhinitis (AR) patients are more susceptible to coronavirus disease 2019 (COVID-19). Objective We aim to investigate the risk factors for COVID-19 in AR patients. Methods A retrospective nationwide cohort study was conducted based on a questionnaire survey in China. The baseline characteristics, region of residence, smoking and drinking status, comorbidities, vaccination status and previous infection information were obtained. Allergen test results, the SARS-CoV-2 nucleic acid test, and antigen detection results were collected. Information on AR and comorbid medication use pre-SARS-CoV-2 infection was also collected. Binary logistic regression and analysis of covariance (different adjusted models) were conducted. Results In all, 830 AR patients were included; 627 patients (75.54%) were infected with SARS-CoV-2. AR comorbid with allergic conjunctivitis (AC) was a protective factor [OR: 0.525 (95% CI = 0.296-0.929), P = 0.027] against SARS-CoV-2 infection, while AR comorbid with food allergy was a risk factor [OR: 6.404 (95% CI = 1.349-30.402), P = 0.0195]. Although fewer patients received four doses of the vaccine, the results showed a significant protective effect against SARS-CoV-2 infection in AR patients [OR: 0.093 (95% CI = 0.025-0.348), P = 0.0004]. Underweight was a protective factor against COVID-19 [OR: 0.287 (95% CI = 0.147-0.562), P = 0.0003] after full multivariable adjustment. Overweight was associated with a 2.071-fold higher risk for COVID-19 compared with normal weight [(95% CI = 1.045-4.105), P = 0.0370]. Additionally, house dust mite (HDM)-specific allergies were also protective against COVID-19 [OR: 0.537 (95% CI = 0.290-0.996), P = 0.0484]. Conclusions This study revealed underlying protective and risk factors, which might be used to improve the management of AR and COVID-19.
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Affiliation(s)
- Xiaozhe Yang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Yutong Sima
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Jinming Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Jing Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Xiangdong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China
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Springer M, Meugnier E, Schnabl K, Hof KS, Champy MF, Sorg T, Petit-Demoulière B, Germain N, Galusca B, Estour B, Vidal H, Klingenspor M, Hager J. Loss of Sult1a1 reduces body weight and increases browning of white adipose tissue. Front Endocrinol (Lausanne) 2024; 15:1448107. [PMID: 39703864 PMCID: PMC11656314 DOI: 10.3389/fendo.2024.1448107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 10/28/2024] [Indexed: 12/21/2024] Open
Abstract
Background and objective Overweight and obesity affects millions of individuals worldwide and consequently represents a major public health concern. Individuals living with overweight and obesity have difficulty maintaining a low body weight due to known physiological mechanisms which prevent further weight loss and drive weight regain. In contrast, mechanisms which promote low body weight maintenance receive less attention and are largely unknown. To uncover these intrinsic mechanisms, we investigated a human cohort of constitutionally thin (CT) individuals which maintain a low body weight and are resistant to weight gain despite exposure to an obesogenic environment. Methods To identify novel genes that contribute to low body weight maintenance, we performed transcriptomics on adipose tissue biopsies collected from CT and normal body weight (NBW) individuals and identified sulfotransferase 1A1 (SULT1A1) as a target for further investigation in mice. Sult1a1 knockout (KO) mice were fed a standard diet to assess the impact of Sult1a1 deletion on metabolic traits. To determine if high-fat feeding recapitulated the CT weight gain resistance phenotype, Sult1a1 KO mice were fed a high-fat diet for 13-weeks. A subset of wild-type and Sult1a1 KO mice from the standard diet were further analyzed for characterization of adipose tissue respiratory capacity. Results In comparison to NBW controls, adipose tissue from CT individuals expresses less SULT1A1. Sult1a1 KO mice weigh 10% less at the end of the study period and on a high-fat diet, Sult1a1 KO mice tended to gain less weight and had reduced fat mass at 14-weeks of age. These changes were associated with reduced fasting insulin and lessened adipose tissue inflammation and fibrosis. Subcutaneous adipose tissue from Sult1a1 KO mice on a standard chow diet had elevated leak respiration, uncoupling protein 1 (UCP1) expression and increased expression of a mitochondrial marker, VDAC, associating Sult1a1 deletion to adipose tissue browning. Conclusions Our results associate Sult1a1 deletion with a tendency for lower body weight through remodeling of white adipose tissue towards a brown phenotype. The presence of UCP1, the expression of an additional mitochondrial protein and increased respiratory capacity suggest browning of the subcutaneous adipose tissue depot of Sult1a1 KO mice.
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Affiliation(s)
- Margherita Springer
- Société des Produits Nestlé S.A., Nestlé Institute of Health Sciences, Lausanne, Switzerland
- Chair for Molecular Nutritional Medicine, Technical University of Munich (TUM) School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Emmanuelle Meugnier
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, Institut National des Sciences Appliquées de Lyon (INSA Lyon), Oullins, France
| | - Katharina Schnabl
- Chair for Molecular Nutritional Medicine, Technical University of Munich (TUM) School of Life Sciences, Technical University of Munich, Freising, Germany
- Else Kröner Fresenius Zentrum (EKFZ) für Ernährungsmedizin, Technical University of Munich, Freising, Germany
- French National Infrastructure for Mouse Phenogenomics (PHENOMIN)-Institut Clinique de la Souris, Creation, Breeding, Phenotyping, Distribution and Archiving of Model Organisms (CELPHEDIA), National Centre for Scientific Research (CNRS), National Institute of Health and Medical Research (INSERM), Université de Strasbourg, Illkirch-Grafenstaden, France
| | | | - Marie-France Champy
- French National Infrastructure for Mouse Phenogenomics (PHENOMIN)-Institut Clinique de la Souris, Creation, Breeding, Phenotyping, Distribution and Archiving of Model Organisms (CELPHEDIA), National Centre for Scientific Research (CNRS), National Institute of Health and Medical Research (INSERM), Université de Strasbourg, Illkirch-Grafenstaden, France
| | - Tania Sorg
- French National Infrastructure for Mouse Phenogenomics (PHENOMIN)-Institut Clinique de la Souris, Creation, Breeding, Phenotyping, Distribution and Archiving of Model Organisms (CELPHEDIA), National Centre for Scientific Research (CNRS), National Institute of Health and Medical Research (INSERM), Université de Strasbourg, Illkirch-Grafenstaden, France
| | - Benoit Petit-Demoulière
- French National Infrastructure for Mouse Phenogenomics (PHENOMIN)-Institut Clinique de la Souris, Creation, Breeding, Phenotyping, Distribution and Archiving of Model Organisms (CELPHEDIA), National Centre for Scientific Research (CNRS), National Institute of Health and Medical Research (INSERM), Université de Strasbourg, Illkirch-Grafenstaden, France
| | - Natacha Germain
- Division of Endocrinology, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Research Group, University Jean Monnet, Saint Etienne, France
| | - Bogdan Galusca
- Division of Endocrinology, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Research Group, University Jean Monnet, Saint Etienne, France
| | - Bruno Estour
- Division of Endocrinology, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Etienne, France
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Research Group, University Jean Monnet, Saint Etienne, France
| | - Hubert Vidal
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, Institut National des Sciences Appliquées de Lyon (INSA Lyon), Oullins, France
| | - Martin Klingenspor
- Chair for Molecular Nutritional Medicine, Technical University of Munich (TUM) School of Life Sciences, Technical University of Munich, Freising, Germany
- Else Kröner Fresenius Zentrum (EKFZ) für Ernährungsmedizin, Technical University of Munich, Freising, Germany
- French National Infrastructure for Mouse Phenogenomics (PHENOMIN)-Institut Clinique de la Souris, Creation, Breeding, Phenotyping, Distribution and Archiving of Model Organisms (CELPHEDIA), National Centre for Scientific Research (CNRS), National Institute of Health and Medical Research (INSERM), Université de Strasbourg, Illkirch-Grafenstaden, France
| | - Jörg Hager
- Société des Produits Nestlé S.A., Nestlé Institute of Health Sciences, Lausanne, Switzerland
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10
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Jackson SE, Warr W, Brown J, Hartmann-Boyce J, Jebb SA, Tudor K, Shahab L, Aveyard P. Weight control efforts and practices and health professional advice: a cross-sectional national survey in England. BMJ Open 2024; 14:e086764. [PMID: 39532377 PMCID: PMC11555096 DOI: 10.1136/bmjopen-2024-086764] [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: 03/23/2024] [Accepted: 10/18/2024] [Indexed: 11/16/2024] Open
Abstract
OBJECTIVES There is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do so is unclear. This study examined the prevalence of weight control efforts and practices, the reported frequency and impact of receipt of GP advice on weight loss attempts and perceptions of the appropriateness of health professionals delivering weight loss advice. DESIGN A nationally representative cross-sectional survey. SETTING England. PARTICIPANTS 1722 adults (≥16 years) surveyed in October 2018 (mean (SD) age=47.4 (19.2), 51.1% women). MAIN OUTCOME MEASURES Weight control efforts and practices, whether a GP gave advice or a specific referral/prescription medication, perception of the appropriateness of GP weight loss advice. RESULTS Two-thirds (64.7% (95% CI 58.1% to 71.3%)) of people with obesity reported trying to lose weight. Of people with obesity who visited their GP in the past year, 40% (95% CI 32.2% to 47.7%) recalled receiving any advice on weight loss: 30.8% (95% CI 23.5% to 38.2%) general advice and 9.2% (95% CI 4.6% to 13.7%) a referral to a weight loss service or prescription medication for weight loss. Having received weight loss advice from a GP was strongly associated with a greater likelihood of trying to lose weight (general advice: ORadj=4.49, 95% CI 2.52 to 8.00; referral/medication: ORadj=9.25, 95% CI 2.65 to 32.3). Views on whether health professionals should deliver weight loss advice were mixed, with a substantial minority (19.4% (95% CI 17.5% to 21.4%)) finding it unacceptable. People with a BMI outside of the healthy weight range (underweight/overweight/obesity), women and those from more disadvantaged social grades were less likely to find it acceptable. CONCLUSIONS Most people with obesity reported trying to lose weight but less than half recalled receiving advice on weight loss from their GP in the past year and few were referred to community weight-loss programmes. Those who recalled receiving GP advice on weight loss were substantially more likely to report taking action to lose weight. One in five people thought GP advice on weight loss was inappropriate.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - William Warr
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | | | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Warneford Hospital, Oxford, UK
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11
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Hussain SS, Loh H, Paul T, Paul T, Njideaka-Kevin T, Bhandari S, Kumar H, Karam A, Metu C, Shupe G, Ferrer GF, Katwal S. A critical review of health and financial implications of obesity during the COVID-19 pandemic. Ann Med Surg (Lond) 2024; 86:5851-5858. [PMID: 39359818 PMCID: PMC11444575 DOI: 10.1097/ms9.0000000000002310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/15/2024] [Indexed: 10/04/2024] Open
Abstract
The COVID-19 was reported in Wuhan, China, in December 2019. There is a link between increased mortality and obese individuals with the disease. The disease has been claimed to have disproportionately affected non-Hispanic blacks and Hispanics. The rise in food accessibility and the drop in the relative cost of junk food items are the two most significant changes in dietary patterns. Around the world, 2.8 million people die from being overweight or obese, and those with more body fat also have a higher risk of diabetes (44%) and heart disease (23%). Obesity weakens the immune system because adipose cells infiltrate the bone marrow, spleen, and thymus. Obesity was substantially more common among COVID-19 patients who were hospitalized than those who were not hospitalized. Over 900 000 adults in the United States are hospitalized due to a COVID-19 infection. Hospitalizations in 271 700 (30.2%) cases have been attributed to obesity. Obese patients may be experiencing reduced thoracic expansion following bariatric surgery. Less tracheal collapse and air-trapping at end-expiration chest computed tomography (CT) were observed post-surgery, and patients reported reduced dyspnea. COVID-19 is estimated to cost the European Union €13.9 billion in secondary care, with 76% of that cost attributed to treatment for overweight and obese individuals. The average price per hospitalized patient also increased with increasing BMI. Screening for obesity, preventive measures, and recommendations for healthy lifestyle changes should be of the utmost importance to decrease both the health and financial implications of COVID-19.
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Affiliation(s)
- Syed Sadam Hussain
- Department of Internal Medicine, Westchester Medical Center, Valhalla, NY
| | - Hanyou Loh
- Department of Medcine, Avalon University School of Medicine, Willemstad, Curacao
| | - Tanya Paul
- Department of Medcine, Avalon University School of Medicine, Willemstad, Curacao
| | - Tashvin Paul
- Department of Medcine, Avalon University School of Medicine, Willemstad, Curacao
| | | | - Sushmita Bhandari
- Department of General Medicine, Shankar Nagar Health Center, Tilottama
| | - Harendra Kumar
- Department of Medicine, Dow University of Health Sciences, Karachi
| | - Alvina Karam
- Department of Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, Pakistan
| | - Chiamaka Metu
- Department of Medicine, V.N. Karazin Kharkiv National University, Ukraine
| | - Ginger Shupe
- Department of Psychiatry, Larkin Community Hospital, Miami, FL, USA
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12
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Libero TD, Falese L, D’Ermo A, Tosti B, Corrado S, Iannaccone A, Diotaiuti P, Rodio A. Physiological Profile Assessment and Self-Measurement of Healthy Students through Remote Protocol during COVID-19 Lockdown. J Funct Morphol Kinesiol 2024; 9:170. [PMID: 39311278 PMCID: PMC11417732 DOI: 10.3390/jfmk9030170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 09/05/2024] [Accepted: 09/15/2024] [Indexed: 09/26/2024] Open
Abstract
Background: The COVID-19 pandemic has led to reduced physical activity and increased sedentary behaviors, negatively impacting mental and physical health. Engaging in physical activity at home during quarantine became essential to counteracting these adverse effects. To develop appropriate physical activity programs, assessing individuals' fitness levels and the impact of inactivity is crucial. This study aims to compare motor abilities-including flexibility, balance, reaction time, cardiovascular endurance, and lower and upper limb strength-assessed both in-person and remotely, to determine the accuracy and repeatability of self-administered tests. Methods: A total of 35 young subjects (age 24.2 ± 1.97 years, BMI 22.4 ± 2.61 kg/m2) participated in this study. Each participant underwent a battery of motor ability tests designed to assess various fitness components. The tests were administered twice for each subject: once in a laboratory setting and once remotely at home. The sequence of tests was randomly assigned to ensure unbiased results. Both the in-person and remote assessments were used to evaluate the accuracy and reliability of self-administered tests. Results: The comparison of test results between the laboratory and remote settings revealed percentage differences ranging from 5% to 10%. This variation is considered an acceptable margin of error, suggesting that the tests conducted remotely were relatively accurate when compared to those performed in a controlled laboratory environment. Conclusions: The findings indicate that remote fitness testing is a promising method for evaluating motor abilities. With an acceptable margin of error, remote assessments can be effectively used to personalize training programs based on individuals' physiological characteristics. This approach may be particularly beneficial during times of limited access to fitness facilities, such as during quarantine, or for individuals seeking more flexible fitness evaluation methods.
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13
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Smith BM, Fitzsimmons AJ, Kovacs AJ, Grover BT, Pfeiffer JD. Impact of Bariatric Surgery on Asthma Severity and Medication Use. Obes Surg 2024; 34:2814-2819. [PMID: 38990483 DOI: 10.1007/s11695-024-07074-y] [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: 07/06/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 07/12/2024]
Abstract
INTRODUCTION Bariatric surgery improves many obesity-related comorbidities, yet the literature remains inconclusive on the impact of bariatric surgery on asthma. Our primary objective was to identify the long-term impact of bariatric surgery on asthma severity and medication use. METHODS A retrospective review was completed of all patients with a diagnosis of asthma who underwent bariatric surgery over 10 years at a single institution. Primary outcomes were the number of asthma medications prescribed at five time points (preoperative, postoperative < 18 months, 19-36 months, 37-60 months, 60 + months) after bariatric surgery. Secondary outcomes were spirometry results and BMI. RESULTS There were 260 patients with 84.6% female predominance. There were 168 sleeve gastrectomy patients and 92 Roux-en-Y gastric bypass patients. Mean age was 47.6 ± 10.7 years, mean BMI was 46.0 ± 6.8 kg/m2, and 54.2% were previous tobacco users. The total number of patients on two or more asthma medications decreased from 46% preoperatively to 41% at 18 months, to 36% at 36 months, and to 32% at 60 months after surgery. The total number of patients free from asthma medication increased from 25% preoperatively to 33% at 60 months postoperatively. Asthma medication use decreased in both surgery groups, and neither operation demonstrated superiority. No significant improvement nor differences were found between groups at any time point regarding FEV1/FVC ratio spirometry measures. CONCLUSION Bariatric surgery reduces the use of medications taken for management of asthma. The amount of asthma medication usage decreases with time and is sustained at 60 months after bariatric surgery.
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Affiliation(s)
- Brandon M Smith
- Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse Clinic - Level 5, La Crosse, WI, 54601, USA
| | - Alec J Fitzsimmons
- Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse Clinic - Level 5, La Crosse, WI, 54601, USA
| | - Attila J Kovacs
- Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse Clinic - Level 5, La Crosse, WI, 54601, USA
| | - Brandon T Grover
- Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse Clinic - Level 5, La Crosse, WI, 54601, USA
| | - Joshua D Pfeiffer
- Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse Clinic - Level 5, La Crosse, WI, 54601, USA.
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14
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Matamalas JT, Chelvanambi S, Decano JL, França RF, Halu A, Santinelli-Pestana DV, Aikawa E, Malhotra R, Aikawa M. Obesity and age are transmission risk factors for SARS-CoV-2 infection among exposed individuals. PNAS NEXUS 2024; 3:pgae294. [PMID: 39192848 PMCID: PMC11348562 DOI: 10.1093/pnasnexus/pgae294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/07/2024] [Indexed: 08/29/2024]
Abstract
The coronavirus disease (COVID-19) pandemic has occurred in Massachusetts in multiple waves led by a series of emerging variants. While the evidence has linked obesity with severe symptoms of COVID-19, the effect of obesity on susceptibility to SARS-CoV-2 infection remains unclear. Identification of intrinsic factors, which increase the likelihood of exposed individuals succumbing to productive SARS-CoV-2 infection could help plan mitigation efforts to curb the illness. We aim to investigate whether obese individuals have a higher susceptibility to developing productive SARS-CoV-2 infection given comparable exposure to nonobese individuals. This case-control study leveraged data from the Mass General Brigham's (MGB) electronic medical records (EMR), containing 687,813 patients, to determine whether obesity at any age increases the proportion of infections. We used PCR results of 72,613 subjects who tested positive to SARS-CoV-2 or declared exposure to the virus independently of the result of the test. For this study, we defined susceptibility as the likelihood of testing positive upon suspected exposure. We demonstrate evidence that SARS-CoV-2 exposed obese individuals were more prone to become COVID positive than nonobese individuals [adjusted odds ratio = 1.34 (95% CI: 1.29-1.39)]. Temporal analysis showed significantly increased susceptibility in obese individuals across the duration of the pandemic in Massachusetts. Obese exposed individuals are at a higher risk of getting infected with SARS-CoV-2. This indicates that obesity is not only a risk factor for worsened outcomes but also increases the risk for infection upon exposure. Identifying such populations early will be crucial for curbing the spread of this infectious disease.
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Affiliation(s)
- Joan T Matamalas
- Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Sarvesh Chelvanambi
- Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Julius L Decano
- Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Raony F França
- Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP 01246-903, Brazil
| | - Arda Halu
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Diego V Santinelli-Pestana
- Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Elena Aikawa
- Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
- Department of Medicine, Center for Excellence in Vascular Biology, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
| | - Rajeev Malhotra
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Masanori Aikawa
- Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
- Department of Medicine, Center for Excellence in Vascular Biology, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
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15
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Douglas ME, Mamawala M, Brown S, Powers MB, Warren AM. Associations of mood symptoms and body mass among individuals with COVID-19. Proc AMIA Symp 2024; 37:755-762. [PMID: 39165826 PMCID: PMC11332635 DOI: 10.1080/08998280.2024.2358294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 08/22/2024] Open
Abstract
Introduction The COVID-19 pandemic has had a significant impact on mental health, and individuals with certain preexisting morbidities-such as obesity-may have disproportionately experienced pandemic-related stress. We aimed to examine whether being obese or overweight was associated with worse mood and trauma among those infected with COVID-19. Methods Data were collected as part of a larger longitudinal survey study (n = 591) examining the psychological impact of COVID-19. Complete baseline data for those who reported testing positive from April 2020 through June 2021 were examined. Results and conclusions Body mass index was correlated with depression (r = 0.13, P < .01) and generalized anxiety disorder (r = 0.10, P = .02), but not with posttraumatic stress disorder (r = 0.06, P = .16). Multivariable analyses revealed that body mass index was no longer a unique predictor, except for those with a body mass index >40 kg/m2, suggesting that other sociodemographic factors, not obesity, were driving mood symptoms for those infected with COVID-19.
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Affiliation(s)
| | | | - Shakeira Brown
- Baylor Scott & White Research Institute, Dallas, Texas, USA
| | - Mark B. Powers
- Baylor Scott & White Research Institute, Dallas, Texas, USA
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16
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Studer AS, Atlas H, Belliveau M, Sleiman A, Deffain A, Garneau PY, Pescarus R, Denis R. Fully ambulatory robotic single anastomosis duodeno-ileal bypass (SADI): 40 consecutive patients in a single tertiary bariatric center. BMC Surg 2024; 24:204. [PMID: 38982419 PMCID: PMC11232187 DOI: 10.1186/s12893-024-02461-9] [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: 08/04/2023] [Accepted: 05/20/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Single Anastomosis Duodeno-Ileal bypass (SADI) is becoming a key option as a revision procedure after laparoscopic sleeve gastrectomy (LSG). However, its safety as an ambulatory procedure (length of stay < 12 h) has not been widely described. METHODS A prospective bariatric study of 40 patients undergoing SADI robotic surgery after LSG with same day discharge (SDD), was undertaken in April 2021. Strict inclusion and exclusion criteria were applied and the enhanced recovery after bariatric surgery protocol was followed. Anesthesia and robotic procedures were standardized. Early follow-up (30 days) analyzed postoperative (PO) outcomes. RESULTS Forty patients (37 F/3 M, mean age: 40.3yo), with a mean pre-operative BMI = 40.5 kg/m2 were operated. Median time after LSG was 54 months (21-146). Preoperative comorbidities included: hypertension (n = 3), obstructive sleep apnea (n = 2) and type 2 diabetes (n = 1). Mean total operative time was 128 min (100-180) (mean robotic time: 66 min (42-85)), including patient setup. All patients were discharged home at least 6 h after surgery. There were four minor complications (10%) and two major complications (5%) in the first 30 days postoperative (one intrabdominal abscess PO day-20 (radiological drainage and antibiotic therapy) and one peritonitis due to duodenal leak PO day-1 (treated surgically)). There were six emergency department visits (15%), readmission rate was 5% (n = 2) and reintervention rate was 2.5% (n = 1) There was no mortality and no unplanned overnight hospitalization. CONCLUSIONS Robotic SADI can be safe for SDD, with appropriate patient selection, in a high-volume center.
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Affiliation(s)
- Anne-Sophie Studer
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada.
| | - Henri Atlas
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
| | - Marc Belliveau
- Department of anesthesiology, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
| | - Amir Sleiman
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
| | - Alexis Deffain
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
| | - Pierre Y Garneau
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
| | - Radu Pescarus
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
| | - Ronald Denis
- Department of bariatric, robotic and minimally invasive surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 boul. Gouin ouest Montréal, Québec, H4J 1C5, Canada
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17
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Bizerea-Moga TO, Pitulice L, Bizerea-Spiridon O, Moga TV. Exploring the Link between Oxidative Stress, Selenium Levels, and Obesity in Youth. Int J Mol Sci 2024; 25:7276. [PMID: 39000383 PMCID: PMC11242909 DOI: 10.3390/ijms25137276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Obesity is a worldwide increasing concern. Although in adults this is easily estimated with the body mass index, in children, who are constantly growing and whose bodies are changing, the reference points to assess weight status are age and gender, and need corroboration with complementary data, making their quantification highly difficult. The present review explores the interaction spectrum of oxidative stress, selenium status, and obesity in children and adolescents. Any factor related to oxidative stress that triggers obesity and, conversely, obesity that induces oxidative stress are part of a vicious circle, a complex chain of mechanisms that derive from each other and reinforce each other with serious health consequences. Selenium and its compounds exhibit key antioxidant activity and also have a significant role in the nutritional evaluation of obese children. The balance of selenium intake, retention, and metabolism emerges as a vital aspect of health, reflecting the complex interactions between diet, oxidative stress, and obesity. Understanding whether selenium status is a contributor to or a consequence of obesity could inform nutritional interventions and public health strategies aimed at preventing and managing obesity from an early age.
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Affiliation(s)
- Teofana Otilia Bizerea-Moga
- Department XI of Pediatrics-1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq No 2, 300041 Timișoara, Romania;
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania
| | - Laura Pitulice
- Department of Biology-Chemistry, West University of Timişoara, Pestallozi 16, 300115 Timişoara, Romania;
- The Institute for Advanced Environmental Research (ICAM), Popa Şapcă 4C, 300054 Timişoara, Romania
| | - Otilia Bizerea-Spiridon
- Department of Biology-Chemistry, West University of Timişoara, Pestallozi 16, 300115 Timişoara, Romania;
- The Institute for Advanced Environmental Research (ICAM), Popa Şapcă 4C, 300054 Timişoara, Romania
| | - Tudor Voicu Moga
- Department VII of Internal Medicine-Gastroenterology Discipline, Advanced Regional Research Center in Gastroenterology and Hepatology, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq No 2, 300041 Timișoara, Romania;
- Gastroenterology and Hepatology Clinic, ‘Pius Brînzeu’ County Emergency Clinical Hospital, Liviu Rebreanu 156, 300723 Timișoara, Romania
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18
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Telang MM, Waghaye S, Muthusamy E, Choudhary S, Alrais ZF, Kasim F, Khatib KI. Association of obesity and mortality in patients with COVID-19 acute respiratory distress syndrome: A retrospective cohort study. Int J Crit Illn Inj Sci 2024; 14:153-159. [PMID: 39512557 PMCID: PMC11540193 DOI: 10.4103/ijciis.ijciis_27_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/04/2024] [Accepted: 07/16/2024] [Indexed: 11/15/2024] Open
Abstract
Background Chronic conditions such as obesity are associated with adverse outcomes in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) patients. The aim of our study was to evaluate the relationship between BMI and outcomes in critically ill patients with COVID-19 ARDS. Methods A retrospective study including all patients with COVID-19 and ARDS on mechanical ventilation admitted to the intensive care unit (ICU) over 2 years. Patients with obesity (BMI ≥30 kg/m2) were compared with those without obesity (BMI >18.5 up to 29.9 kg/m2). Outcomes compared were primary (mortality, duration of mechanical ventilation, and length of ICU stay) and secondary complications during the ICU course (inotrope requirement, acute kidney injury [AKI] requiring renal replacement therapy [RRT], and bloodstream and urinary tract infections). Results One hundred and eight patients were included in the study. The mean age of patients was 52 years, and 94 (87%) patients were males. As compared to COVID-19 ARDS patients without obesity, COVID-19 patients with obesity were more prone to develop complications like AKI, necessitating continuous RRT (P = 0.005). There was no significant difference in other complications between the two groups (all P > 0.05). There was no increased mortality in these obese patients (P = 0.056). In these patients with obesity, those who also had ischemic heart disease had an increased likelihood of mortality (P = 0.036). Conclusion Our study concludes that patients with COVID-19 ARDS who are obese are not at higher risk of mortality and more likely to develop renal complications. When these patients develop cardiac complications or bloodstream infections, they have a significantly higher risk of mortality.
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Affiliation(s)
- Madhavi Mahesh Telang
- Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates
| | - Samrat Waghaye
- Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates
| | - Elangho Muthusamy
- Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates
| | - Sunil Choudhary
- Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates
| | - Zeyad Faoor Alrais
- Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates
| | - Fathima Kasim
- Rashid Hospital and Emergency Trauma Centre, Intensive Care Unit, Dubai, United Arab Emirates
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19
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Srikanth S, Garg V, Subramanian L, Verma J, Sharma H, Klair HS, Kavathia SA, Teja JK, Vasireddy NS, Anmol K, Kolli D, Bodhankar SS, Hashmi S, Chauhan S, Desai R. In-hospital outcomes in COVID-19 patients with non-alcoholic fatty liver disease by severity of obesity: Insights from national inpatient sample 2020. World J Hepatol 2024; 16:912-919. [PMID: 38948433 PMCID: PMC11212648 DOI: 10.4254/wjh.v16.i6.912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/15/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular diseases independently of other risk factors. However, data on its effect on cardiovascular outcomes in coronavirus disease 2019 (COVID-19) hospitalizations with varied obesity levels is scarce. Clinical management and patient care depend on understanding COVID-19 admission results in NAFLD patients with varying obesity levels. AIM To study the in-hospital outcomes in COVID-19 patients with NAFLD by severity of obesity. METHODS COVID-19 hospitalizations with NAFLD were identified using International Classification of Disease -10 CM codes in the 2020 National Inpatient Sample database. Overweight and Obesity Classes I, II, and III (body mass index 30-40) were compared. Major adverse cardiac and cerebrovascular events (MACCE) (all-cause mortality, acute myocardial infarction, cardiac arrest, and stroke) were compared between groups. Multivariable regression analyses adjusted for sociodemographic, hospitalization features, and comorbidities. RESULTS Our analysis comprised 13260 hospitalizations, 7.3% of which were overweight, 24.3% Class I, 24.1% Class II, and 44.3% Class III. Class III obesity includes younger patients, blacks, females, diabetics, and hypertensive patients. On multivariable logistic analysis, Class III obese patients had higher risks of MACCE, inpatient mortality, and respiratory failure than Class I obese patients. Class II obesity showed increased risks of MACCE, inpatient mortality, and respiratory failure than Class I, but not significantly. All obesity classes had non-significant risks of MACCE, inpatient mortality, and respiratory failure compared to the overweight group. CONCLUSION Class III obese NAFLD COVID-19 patients had a greater risk of adverse outcomes than class I. Using the overweight group as the reference, unfavorable outcomes were not significantly different. Morbid obesity had a greater risk of MACCE regardless of the referent group (overweight or Class I obese) compared to overweight NAFLD patients admitted with COVID-19.
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Affiliation(s)
- Sashwath Srikanth
- Department of Medicine, ECU Health Medical Center, Greenville, NC 27834, United States
| | - Vibhor Garg
- Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY 10461, United States
| | - Lakshmi Subramanian
- Department of Medicine, ECU Health Medical Center, Greenville, NC 27834, United States
| | - Jyoti Verma
- Department of Medicine, North Alabama Medical Centre, Florence, AL 35630, United States
| | - Hansika Sharma
- Department of General Medicine, Gandhi Medical College, Secunderabad 500003, Telangana, India
| | - Harroop Singh Klair
- Department of Medicine, Government Medical College, Patiala 147001, Punjab, India
| | - Shrenil A Kavathia
- Department of Medicine, B.J. Medical College, Ahmedabad 380016, Gujarat, India
| | - Jithin Kolli Teja
- Department of Medicine, JSS Medical College, Mysore 570015, Karnataka, India
| | - Nikhil Sai Vasireddy
- Department of Internal Medicine, Gandhi Medical College, Secunderabad 500003, Telangana, India
| | - Kumar Anmol
- Department of Medicine, Kasturba Medical College, Manipal 575001, Karnataka, India
| | - Dhanush Kolli
- Department of Medicine, Kasturba Medical College, Manipal 575001, Karnataka, India
| | | | - Sobya Hashmi
- Clinical Extern, Department of Internal Medicine, Beaumont Hospital, Dearborn, MI 48124, United States
| | - Shaylika Chauhan
- Department of Internal Medicine, Geisinger Health System, Wilkes-Barre, PA 18702, United States.
| | - Rupak Desai
- Independent Researcher, Atlanta, GA 30079, United States
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20
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Carvajal JJ, García-Castillo V, Cuellar SV, Campillay-Véliz CP, Salazar-Ardiles C, Avellaneda AM, Muñoz CA, Retamal-Díaz A, Bueno SM, González PA, Kalergis AM, Lay MK. New insights into the pathogenesis of SARS-CoV-2 during and after the COVID-19 pandemic. Front Immunol 2024; 15:1363572. [PMID: 38911850 PMCID: PMC11190347 DOI: 10.3389/fimmu.2024.1363572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/24/2024] [Indexed: 06/25/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the respiratory distress condition known as COVID-19. This disease broadly affects several physiological systems, including the gastrointestinal, renal, and central nervous (CNS) systems, significantly influencing the patient's overall quality of life. Additionally, numerous risk factors have been suggested, including gender, body weight, age, metabolic status, renal health, preexisting cardiomyopathies, and inflammatory conditions. Despite advances in understanding the genome and pathophysiological ramifications of COVID-19, its precise origins remain elusive. SARS-CoV-2 interacts with a receptor-binding domain within angiotensin-converting enzyme 2 (ACE2). This receptor is expressed in various organs of different species, including humans, with different abundance. Although COVID-19 has multiorgan manifestations, the main pathologies occur in the lung, including pulmonary fibrosis, respiratory failure, pulmonary embolism, and secondary bacterial pneumonia. In the post-COVID-19 period, different sequelae may occur, which may have various causes, including the direct action of the virus, alteration of the immune response, and metabolic alterations during infection, among others. Recognizing the serious adverse health effects associated with COVID-19, it becomes imperative to comprehensively elucidate and discuss the existing evidence surrounding this viral infection, including those related to the pathophysiological effects of the disease and the subsequent consequences. This review aims to contribute to a comprehensive understanding of the impact of COVID-19 and its long-term effects on human health.
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Affiliation(s)
- Jonatan J. Carvajal
- Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, University of Antofagasta, Antofagasta, Chile
| | - Valeria García-Castillo
- Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, University of Antofagasta, Antofagasta, Chile
| | - Shelsy V. Cuellar
- Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, University of Antofagasta, Antofagasta, Chile
| | | | - Camila Salazar-Ardiles
- Center for Research in Physiology and Altitude Medicine (FIMEDALT), Biomedical Department, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Andrea M. Avellaneda
- Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, University of Antofagasta, Antofagasta, Chile
- Department of Basic Sciences, Faculty of Sciences, Universidad Santo Tomás, Antofagasta, Chile
| | - Christian A. Muñoz
- Research Center in Immunology and Biomedical Biotechnology of Antofagasta (CIIBBA), University of Antofagasta, Antofagasta, Chile
- Department of Medical Technology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
- Millennium Institute on Immunology and Immunotherapy, Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, Department of Medical Technology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Angello Retamal-Díaz
- Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, University of Antofagasta, Antofagasta, Chile
- Research Center in Immunology and Biomedical Biotechnology of Antofagasta (CIIBBA), University of Antofagasta, Antofagasta, Chile
- Millennium Institute on Immunology and Immunotherapy, Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, Department of Medical Technology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Susan M. Bueno
- Millennium Institute on Immunology and Immunotherapy, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo A. González
- Millennium Institute on Immunology and Immunotherapy, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alexis M. Kalergis
- Millennium Institute on Immunology and Immunotherapy, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Margarita K. Lay
- Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, University of Antofagasta, Antofagasta, Chile
- Research Center in Immunology and Biomedical Biotechnology of Antofagasta (CIIBBA), University of Antofagasta, Antofagasta, Chile
- Millennium Institute on Immunology and Immunotherapy, Department of Biotechnology, Faculty of Marine Sciences and Biological Resources, Department of Medical Technology, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
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21
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Qamar A, Abramov D, Bang V, Chew NWS, Kobo O, Mamas MA. Has the first year of the COVID pandemic impacted the trends in obesity-related CVD mortality between 1999 and 2019 in the United States? INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 21:200248. [PMID: 38590764 PMCID: PMC10999992 DOI: 10.1016/j.ijcrp.2024.200248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/12/2023] [Accepted: 02/16/2024] [Indexed: 04/10/2024]
Abstract
Background During the covid-19 pandemic there was a marked rise in the number of cardiovascular deaths. Obesity is a well-known modifiable risk factor for cardiovascular disease and has been identified as a factor which leads to poorer covid-19 related outcomes. In this study we aimed to analyse the impact of covid-19 on obesity-related cardiovascular deaths compared to trends seen 20 years prior. We also analysed the influence different demographics had on mortality. Methods Multiple Cause of Mortality database was accessed through CDC WONDER to obtain the obesity-related and general cardiovascular crude mortality and age adjusted mortality rates (AMMR) between 1999 and 2020 in the US. The obesity-related sample was stratified by demographics and cardiovascular mortality was subdivided into ischemic heart disease, heart failure, hypertension and cerebrovascular disease. Joinpoint Regression Program (Version 4.9.1.0) was used to calculate the average annual percent change (AAPC) in AAMR, and hence projected AAMR. Excess mortality was calculated by comparing actual AAMR in 2020 to projected values. Results and discussion There were an estimated 3058 excess deaths during the early stages of the pandemic impacting all cohorts. The greatest excess mortalities were seen in men, rural populations and in Asian/Pacific Islander and Native Americans. Interestingly the greatest overall mortality was seen in the Black American population. Our study highlights important, both pre and during the pandemic, in obesity related cardiovascular disease mortality which has important implications for ongoing public health measures.
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Affiliation(s)
- Afifa Qamar
- Lancashire Teaching Hospitals, Preston, England, United Kingdom
| | - Dmitry Abramov
- Division of Cardiology, Department of Medicine, Loma Linda Health, Loma Linda, CA, USA
| | - Vijay Bang
- Lilavati Hospital and Research Center, Mumbai, India
| | - Nicholas WS. Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Ofer Kobo
- Department of Cardiology, Hillel Yaffe Medical Center, Israel
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, United Kingdom
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, United Kingdom
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22
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Neppala S, Chigurupati HD, Mopuru NN, Alle NR, James A, Bhalodia A, Shaik S, Bandaru RR, Nanjundappa A, Sunkara P, Gummadi J, Desai R. Impact Of body Mass Index on Cardiopulmonary Outcomes of COVID-19 Hospitalizations Complicated by Severe Sepsis. OBESITY PILLARS 2024; 10:100101. [PMID: 38435542 PMCID: PMC10905037 DOI: 10.1016/j.obpill.2024.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
Background Body Mass Index (BMI) has a significant impact on Coronavirus disease (COVID-19) patient outcomes; however, major adverse cardiac and cerebrovascular outcomes in patients with severe sepsis have been poorly understood. Our study aims to explore and provide insight into its association. Methods This is an observational study looking at the impact of BMI on COVID-19-severe sepsis hospitalizations. The primary outcomes are adjusted odds of all-cause in-hospital mortality, respiratory failure, and major adverse cardiac and cerebrovascular events (MACCE), which include acute myocardial infarction, cardiac arrest, and acute ischemic stroke. The secondary outcome was healthcare resource utilization. Coexisting comorbidities and patient features were adjusted with multivariable regression analyses. Results Of 51,740 patients with severe COVID-19-sepsis admissions, 11.4% were overweight, 24.8% had Class I obesity (BMI 30-34.9), 19.8% had Class II obesity (BMI 35-39.9), and 43.9% had the categorization of Class III obesity (BMI >40) cohorts with age>18 years. The odds of MACCE in patients with class II obesity and class III obesity (OR 1.09 and 1.54; 95CI 0.93-1.29 and 1.33-1.79) were significantly higher than in overweight (p < 0.001). Class I, Class II, and Class III patients with obesity revealed lower odds of respiratory failure compared to overweight (OR 0.89, 0.82, and 0.82; 95CI 0.75-1.05, 0.69-0.97, and 0.70-0.97), but failed to achieve statistical significance (p = 0.079). On multivariable regression analysis, all-cause in-hospital mortality revealed significantly higher odds in patients with Class III obesity, Class II, and Class I (OR 1.56, 1.17, and 1.06; 95CI 1.34-1.81, 0.99-1.38, and 0.91-1.24) vs. overweight patients (p < 0.001). Conclusions Patients with Class II and Class III obesity had significantly higher odds of MACCE and in-hospital mortality in COVID-19-severe sepsis admissions.
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Affiliation(s)
| | - Himaja Dutt Chigurupati
- Department of Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA
| | - Nikhilender Nag Mopuru
- Department of Medicine, Kamineni Academy of medical sciences and research Centre, Hyderabad, India
| | | | - Alpha James
- Department of Medicine, Bukovinian State Medical University, Chernivitsi, Ukraine
| | - Ami Bhalodia
- Department of Medicine, Pandit Deendayal Upadhyay Medical College, Gujrat, India
| | - Sajida Shaik
- Department of Medicine, Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Andhra Pradesh, India
| | | | | | - Praveena Sunkara
- Department of Medicine, Medstar Medical group, Charlotte Hall, MD, USA
| | - Jyotsna Gummadi
- Department of Medicine, MedStar Franklin Square Medical Center, Baltimore, MD, USA
| | - Rupak Desai
- Independent Outcomes Researcher, Atlanta, GA, USA
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23
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Castro-Balado A, Varela-Rey I, Mejuto B, Mondelo-García C, Zarra-Ferro I, Rodríguez-Jato T, Fernández-Ferreiro A. Updated antimicrobial dosing recommendations for obese patients. Antimicrob Agents Chemother 2024; 68:e0171923. [PMID: 38526051 PMCID: PMC11064535 DOI: 10.1128/aac.01719-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
The prevalence of obesity has increased considerably in the last few decades. Pathophysiological changes in obese patients lead to pharmacokinetic (PK) and pharmacodynamic (PD) alterations that can condition the correct exposure to antimicrobials if standard dosages are used. Inadequate dosing in obese patients can lead to toxicity or therapeutic failure. In recent years, additional antimicrobial PK/PD data, extended infusion strategies, and studies in critically ill patients have made it possible to obtain data to provide a better dosage in obese patients. Despite this, it is usually difficult to find information on drug dosing in this population, which is sometimes contradictory. This is a comprehensive review of the dosing of different types of antimicrobials (antibiotics, antifungals, antivirals, and antituberculosis drugs) in obese patients, where the literature on PK and possible dosing strategies in obese adults was critically assessed.
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Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Iria Varela-Rey
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Beatriz Mejuto
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Teresa Rodríguez-Jato
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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24
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Wen Q, Xie X, Ren Q, Pan R, Du Y. BDE-99 stimulates generation of aberrant brown/beige adipocytes. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 347:123761. [PMID: 38467365 DOI: 10.1016/j.envpol.2024.123761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024]
Abstract
Adipose tissue compromises one of the principal depots where brominated flame retardants (BFR) accumulate in vivo, yet whether BFR disturb thermogenic brown/beige adipocytes is still not referred to date. Herein, effects of BDE-99, a major congener of polybrominated diphenyl ethers (PBDEs) detected in humans, on brown/beige adipocytes were explored for the first time, aiming to provide new knowledge evaluating the obesogenic and metabolic disrupting effects of BFR. Our results firstly demonstrated that exposure to BDE-99 during the lineage commitment period significantly promoted C3H10T1/2 MSCs differentiating into brown/beige adipocytes, evidenced by the increase of brown/beige adipocyte marker UCP1, Cidea as well as mitochondrial membrane potential and basal respiration rate, which was similar to pharmacological PPARγ agonist rosiglitazone. Unexpectedly, the mitochondrial maximal respiration rate of BDE-99 stimulated brown/beige adipocytes was not synchronously enhanced and resulted in a significant reduction of mitochondrial spare respiration capacity (SRC) compared to control or rosiglitazone stimulated adipocytes, indicating a deficient energy-dissipating capacity of BDE-99 stimulated thermogenic adipocytes. Consistently with compromised mitochondrial SRC, lipidomic analysis further revealed that the lipids profile of mitochondria derived from BDE-99 stimulated brown/beige adipocytes were quite different from control or rosiglitazone stimulated cells. In detail, BDE-99 group contains more free fatty acid (FFA) and lyso-PE in mitochondria. In addition to energy metabolism, our results also demonstrated that BDE-99 stimulated brown/beige adipocytes were deficient in endocrine, which secreted more adverse adipokine named resistin, coinciding with comparable beneficial adipokine adiponectin compared with that of rosiglitazone. Taken together, our results showed for the first time that BDE-99 stimulated brown/beige adipocytes were aberrant in energy metabolism and endocrine, which strongly suggests that BDE-99 accumulated in human adipose tissue could interfere with brown/beige adipocytes to contribute to the occurrence of obesity and relevant metabolic disorders.
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Affiliation(s)
- Qing Wen
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100190, China; Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Xinni Xie
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100190, China.
| | - Qidong Ren
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Ruiying Pan
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Yuguo Du
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100190, China
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Qin W, Yang J, Deng C, Ruan Q, Duan K. Efficacy and safety of semaglutide 2.4 mg for weight loss in overweight or obese adults without diabetes: An updated systematic review and meta-analysis including the 2-year STEP 5 trial. Diabetes Obes Metab 2024; 26:911-923. [PMID: 38016699 DOI: 10.1111/dom.15386] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
AIM To explore the safety and efficacy of subcutaneous semaglutide 2.4 mg, administered once a week in non-diabetic overweight or obese individuals. METHODS A thorough search was performed of various databases including PubMed, Embase, the Cochrane Library, Web of Science, clinicaltrials.gov, CNKI and Wanfang from their inception up to April 11, 2023. Our aim was to identify randomized controlled trials (RCTs) that compared the efficacy of semaglutide administered once weekly with placebo in overweight or obese adults. Through a review of the literature, data were extracted from relevant studies and assessed for quality, and a meta-analysis was conducted using RevMan 5.4.1 software. RESULTS Six RCTs comprising 3962 overweight or obese individuals were identified. The findings indicated that, in comparison to the placebo group, semaglutide caused a significant and sustainable reduction in the percentage of body weight (BW; mean difference [MD]: -11.80% [95% confidence interval {CI} -12.93, -10.68]; P < 0.00001) as well as a decrease in absolute BW (MD: -12.2 kg [95% CI -13.3, -11.1]; P < 0.00001), body mass index (MD: -4.5 kg/m2 [95% CI -4.9, -4.1]; P < 0.00001) and waist circumference (MD:-9.4 cm [95% CI -10.1, -8.8]; P < 0.00001). Moreover, it achieved a higher proportion of patients who experienced weight loss exceeding 5%, 10%, 15% and 20%. Furthermore, semaglutide showed significant efficacy in controlling blood pressure, blood sugar levels, C-reactive protein levels, and lipid profiles. In terms of safety, the most common adverse effects following semaglutide treatment were gastrointestinal adverse reactions (risk ratio: 1.49 [95% CI 1.38, 1.60]; P < 0.00001), which were generally mild to moderate in severity and temporary. CONCLUSION In overweight or obese non-diabetic individuals, semaglutide had a remarkable and sustained weight loss effect that was well tolerated and safe.
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Affiliation(s)
- Wenhui Qin
- Department of Endocrinology and Metabolism, Jingshan Union Hospital of Huazhong University of Science and Technology, Jingmen, China
| | - Jun Yang
- Department of Endocrinology and Metabolism, Jingshan Union Hospital of Huazhong University of Science and Technology, Jingmen, China
| | - Chao Deng
- Department of Pharmacy, Jingshan Union Hospital of Huazhong University of Science and Technology, Jingmen, China
| | - Qinjuan Ruan
- Department of Pharmacy, Jingshan Union Hospital of Huazhong University of Science and Technology, Jingmen, China
| | - Kai Duan
- Department of Nephrology, Jingshan Union Hospital of Huazhong University of Science and Technology, Jingmen, China
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26
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Davey MG, Donlon NE, Fearon NM, Heneghan HM, Conneely JB. Evaluating the Impact of Enhanced Recovery After Surgery Protocols on Surgical Outcomes Following Bariatric Surgery-A Systematic Review and Meta-analysis of Randomised Clinical Trials. Obes Surg 2024; 34:778-789. [PMID: 38273146 PMCID: PMC10899423 DOI: 10.1007/s11695-024-07072-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Enhanced recovery after surgery (ERAS) programmes are evidence-based care improvement processes for surgical patients, which are designed to decrease the impact the anticipated negative physiological cascades following surgery. AIM To perform a systematic review and meta-analysis of randomised clinical trials (RCTs) to evaluate the impact of ERAS protocols on outcomes following bariatric surgery compared to standard care (SC). METHODS A systematic review was performed in accordance with PRISMA guidelines. Meta-analysis was performed using Review Manager version 5.4 RESULTS: Six RCTs including 740 patients were included. The mean age was 40.2 years, and mean body mass index was 44.1 kg/m2. Overall, 54.1% underwent Roux-en-Y gastric bypass surgery (400/740) and 45.9% sleeve gastrectomy (340/700). Overall, patients randomised to ERAS programmes had a significant reduction in nausea and vomiting (odds ratio (OR): 0.42, 95% confidence interval (CI): 0.19-0.95, P = 0.040), intraoperative time (mean difference (MD): 5.40, 95% CI: 3.05-7.77, P < 0.001), time to mobilisation (MD: - 7.78, 95% CI: - 5.46 to - 2.10, P < 0.001), intensive care unit stay (ICUS) (MD: 0.70, 95% CI: 0.13-1.27, P = 0.020), total hospital stay (THS) (MD: - 0.42, 95% CI: - 0.69 to - 0.16, P = 0.002), and functional hospital stay (FHS) (MD: - 0.60, 95% CI: - 0.98 to - 0.22, P = 0.002) compared to those who received SC. CONCLUSION ERAS programmes reduce postoperative nausea and vomiting, intraoperative time, time to mobilisation, ICUS, THS, and FHS compared to those who received SC. Accordingly, ERAS should be implemented, where feasible, for patients indicated to undergo bariatric surgery. Trial registration International Prospective Register of Systematic Reviews (PROSPERO - CRD42023434492.
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Affiliation(s)
- Matthew G Davey
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland.
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
| | - Noel E Donlon
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Naomi M Fearon
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Helen M Heneghan
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - John B Conneely
- Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
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27
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Manno V, Minardi V, Masocco M, Cobellis F, Minelli G, Greco D. First national analysis of severe obesity hospitalizations in Italy: insights from discharge card database. Front Public Health 2024; 12:1332076. [PMID: 38584920 PMCID: PMC10995918 DOI: 10.3389/fpubh.2024.1332076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/31/2024] [Indexed: 04/09/2024] Open
Abstract
Background Obesity is associated with numerous severe diseases necessitating intensive healthcare for diagnosis and treatment. Most patients with obesity, especially in its severe form, require at least one hospitalization. However, few studies in Italy have assessed the burden of obesity on the National Health System. This study aims to routinely estimate the 'disease burden' by analyzing hospital admissions related to severe obesity. Subjects We analyzed the medical records of the Italian national hospital discharge database, including all patients older than 18 years discharged with the diagnosis of 'severe obesity'.' We included patients who underwent bariatric surgery, even without an explicit obesity code, such as laparoscopic restrictive gastric procedures, other stomach operations, and high gastric bypass. Special focus was given to those who underwent abdominal reshaping surgery. The cross-sectional survey PASSI in Italy served as an additional data source to estimate. The phenomenon was described using appropriate indicators, including rates and ratios between rates. Linear regression was employed to analyze trends in standardized rates over time. Results Between 2014 and 2021, a total of 243,325 patients were discharged with a severe obesity code in Italy. Among these patients, 36.8% underwent at least one bariatric surgery procedure. We investigated the types of bariatric surgery procedures performed. The most frequent procedure was "other operations on the stomach," where sleeve gastrectomy is included which also appears to be steadily increasing during the study period together with the gastric bypass, while the gastric bondage is decreasing over time. Conclusion These findings underscore the significant burden of severe obesity on Italy's healthcare system, a burden that is progressively increasing. The growing utilization of bariatric surgery suggests an escalating trend toward adopting drastic solutions to combat this health issue.
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Affiliation(s)
- Valerio Manno
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Rome, Italy
| | - Maria Masocco
- National Centre for Disease Prevention and Health Promotion, Rome, Italy
| | - Francesco Cobellis
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Donato Greco
- Cobellis Clinic Vallo Della Lucania (SA), Salerno, Italy
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Yeh CL, Wu JM, Chen KY, Wu MH, Yang PJ, Lee PC, Chen PD, Kuo TC, Yeh SL, Lin MT. Calcitriol attenuates poly(I:C)-induced lung injury in obese mice via modulating toll-like receptor 3- and renin-angiotensin system-associated signal pathways. Int Immunopharmacol 2024; 128:111522. [PMID: 38246004 DOI: 10.1016/j.intimp.2024.111522] [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: 11/09/2023] [Revised: 12/26/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024]
Abstract
This study investigated the effects of calcitriol on polyinosinic-polycytidylic acid (poly(I:C))-induced acute lung injury (ALI) and its association with Toll-like receptor 3 (TLR3) and renin-angiotensin system (RAS) signal pathways in obese mice. Normal mice were fed a high-fat diet to induce obesity. Obese mice were divided into four groups: SS group, intratracheally instilled with saline and intravenous (IV) saline injection via tail vein; SD group, instilled with saline and IV calcitriol injection; PS group, instilled with poly(I:C) and IV saline injection; and PD group, instilled with poly(I:C) and IV calcitriol injection. All mice were sacrificed 12 or 24 h after poly(I:C) stimulation. The results showed that poly(I:C) instillation led to increased production of systemic inflammatory cytokines. In the lungs, the population of macrophages decreased, while more neutrophils were recruited. TLR3-associated genes including IRF3, nuclear factor-κB, interferon-β and phosphorylated IRF3 expression levels, were upregulated. The RAS-associated AT1R and ACE2 protein levels increased, whereas AT2R, Ang(1-7), and MasR levels decreased. Also, reduced tight junction (TJ) proteins and elevated lipid peroxide levels were observed 24 h after poly(I:C) stimulation. Compared to the PS group, the PD group exhibited reduced systemic and lung inflammatory cytokine levels, increased macrophage while decreased neutrophil percentages, downregulated TLR3-associated genes and phosphorylated IRF3, and polarized toward the RAS-AT2R/Ang(1-7)/MasR pathway in the lungs. Higher lung TJ levels and lower injury scores were also noted. These findings suggest that calcitriol treatment after poly(I:C) instillation alleviated ALI in obese mice possibly by downregulating TLR3 expression and tending toward the RAS-associated anti-inflammatory pathway.
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Affiliation(s)
- Chiu-Li Yeh
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan; Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jin-Ming Wu
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuen-Yuan Chen
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Hsun Wu
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Jen Yang
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Chu Lee
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Da Chen
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Chun Kuo
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sung-Ling Yeh
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Tsan Lin
- Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
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Angeles-Martinez J, Monroy-Muñoz IE, Muñoz-Medina JE, Fernandes-Matano L, Salas-Lais ÁG, Hernández-Cueto MDLÁ, Bravo-Flores E, León-Juárez M, Santacruz-Tinoco CE, Montes-Herrera D. A Potential Association between Abdominal Obesity and the Efficacy of Humoral Immunity Induced by COVID-19 and by the AZD1222, Convidecia, BNT162b2, Sputnik V, and CoronaVac Vaccines. Vaccines (Basel) 2024; 12:88. [PMID: 38250901 PMCID: PMC10819553 DOI: 10.3390/vaccines12010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/31/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Abdominal obesity is highly prevalent in Mexico and has a poor prognosis in terms of the severity of coronavirus disease (COVID-19) and low levels of antibodies induced by infection and vaccination. We evaluated the humoral immune response induced by COVID-19 and five different vaccination schedules in Mexican individuals with abdominal obesity and the effects of other variables. This prospective longitudinal cohort study included 2084 samples from 389 participants. The levels of anti-S1/S2 and anti-RBD IgG antibodies were measured at various time points after vaccination. A high prevalence of hospitalization and oxygen use was observed in individuals with abdominal obesity (AO) who had COVID-19 before vaccination; however, they also had high levels of anti-S1/S2 and anti-RBD-neutralizing IgG antibodies. The same was true for vaccination-induced antibody levels. However, their longevity was low. Interestingly, we did not observe significant differences in vaccine reactogenicity between abdominally obese and abdominally non-obese groups. Finally, individuals with a higher body mass index, older age, and previous COVID-19 had higher levels of antibodies induced by COVID-19 and vaccination. Therefore, it is important to evaluate other immunological and inflammatory factors to better understand the pathogenesis of COVID-19 in the presence of risk factors and to propose effective vaccination schedules for vulnerable populations.
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Affiliation(s)
- Javier Angeles-Martinez
- Central Epidemiology Laboratory, Mexican Social Security Institute, Mexico City 02990, Mexico; (Á.G.S.-L.); (M.D.L.Á.H.-C.)
| | - Irma Eloisa Monroy-Muñoz
- Reproductive and Perinatal Health Research Department, National Institute of Perinatology, Mexico City 11000, Mexico;
| | - José Esteban Muñoz-Medina
- Quality of Supplies and Specialized Laboratories Coordination, Mexican Social Security Institute, Mexico City 07760, Mexico; (J.E.M.-M.); (L.F.-M.)
| | - Larissa Fernandes-Matano
- Quality of Supplies and Specialized Laboratories Coordination, Mexican Social Security Institute, Mexico City 07760, Mexico; (J.E.M.-M.); (L.F.-M.)
| | - Ángel Gustavo Salas-Lais
- Central Epidemiology Laboratory, Mexican Social Security Institute, Mexico City 02990, Mexico; (Á.G.S.-L.); (M.D.L.Á.H.-C.)
| | | | | | - Moisés León-Juárez
- Immunobiochemistry Department, National Institute of Perinatology, Mexico City 11000, Mexico;
| | | | - Daniel Montes-Herrera
- Central Epidemiology Laboratory, Mexican Social Security Institute, Mexico City 02990, Mexico; (Á.G.S.-L.); (M.D.L.Á.H.-C.)
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Al Otaibi T, Nagib A, Nair P, Halim MA, Khaled M, Hammad MA, Mahmoud TS, Sobhy I, Zakaria Z, Atta A, Deraz A, Mostafa A, Abuelmagd M, Shaker M, Alserwy N, Fyyad Z, Rida S, Aboatya H, Adel M, Balaha M, Atea K, Gheith O. Acute Kidney Injury Among COVID-19-Positive Patients Is Associated With Higher Mortality: A Single-Center Experience. EXP CLIN TRANSPLANT 2024; 22:290-298. [PMID: 38385415 DOI: 10.6002/ect.mesot2023.p98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Renal complications of COVID-19 are not yet well studied. We aimed to evaluate acute kidney injury prevalence among hospitalized patients with COVID-19 infection and explore its effect on patient outcomes. MATERIALS AND METHODS We retrospectively evaluated 586 hospitalized patients with COVID-19. Of these patients, 267 (45.5%) developed acute kidney injury, as classified according to the Kidney Disease Improving Global Outcomes guidelines. We compared this group with 319 patients (54.5%) without acute kidney injury. RESULTS Most patients in both study groups were men; mean age was 60.8 ± 14 versus 51.7 ± 16 years. Comorbid conditions that were substantially predominant among patients with acute kidney injury were diabetes mellitus (64% vs 42.9%), hypertension (72.6% vs 43.5%), and ischemic heart disease (25% vs 14.7%). Fever, cough, shortness of breath, and dehydration were the main presentations among patients with acute kidney injury, and patients in this group had greater prevalence of radiological findings concordant with COVID-19 (86.8% vs 59.8%). Sepsis, volume depletion, shock, arrhythmias, and acute respiratory distress syndrome were higher in patients with acute kidney injury. Anticoagulation (85% vs 59.2%), vasopressors, plasma infusions, antimicrobials, and steroids were more frequently used in patients with acute kidney injury. More patients with acute kidney injury had acute respiratory failure requiring mechanical ventilation (62.3% vs 32.9%), with higher overall mortality rate (63.2% vs 31.1%). CONCLUSIONS We found more frequent prevalence of acute kidney injury associated with severe COVID-19 than shown in reports from Chinese, European, and North American cohorts. Patients with COVID-19 who developed acute kidney injury had risk factors such as hypertension and diabetes, greater need for mechanical ventilation, were males, and were older age. Mortality was high in this population, especially among older patients and those who developed Kidney Disease Improving Global Outcomes stage 3 disease.
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31
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Yang Y, Song Y, Hou D. Obesity and COVID-19 Pandemics: Epidemiology, Mechanisms, and Management. Diabetes Metab Syndr Obes 2023; 16:4147-4156. [PMID: 38145256 PMCID: PMC10749174 DOI: 10.2147/dmso.s441762] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023] Open
Abstract
Obesity is a principle causative factor of various metabolic dysfunctions, chronic inflammation, and multi-organ impairment. The global epidemic of obesity has constituted the greatest threat to global health. Emerging evidence has associated obesity with an increased risk of severe infection and poor outcomes from coronavirus disease 2019 (COVID-19). During current COVID-19 pandemic, the interaction between COVID-19 and obesity has exaggerated the disease burden of obesity more than ever before. Thus, there is an urgent need for consideration of universal measures to reduce the risk of complications and severe illness from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in obesity population. In this review, we first summarized the clinical evidence on the effect of obesity on susceptibility, severity, and prognosis of COVID-19. Then we discussed and the underlying mechanisms, including respiratory pathophysiology of obesity, dysregulated inflammation, upregulated angiotensin-converting enzyme 2 (ACE2) expression, hyperglycemia, and adipokines. Finally, we proposed recommendations on how to reduce the spread and pandemic of SARS-CoV-2 infection by prevention and treatment of obesity.
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Affiliation(s)
- Yanping Yang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
| | - Yuanlin Song
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
- Shanghai Respiratory Research Institute, Shanghai, People’s Republic of China
| | - Dongni Hou
- Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
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Gostimirovic M, Rajkovic J, Bukarica A, Simanovic J, Gojkovic-Bukarica L. Resveratrol and Gut Microbiota Synergy: Preventive and Therapeutic Effects. Int J Mol Sci 2023; 24:17573. [PMID: 38139400 PMCID: PMC10743535 DOI: 10.3390/ijms242417573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
The role of an imbalanced high-fat diet in the pathophysiology of common chronic noncommunicable diseases has been known for years. More recently, the concept of 'gut microbiota' and the interaction between their composition and gut metabolites produced from the intake of dietary products have gained the focus of researchers, mostly from the perspective of the prevention of cardiovascular and metabolic disorders, which are still the leading cause of death globally. The aim of this work is to highlight the health benefits of the interaction between resveratrol (RSV), red grape polyphenol, and gut microbiota, through aspects of their therapeutic and preventive potentials. Since changed microbiota (mostly as a consequence of antibiotic overuse) contribute to the persistence of post ('long')-COVID-19 symptoms, these aspects will be covered too. Data were obtained from the electronic databases (MedLine/PubMed), according to specific keywords regarding the protective role of resveratrol, the gut microbiota, and their synergy. RSV exerts beneficial properties in the modulation of cardiovascular, metabolic, and post-COVID-19-related disorders. In healthy individuals, it maintains an ergogenic capacity, prevents oxidative stress, and modulates the inflammatory response. Overall, it improves quality of life. The RSV-gut-microbiota interaction is beneficial in terms of maintaining human health. Along with physical activity, it is key for the prevention of chronic noncommunicable diseases.
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Affiliation(s)
- Milos Gostimirovic
- Department of Cardiovascular Pharmacology, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia; (M.G.); (J.S.); (L.G.-B.)
| | - Jovana Rajkovic
- Department of Cardiovascular Pharmacology, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia; (M.G.); (J.S.); (L.G.-B.)
| | - Ana Bukarica
- Institute for Cardiovascular Diseases Dedinje, Faculty of Medicine, University of Belgrade, 11040 Belgrade, Serbia;
| | - Jovana Simanovic
- Department of Cardiovascular Pharmacology, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia; (M.G.); (J.S.); (L.G.-B.)
| | - Ljiljana Gojkovic-Bukarica
- Department of Cardiovascular Pharmacology, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia; (M.G.); (J.S.); (L.G.-B.)
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Li C, Islam N, Gutierrez JP, Gutiérrez-Barreto SE, Castañeda Prado A, Moolenaar RL, Lacey B, Richter P. Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis. BMJ Glob Health 2023; 8:e012581. [PMID: 38097276 PMCID: PMC10729095 DOI: 10.1136/bmjgh-2023-012581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/04/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Despite a growing body of scholarly research on the risks of severe COVID-19 associated with diabetes, hypertension and obesity, there is a need for estimating pooled risk estimates with adjustment for confounding effects. We conducted a systematic review and meta-analysis to estimate the pooled adjusted risk ratios of diabetes, hypertension and obesity on COVID-19 mortality. METHODS We searched 16 literature databases for original studies published between 1 December 2019 and 31 December 2020. We used the adapted Newcastle-Ottawa Scale to assess the risk of bias. Pooled risk ratios were estimated based on the adjusted effect sizes. We applied random-effects meta-analysis to account for the uncertainty in residual heterogeneity. We used contour-funnel plots and Egger's test to assess possible publication bias. RESULTS We reviewed 34 830 records identified in literature search, of which 145 original studies were included in the meta-analysis. Pooled adjusted risk ratios were 1.43 (95% CI 1.32 to 1.54), 1.19 (95% CI 1.09 to 1.30) and 1.39 (95% CI 1.27 to 1.52) for diabetes, hypertension and obesity (body mass index ≥30 kg/m2) on COVID-19 mortality, respectively. The pooled adjusted risk ratios appeared to be stronger in studies conducted before April 2020, Western Pacific Region, low- and middle-income countries, and countries with low Global Health Security Index scores, when compared with their counterparts. CONCLUSIONS Diabetes, hypertension and obesity were associated with an increased risk of COVID-19 mortality independent of other known risk factors, particularly in low-resource settings. Addressing these chronic diseases could be important for global pandemic preparedness and mortality prevention. PROSPERO REGISTRATION NUMBER CRD42021204371.
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Affiliation(s)
- Chaoyang Li
- Division of Global Health Protection, Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nazrul Islam
- Faculty of Medicine, University of Southampton, Southampton, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Juan Pablo Gutierrez
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | | | - Andrés Castañeda Prado
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Ronald L Moolenaar
- Division of Global Health Protection, Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ben Lacey
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Patricia Richter
- Division of Global Health Protection, Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Subramaniam A, Ling RR, Ridley EJ, Pilcher DV. The impact of body mass index on long-term survival after ICU admission due to COVID-19: A retrospective multicentre study. CRIT CARE RESUSC 2023; 25:182-192. [PMID: 38234325 PMCID: PMC10790021 DOI: 10.1016/j.ccrj.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 01/19/2024]
Abstract
Objective The impact of obesity on long-term survival after intensive care unit (ICU) admission with severe coronavirus disease 2019 (COVID-19) is unclear. We aimed to quantify the impact of obesity on time to death up to two years in patients admitted to Australian and New Zealand ICUs. Design Retrospective multicentre study. Setting 92 ICUs between 1st January 2020 through to 31st December 2020 in New Zealand and 31st March 2022 in Australia with COVID-19, reported in the Australian and New Zealand Intensive Care Society adult patient database. Participants All patients with documented height and weight to estimate the body mass index (BMI) were included. Obesity was classified patients according to the World Health Organization recommendations. Interventions and main outcome measures The primary outcome was survival time up to two years after ICU admission. The effect of obesity on time to death was assessed using a Cox proportional hazards model. Confounders were acute illness severity, sex, frailty, hospital type and jurisdiction for all patients. Results We examined 2,931 patients; the median BMI was 30.2 (IQR 25.6-36.0) kg/m2. Patients with a BMI ≥30 kg/m2 were younger (median [IQR] age 57.7 [46.2-69.0] vs. 63.0 [50.0-73.6]; p < 0.001) than those with a BMI <30 kg/m2. Most patients (76.6%; 2,244/2,931) were discharged alive after ICU admission. The mortality at two years was highest for BMI categories <18.5 kg/m2 (35.4%) and 18.5-24.9 kg/m2 (31.1%), while lowest for BMI ≥40 kg/m2 (14.5%). After adjusting for confounders and with BMI 18.5-24.9 kg/m2 category as a reference, only the BMI ≥40 kg/m2 category patients had improved survival up to 2 years (hazard ratio = 0.51; 95%CI: 0.34-0.76). Conclusions The obesity paradox appears to exist beyond hospital discharge in critically ill patients with COVID-19 admitted in Australian and New Zealand ICUs. A BMI ≥40 kg/m2 was associated with a higher survival time of up to two years.
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Affiliation(s)
- Ashwin Subramaniam
- Department of Intensive Care, Peninsula Health, Frankston, Victoria, Australia
- Department of Intensive Care, Dandenong Hospital, Monash Health, Dandenong, Victoria, Australia
- Peninsula Clinical School, Monash University, Frankston, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ryan Ruiyang Ling
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emma J. Ridley
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Nutrition and Dietetics, Alfred Hospital, Melbourne, Victoria, Australia
| | - David V. Pilcher
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Alfred Hospital, Melbourne, Victoria, Australia
- Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Victoria, Australia
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Crnjaković M, Deveđija S, Vukorepa G, Rutović S, Sporiš D, Trkulja V. Increased carotid intima-media thickness is associated with higher odds of unfavorable outcomes in adults without advanced vascular diseases presenting with non-severe COVID-19 pneumonia: a nested case-control study. Croat Med J 2023; 64:344-353. [PMID: 37927189 PMCID: PMC10668038 DOI: 10.3325/cmj.2023.64.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/05/2023] [Indexed: 02/07/2025] Open
Abstract
AIM To evaluate the association between carotid intima-media thickness (CIMT) at hospital admission and unfavorable outcomes in adults without advanced vascular diseases presenting with non-severe COVID-19 pneumonia to assess the feasibility of evaluating CIMT as a risk stratification aid in this setting. METHODS This proof-of-concept nested case-control study enrolled consecutive non-vaccinated adults free of advanced vascular diseases presenting with verified non-severe COVID-19 pneumonia between December 2020 and June 2021. CIMT was measured at admission, and patients were managed in line with the national Ministry of Health guidelines. Those who died or required mechanical ventilation (MV) during the index hospital stay were considered cases and were matched (entropy balancing, exact matching) on a set of covariates to survivors not requiring MV (controls). Frequentist and Bayesian logistic models were fitted to the case status. RESULTS The study enrolled 207 patients: 27 (13%) cases and 180 controls. All were retained in the analysis after entropy balancing, while 27 cases were exactly matched to 99 controls. Higher CIMT at the proximal internal carotid artery (both left and right) was consistently associated with higher odds of being a case: all odds ratio point-estimates were ≥1.50 with lower limits of the 99% confidence intervals/credibility intervals ≥1.00 with two-sided probabilities of OR>1.00 greater than 99.5%. The susceptibility of the estimates to unmeasured confounding was low. CONCLUSION This study supports the feasibility of CIMT as a risk stratification aid in adults free of advanced vascular disease presenting with non-severe COVID-19 pneumonia.
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Affiliation(s)
| | | | | | | | | | - Vladimir Trkulja
- Vladimir Trkulja, Department of Pharmacology, Zagreb University School of Medicine, Šalata 11, 10000 Zagreb, Croatia,
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Zhang J, Wen J, Wan X, Luo P. The causal relationship between air pollution, obesity, and COVID-19 risk: a large-scale genetic correlation study. Front Endocrinol (Lausanne) 2023; 14:1221442. [PMID: 37867515 PMCID: PMC10585274 DOI: 10.3389/fendo.2023.1221442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/10/2023] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE Observational evidence reported that air pollution is a significant risk element for numerous health problems, such as obesity and coronavirus disease 2019 (COVID-19), but their causal relationship is currently unknown. Our objective was to probe the causal relationship between air pollution, obesity, and COVID-19 and to explore whether obesity mediates this association. METHODS We obtained instrumental variables strongly correlated to air pollutants [PM2.5, nitrogen dioxide (NO2) and nitrogen oxides (NOx)], 9 obesity-related traits (abdominal subcutaneous adipose tissue volume, waist-to-hip ratio, body mass index, hip circumference, waist circumference, obesity class 1-3, visceral adipose tissue volume), and COVID-19 phenotypes (susceptibility, hospitalization, severity) from public genome-wide association studies. We used clinical and genetic data from different public biological databases and performed analysis by two-sample and two-step Mendelian randomization. RESULTS PM2.5 genetically correlated with 5 obesity-related traits, which obesity class 1 was most affected (beta = 0.38, 95% CI = 0.11 - 0.65, p = 6.31E-3). NO2 genetically correlated with 3 obesity-related traits, which obesity class 1 was also most affected (beta = 0.33, 95% CI = 0.055 - 0.61, p = 1.90E-2). NOx genetically correlated with 7 obesity-related traits, which obesity class 3 was most affected (beta = 1.16, 95% CI = 0.42-1.90, p = 2.10E-3). Almost all the obesity-related traits genetically increased the risks for COVID-19 phenotypes. Among them, body mass index, waist circumference, hip circumference, waist-to-hip ratio, and obesity class 1 and 2 mediated the effects of air pollutants on COVID-19 risks (p < 0.05). However, no direct causal relationship was observed between air pollution and COVID-19. CONCLUSION Our study suggested that exposure to heavy air pollutants causally increased risks for obesity. Besides, obesity causally increased the risks for COVID-19 phenotypes. Attention needs to be paid to weight status for the population who suffer from heavy air pollution, as they are more likely to be susceptible and vulnerable to COVID-19.
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Affiliation(s)
- Jingwei Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wen
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xin Wan
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Shin J, Shimomura I. COVID-19, Obesity, and GRP78: Unraveling the Pathological Link. J Obes Metab Syndr 2023; 32:183-196. [PMID: 37752707 PMCID: PMC10583770 DOI: 10.7570/jomes23053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/16/2023] [Accepted: 09/22/2023] [Indexed: 09/28/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, driven by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to an unprecedented global surge in infections and fatalities. Notably, obesity has emerged as an important susceptibility factor for COVID-19; however, the pathological mechanisms for this remain poorly understood. Recent studies proposed a role for glucose-regulated protein 78 (GRP78), a protein implicated in both obesity and metabolic syndrome, which may function as a binding partner and/or co-receptor for SARS-CoV-2. Given its crucial involvement in diverse biological processes, GRP78 likely plays a major role in multiple facets of the viral life cycle and the pathology of COVID-19. This perspective review discusses the potential contributions of GRP78 to the dynamics of SARS-CoV-2 infection and pathology, particularly in the context of obesity. The primary objective is to facilitate a deeper understanding of the pathogenesis of COVID-19. Through this exploration, we aim to illuminate the complex interactions underpinning the nexus of COVID-19, obesity, and GRP78, ultimately paving the way for informed therapeutic strategies and preventive measures.
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Affiliation(s)
- Jihoon Shin
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
- Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
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das Virgens IPA, Sousa IM, Bezerra ADL, Fayh APT. Assessment of body composition in adults hospitalized with acute COVID-19: a scoping review. Front Nutr 2023; 10:1176441. [PMID: 37743922 PMCID: PMC10513420 DOI: 10.3389/fnut.2023.1176441] [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] [Received: 02/28/2023] [Accepted: 07/07/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Body composition (BC) assessment can supply accurate information for in-hospital nutritional evaluation. The aim of this study was to explore in the literature how the studies assessed BC, for what purpose, and investigate the role of BC findings in COVID-19 hospitalized patients' outcomes. Methods A scoping review was conducted according to the methodology available on the Joanna Briggs Institute website. We used the PCC acronym for the systematic search (population: adults with COVID-19, concept: assessment of BC, context: hospital setting) and performed it on PubMed, Scopus, and the Web of Science on 16 September 2022. Eligibility criteria consisted of the utilization of BC assessment tools in COVID-19 patients. Studies in which BC was solely measured with anthropometry (perimeters and skinfolds) were excluded. No language restriction was applied. Results Fifty-five studies were eligible for the review. Out of the 55 studies, 36 used computed tomography (CT), 13 used bioelectrical impedance (BIA), and 6 used ultrasound (US). No studies with D3-creatinine, 24 h urine excretion, dual-energy X-ray absorptiometry, or magnetic resonance were retrieved. BC was mainly assessed to test associations with adverse outcomes such as disease severity and mortality. Discussion Studies assessing BC in hospitalized patients with COVID-19 used mainly CT and BIA and associated the parameters with severity and mortality. There is little evidence of BC being assessed by other methods, as well as studies on BC changes during hospitalization.
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Affiliation(s)
- Isabel Pinto Amorim das Virgens
- Graduation Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Center for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Iasmin Matias Sousa
- Graduation Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Agnes Denise Lima Bezerra
- Graduation Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana Paula Trussardi Fayh
- Graduation Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Shipman S, Owens T, Gilbertson C, Shipman J. Hospital Admission Rates and Mortality Among Emergency Department Patients with COVID-19 Discharged with Remote Patient Monitoring with or without HO 2ME - A Value-Based Approach. THE JOURNAL OF THE OKLAHOMA STATE MEDICAL ASSOCIATION 2023; 116:167-171. [PMID: 39267658 PMCID: PMC11391851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Background The pandemic caused by the novel Coronavirus 2019 (COVID-19) overwhelmed healthcare systems with emergency department (ED) and hospital overcrowding. Our hospital system was able to discharge a subset of COVID-19 patients home with remote patient monitoring (RPM) and home oxygen (HO2ME) if needed, which opened up beds for the more critical patients. The objective of this study was to review the all-cause 30-day mortality and admission rates for patients chosen for our program, and to additionally examine the financial impact. Methods This was a retrospective cohort study of ED patients who were included if they tested positive for SARS-CoV-2 RNA on nasopharyngeal swab and received emergency care for COVID-19 at any INTEGRIS facility during 10/27/2020-9/8/2021. For the primary statistical analysis, descriptive statistics were calculated and reported as medians with interquartile ranges. For the purpose of financial analysis, we filtered a subset of insured patients who were sent home with oxygen. Results 490 patients were enrolled with a median age of 62 and median body mass index (BMI) of 31. Of the 490 patients, 151 patients (31%) met requirements for home oxygen and were discharged with oxygen. Over a median enrollment time of 15 days, patients discharged from the emergency department on the RPM program were observed to have an all-cause 30-day mortality rate of 3.2% (95% Cl, 1.8%-5.2%). The observed rate of all-cause hospital admission within 30 days was 17%. The financial analysis revealed savings to insurance companies. Conclusions This study demonstrated that rapidly deploying a RPM program for patients with acute COVID-19 infection allowed our health system to safely care for patients in their homes. The program opened hospital beds for more severe and critically ill COVID-19 patients who necessitated more intense monitoring and inpatient care, while simultaneously observing low 30-day all-cause mortality and hospital admission rates.
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Affiliation(s)
- Stacia Shipman
- INTEGRIS Southwest Medical Center, Department of Emergency Medicine, Oklahoma City, OK
| | - Tomas Owens
- INTEGRIS Baptist Medical Center, Department of Family Medicine, Oklahoma City, OK
| | - Chelsey Gilbertson
- INTEGRIS Southwest Medical Center, Department of Emergency Medicine, Oklahoma City, OK
| | - Jeffrey Shipman
- INTEGRIS Southwest Medical Center, Department of Emergency Medicine, Oklahoma City, OK
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Carletti P, Shah A, Bair C, Curran C, Mai A, Patel R, Moorthy R, Villate N, Davis JL, Vitale AT, Shakoor A, Hassman L. The spectrum of COVID-19-associated chorioretinal vasculopathy. Am J Ophthalmol Case Rep 2023; 31:101857. [PMID: 37255549 PMCID: PMC10193817 DOI: 10.1016/j.ajoc.2023.101857] [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] [Received: 12/15/2022] [Revised: 04/08/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose Although conjunctivitis represents the most common ocular manifestation of COVID-19 infection, sight-threatening retinal involvement has been reported. Herein, we report and characterize with multimodal retinal imaging 5 cases of acute vision loss secondary to presumed chorioretinal vasculopathy temporally associated with COVID-19 infection with varying severity, visual morbidity, and treatment response, and review the available literature on the association between COVID-19 infection and retinal microvascular changes. Design Observational case series and literature review. Methods Multicenter case series of 5 patients who presented to academic centers and private offices with acute vision loss temporally associated with COVID-19 infection. A review of the literature was conducted using online databases. Results 10 eyes of 5 patients, 3 men and 2 women, with a mean age of 30.8 years (median 33, range 16-44) were described. All patients had a recently preceding episode of COVID-19, with symptomatology ranging from mild infection to life-threatening encephalopathy. Treatment for their retinal disease included topical, oral, intravitreal, and intravenous steroids, steroid-sparing immunosuppression, retinal photocoagulation, antivirals, and antiplatelet and anticoagulant agents. Treatment response and visual recovery ranged from complete recovery of baseline acuity to permanent vision loss and need for chronic immunosuppression. Conclusions and Importance Clinicians should be mindful of the potential for vision-threatening retinal involvement after COVID-19 infection. If found, treatment with both anti-inflammatory therapy and anticoagulation should be considered, in addition to close monitoring, as some patients with this spectrum of disease may require chronic immune suppression and/or anti-VEGF therapy.
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Affiliation(s)
- Piero Carletti
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Aaditya Shah
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Christopher Bair
- John A. Moran Eye Center, University of Utah Health, Salt Lake City, UT, United States
| | | | - Anthony Mai
- John A. Moran Eye Center, University of Utah Health, Salt Lake City, UT, United States
| | - Rachel Patel
- John A. Moran Eye Center, University of Utah Health, Salt Lake City, UT, United States
| | - Ramana Moorthy
- Associated Vitreoretinal and Uveitis Consultants, Indianapolis, IN, USA
| | - Natalia Villate
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
- Fort Lauderdale Eye Institute, Fort Lauderdale, FL, USA
| | - Janet L Davis
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Albert T Vitale
- John A. Moran Eye Center, University of Utah Health, Salt Lake City, UT, United States
| | - Akbar Shakoor
- John A. Moran Eye Center, University of Utah Health, Salt Lake City, UT, United States
| | - Lynn Hassman
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
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Uddin N, Acter T, Rashid MH, Chowdhury AI, Jahan EA. Coping with the COVID-19 pandemic by strengthening immunity as a nonpharmaceutical intervention: A major public health challenge. Health Sci Rep 2023; 6:e1562. [PMID: 37720166 PMCID: PMC10500053 DOI: 10.1002/hsr2.1562] [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] [Received: 03/20/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Background and Aims The global Coronavirus-2 outbreak has emerged as a significant threat to majority of individuals around the world. The most effective solution for addressing this viral outbreak is through vaccination. Simultaneously, the virus's mutation capabilities pose a potential risk to the effectiveness of both vaccines and, in certain instances, newly developed drugs. Conversely, the human body's immune system exhibits a robust ability to combat viral outbreaks with substantial confidence, as evidenced by the ratio of fatalities to affected individuals worldwide. Hence, an alternative strategy to mitigate this pandemic could involve enhancing the immune system's resilience. Methods The research objective of the review is to acquire a comprehensive understanding of the role of inflammation and immunity in COVID-19. The pertinent literature concerning immune system functions, the impact of inflammation against viruses like SARS-CoV-2, and the connection between nutritional interventions, inflammation, and immunity was systematically explored. Results Enhancing immune function involves mitigating the impact of key factors that negatively influence the immune response. Strengthening the immune system against emerging diseases can be achieved through nonpharmaceutical measures such as maintaining a balanced nutrition, engaging in regular exercise, ensuring adequate sleep, and managing stress. Conclusion This review aims to convey the significance of and provide recommendations for immune-strengthening strategies amidst the ongoing COVID-19 pandemic.
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Affiliation(s)
- Nizam Uddin
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
| | - Thamina Acter
- Department of Mathematical and Physical SciencesEast West UniversityDhakaBangladesh
| | - Md. Harun‐Ar Rashid
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
| | - Akibul Islam Chowdhury
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
| | - Effat Ara Jahan
- Department of Nutrition and Food Engineering, Faculty of Allied Health ScienceDaffodil International UniversityDhakaBangladesh
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Gong Y, Yang D, Liu J, Barrett H, Sun J, Peng H. Disclosing Environmental Ligands of L-FABP and PPARγ: Should We Re-evaluate the Chemical Safety of Hydrocarbon Surfactants? ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:11913-11925. [PMID: 37527448 DOI: 10.1021/acs.est.3c02898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Chemical contaminants can cause adverse effects by binding to the liver-fatty acid binding protein (L-FABP) and peroxisome proliferator-activated nuclear receptor γ (PPARγ), which are vital in lipid metabolism. However, the presence of numerous compounds in the environment has hindered the identification of their ligands, and thus only a small portion have been discovered to date. In this study, protein Affinity Purification with Nontargeted Analysis (APNA) was employed to identify the ligands of L-FABP and PPARγ in indoor dust and sewage sludge. A total of 83 nonredundant features were pulled-out by His-tagged L-FABP as putative ligands, among which 13 were assigned as fatty acids and hydrocarbon surfactants. In contrast, only six features were isolated when His-tagged PPARγ LBD was used as the protein bait. The binding of hydrocarbon surfactants to L-FABP and PPARγ was confirmed using both recombinant proteins and reporter cells. These hydrocarbon surfactants, along with >50 homologues and isomers, were detected in dust and sludge at high concentrations. Fatty acids and hydrocarbon surfactants explained the majority of L-FABP (57.7 ± 32.9%) and PPARγ (66.0 ± 27.1%) activities in the sludge. This study revealed hydrocarbon surfactants as the predominant synthetic ligands of L-FABP and PPARγ, highlighting the importance of re-evaluating their chemical safety.
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Affiliation(s)
- Yufeng Gong
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Diwen Yang
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Jiabao Liu
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
- The Donnelly Centre, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Holly Barrett
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Jianxian Sun
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Hui Peng
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
- School of the Environment, University of Toronto, Toronto, Ontario M5S 3H6, Canada
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Davey MG, Ryan OK, Ryan ÉJ, Donlon NE, Reynolds IS, Fearon NM, Martin ST, Heneghan HM. The Impact of Bariatric Surgery on the Incidence of Colorectal Cancer in Patients with Obesity-a Systematic Review and Meta-analysis of Registry Data. Obes Surg 2023; 33:2293-2302. [PMID: 37341934 PMCID: PMC10345076 DOI: 10.1007/s11695-023-06674-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/23/2023] [Accepted: 06/07/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Cancer and obesity represent two of the most significant global health concerns. The risk of malignancy, including colorectal cancer (CRC), increases with obesity. The aim of this study was to perform a systematic review and meta-analysis to determine the value of bariatric surgery in reducing CRC risk in patients with obesity using registry data. MATERIALS AND METHODS A systematic review and meta-analysis were performed as per PRISMA guidelines. The risk of CRC was expressed as a dichotomous variable and reported as odds ratios (OR) with 95% confidence intervals (CIs) using the Mantel-Haenszel method. A multi-treatment comparison was performed, examining the risk reduction associated with existing bariatric surgery techniques. Analysis was performed using RevMan, R packages, and Shiny. RESULTS Data from 11 registries including 6,214,682 patients with obesity were analyzed. Of these, 14.0% underwent bariatric surgery (872,499/6,214,682), and 86.0% did not undergo surgery (5,432,183/6,214,682). The mean age was 49.8 years, and mean follow-up was 5.1 years. In total, 0.6% of patients who underwent bariatric surgery developed CRC (4,843/872,499), as did 1.0% of unoperated patients with obesity (54,721/5,432,183). Patients with obesity who underwent bariatric surgery were less likely to develop CRC (OR: 0.53, 95% CI: 0.36-0.77, P < 0.001, I2 = 99%). Patients with obesity undergoing gastric bypass surgery (GB) (OR: 0.513, 95% CI: 0.336-0.818) and sleeve gastrectomy (SG) (OR: 0.484, 95% CI: 0.307-0.763) were less likely to develop CRC than unoperated patients. CONCLUSION At a population level, bariatric surgery is associated with reduced CRC risk in patients with obesity. GB and SG are associated with the most significant reduction in CRC risk. PROSPERO REGISTRATION CRD42022313280.
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Affiliation(s)
- Matthew G Davey
- Discipline of Surgery, The Lambe Institute for Translational Research, University of Galway, Galway, H91YR71, Ireland.
| | - Odhrán K Ryan
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Éanna J Ryan
- Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland
| | - Noel E Donlon
- Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland
| | - Ian S Reynolds
- Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland
| | - Naomi M Fearon
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Sean T Martin
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Helen M Heneghan
- Surgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
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Yi X, Fu D, Wang G, Wang L, Li J. Development and Validation of a Prediction Model of the Risk of Pneumonia in Patients with SARS-CoV-2 Infection. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:6696048. [PMID: 37496884 PMCID: PMC10368499 DOI: 10.1155/2023/6696048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/04/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023]
Abstract
Objective To establish a prediction model of pneumonia risk in SARS-CoV-2-infected patients to reduce unnecessary chest CT scans. Materials and Methods The model was constructed based on a retrospective cohort study. We selected SARS-CoV-2 test-positive patients and collected their clinical data and chest CT images from the outpatient and emergency departments of Hunan Provincial People's Hospital, China. Univariate and multivariate logistic regression and least absolute shrinkage and selection operator (LASSO) regression were utilized to identify predictors of pneumonia risk for patients infected with SARS-CoV-2. These predictors were then incorporated into a nomogram to establish the model. To ensure its performance, the model was evaluated from the aspects of discrimination, calibration, and clinical validity. In addition, a smoothed curve was fitted using a generalized additive model (GAM) to explore the association between the pneumonia grade and the model's predicted probability of pneumonia. Results We selected 299 SARS-CoV-2 test-positive patients, of whom 205 cases were in the training cohort and 94 cases were in the validation cohort. Age, CRP natural log-transformed value (InCRP), and monocyte percentage (%Mon) were found to be valid predictors of pneumonia risk. This predictive model achieved good discrimination of AUC in the training and validation cohorts which was 0.7820 (95% CI: 0.7254-0.8439) and 0.8432 (95% CI: 0.7588-0.9151), respectively. At the cut-off value of 0.5, it had a sensitivity and specificity of 70.75% and 66.33% in the training cohort and 76.09% and 73.91% in the validation cohort, respectively. With suitable calibration accuracy shown in calibration curves, decision curve analysis indicated high clinical value in predicting pneumonia probability in SARS-CoV-2-infected patients. The probability of pneumonia predicted by the model was positively correlated with the actual pneumonia classification. Conclusion This study has developed a pneumonia risk prediction model that can be utilized for diagnostic purposes in predicting the probability of pneumonia in patients infected with SARS-CoV-2.
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Affiliation(s)
- Xi Yi
- Department of Radiology, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha 410016, China
| | - Daiyan Fu
- Department of Respiratory Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha 410016, China
| | - Guiliang Wang
- Department of Radiology, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha 410016, China
| | - Lile Wang
- Department of Respiratory Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha 410016, China
| | - Jirong Li
- Department of Radiology, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha 410016, China
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Neira-Goulart M, de Sá NBR, Ribeiro-Alves M, Perazzo H, Geraldo KM, Ribeiro MPD, Cardoso SW, Grinsztejn B, Veloso VG, Rodrigues Gomes L, Cazote ADS, de Almeida DV, Giacoia-Gripp CBW, Côrtes FH, Morgado MG. Inflammasome genes polymorphisms are associated with progression to mechanical ventilation and death in a cohort of hospitalized COVID-19 patients in a reference hospital in Rio de Janeiro, Brazil. Gene 2023; 865:147325. [PMID: 36870425 PMCID: PMC9979696 DOI: 10.1016/j.gene.2023.147325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/23/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
COVID-19 has a broad spectrum of clinical manifestations. We assessed the impact of single nucleotide polymorphisms (SNPs) of inflammasome genesas risk factors for progression toCOVID-19 critical outcomes, such as mechanical ventilation support (MVS) or death.The study included 451 hospitalized individuals followed up at the INI/FIOCRUZ, Rio de Janeiro, Brazil, from 06/2020 to 03/2021. SNPs genotyping was determined by Real-Time PCR. We analyzed risk factors for progression to MVS (n = 174[38.6 %]) or death (n = 175[38.8 %])as a result of COVID-19 by Cox proportional hazardmodels.Slower progression toMVSwas associated with allele G (aHR = 0.66;P = 0.005) or the genotype G/G (aHR = 0.391;P = 0.006) in the NLRP3 rs10754558 or the allele G (aHR = 0.309;P = 0.004) in the IL1βrs1143634, while C allele in the NLRP3 rs4612666 (aHR = 2.342;P = 0.006) or in the rs10754558 (aHR = 2.957;P = 0.005) were associated with faster progression to death. Slower progression to death was associated to allele G (aHR = 0.563;P = 0.006) or the genotype A/G (aHR = 0.537;P = 0.005) in the CARD8 rs6509365; the genotype A/C in the IFI16 rs1101996 (aHR = 0.569;P = 0.011); the genotype T/T (aHR = 0.394;P = 0.004) or allele T (aHR = 0.68;P = 0.006) in the NLRP3 rs4612666, and the genotype G/G (aHR = 0.326;P = 0.005) or allele G (aHR = 0,68;P = 0.014) in the NLRP3 rs10754558. Our results suggest that inflammasome genetic variations might influence the critical clinical course of COVID-19.
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Affiliation(s)
- Milena Neira-Goulart
- Laboratory of AIDS & Molecular Immunology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | | | - Marcelo Ribeiro-Alves
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Hugo Perazzo
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Kim Mattos Geraldo
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Maria Pia Diniz Ribeiro
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Sandra Wagner Cardoso
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Beatriz Grinsztejn
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Valdiléa G Veloso
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Larissa Rodrigues Gomes
- Center of Technological Development in Health (CDTS)/National Institute of Science and Technological for Innovation on Neglected Population Diseases (INCT-IDPN), FIOCRUZ, Rio de Janeiro, Brazil.
| | - Andressa da Silva Cazote
- Laboratory of AIDS & Molecular Immunology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | - Fernanda Heloise Côrtes
- Laboratory of AIDS & Molecular Immunology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Mariza Gonçalves Morgado
- Laboratory of AIDS & Molecular Immunology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
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Ragnoli B, Da Re B, Galantino A, Kette S, Salotti A, Malerba M. Interrelationship between COVID-19 and Coagulopathy: Pathophysiological and Clinical Evidence. Int J Mol Sci 2023; 24:ijms24108945. [PMID: 37240292 DOI: 10.3390/ijms24108945] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Since the first description of COVID-19 infection, among clinical manifestations of the disease, including fever, dyspnea, cough, and fatigue, it was observed a high incidence of thromboembolic events potentially evolving towards acute respiratory distress syndrome (ARDS) and COVID-19-associated-coagulopathy (CAC). The hypercoagulation state is based on an interaction between thrombosis and inflammation. The so-called CAC represents a key aspect in the genesis of organ damage from SARS-CoV-2. The prothrombotic status of COVID-19 can be explained by the increase in coagulation levels of D-dimer, lymphocytes, fibrinogen, interleukin 6 (IL-6), and prothrombin time. Several mechanisms have been hypothesized to explain this hypercoagulable process such as inflammatory cytokine storm, platelet activation, endothelial dysfunction, and stasis for a long time. The purpose of this narrative review is to provide an overview of the current knowledge on the pathogenic mechanisms of coagulopathy that may characterize COVID-19 infection and inform on new areas of research. New vascular therapeutic strategies are also reviewed.
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Affiliation(s)
| | - Beatrice Da Re
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
| | | | - Stefano Kette
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
| | - Andrea Salotti
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
| | - Mario Malerba
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
- Department of Traslational Medicine, University of Eastern Piedmont (UPO), 28100 Novara, Italy
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47
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Lavie CJ, Bhatt DL, Neeland IJ, Heymsfield SB. Editorial commentary: Weight loss for cardiovascular disease prevention - is semaglutide the answer? Trends Cardiovasc Med 2023; 33:167-169. [PMID: 34999021 DOI: 10.1016/j.tcm.2021.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121-2483, USA.
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USA
| | - Ian J Neeland
- UH Center for Cardiovascular Prevention and Center for Integrated, and Novel Approaches in Vascular-Metabolic Disease (CINEMA), Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland OH, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
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48
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Meng F, Nie P, Sousa-Poza A. Obesity inequality and well-being in Germany. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101236. [PMID: 36867949 DOI: 10.1016/j.ehb.2023.101236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 05/08/2023]
Abstract
Using 2002-2018 German Socio-Economic Panel (GSOEP) data for German adults aged 18 + , this study measures changes in the body mass index (BMI) distribution and obesity inequality to estimate the relation between the latter and subjective well-being. In addition to documenting a significant association between the various measures of obesity inequality and subjective well-being, especially among women, we show a significant increase in obesity inequality, particularly among females and those with low education and/or low income. This rising inequality points to the need to combat obesity through initiatives targeted at specific sociodemographic groups.
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Affiliation(s)
- Fan Meng
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany.
| | - Peng Nie
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany; School of Economics and Finance, Xi'an Jiaotong University, 710061 Xi'an, China; IZA, Bonn, Germany; Health Econometrics and Data Group, University of York, United Kingdom.
| | - Alfonso Sousa-Poza
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany; IZA, Bonn, Germany.
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49
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Chen Y, Song W, Li C, Wang J, Liu F, Ye Z, Ren P, Tong Y, Li J, Ou Z, Lee ACY, Cai JP, Wong BHY, Chan JFW, Yuen KY, Zhang AJX, Chu H. COVID-19 mRNA vaccine protects against SARS-CoV-2 Omicron BA.1 infection in diet-induced obese mice through boosting host innate antiviral responses. EBioMedicine 2023; 89:104485. [PMID: 36857860 PMCID: PMC9970285 DOI: 10.1016/j.ebiom.2023.104485] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Obesity is a worldwide epidemic and is considered a risk factor of severe manifestation of Coronavirus Disease 2019 (COVID-19). The pathogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and host responses to infection, re-infection, and vaccination in individuals with obesity remain incompletely understood. METHODS Using the diet-induced obese (DIO) mouse model, we studied SARS-CoV-2 Alpha- and Omicron BA.1-induced disease manifestations and host immune responses to infection, re-infection, and COVID-19 mRNA vaccination. FINDINGS Unlike in lean mice, Omicron BA.1 and Alpha replicated to comparable levels in the lungs of DIO mice and resulted in similar degree of tissue damages. Importantly, both T cell and B cell mediated adaptive immune responses to SARS-CoV-2 infection or COVID-19 mRNA vaccination are impaired in DIO mice, leading to higher propensity of re-infection and lower vaccine efficacy. However, despite the absence of neutralizing antibody, vaccinated DIO mice are protected from lung damage upon Omicron challenge, accompanied with significantly more IFN-α and IFN-β production in the lung tissue. Lung RNAseq and subsequent experiments indicated that COVID-19 mRNA vaccination in DIO mice boosted antiviral innate immune response, including the expression of IFN-α, when compared to the nonvaccinated controls. INTERPRETATION Our findings suggested that COVID-19 mRNA vaccination enhances host innate antiviral responses in obesity which protect the DIO mice to a certain degree when adaptive immunity is suboptimal. FUNDING A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.
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Affiliation(s)
- Yanxia Chen
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Wenchen Song
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China
| | - Can Li
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China
| | - Jiaxuan Wang
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Feifei Liu
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Zhanhong Ye
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Peidi Ren
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Yihan Tong
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Junhua Li
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Zhihua Ou
- Shenzhen Key Laboratory of Unknown Pathogen Identification, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Andrew Chak-Yiu Lee
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China
| | - Jian-Piao Cai
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China
| | - Bosco Ho-Yin Wong
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China
| | - Jasper Fuk-Woo Chan
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China; Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China; Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Academician Workstation of Hainan Province, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, Hainan Province, People's Republic of China; and The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Kwok-Yung Yuen
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China; Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China; Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Academician Workstation of Hainan Province, Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, Hainan Province, People's Republic of China; and The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Anna Jin-Xia Zhang
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China; Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China.
| | - Hin Chu
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China; Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, People's Republic of China; Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People's Republic of China.
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50
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Association between Body Mass Index and Hospital Outcomes for COVID-19 Patients: A Nationwide Study. J Clin Med 2023; 12:jcm12041617. [PMID: 36836153 PMCID: PMC9967784 DOI: 10.3390/jcm12041617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) caused significant morbidity and mortality worldwide. There is limited information describing the hospital outcomes of COVID-19 patients in regard to specific body mass index (BMI) categories. METHODS We utilized the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) 2020 database to collect information on patients hospitalized for COVID-19 in the United States. Using the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) coding system, adult patients (≥18 years of age) with a primary hospitalization for COVID-19 were identified. Adjusted analyses were performed to assess for mortality, morbidity, and resource utilization, and compare the outcomes among patients categorized according to BMI. RESULTS A total of 305,284 patients were included in this study. Of them, 248,490 had underlying obesity, defined as BMI ≥ 30. The oldest patients were observed to have BMI < 19, while youngest patients were in the BMI > 50 category. BMI < 19 category had the highest crude in-hospital mortality rate. However, after adjusted regression, patients with BMI > 50 (adjusted odds ratio (aOR) 1.63, 95% CI 1.48-1.79, p-value < 0.001) had the highest increased odds, at 63%, of in-hospital mortality compared to all other patients in the study. Patients with BMI > 50 also had the highest increased odds of needing invasive mechanical ventilation (IMV) and mortality associated with IMV compared to all other patient, by 37% and 61%, respectively. Obese patients were noted to have shorter average hospital length of stay (LOS), by 1.07 days, compared to non-obese patients, but there was no significant difference in average hospitalization charges. CONCLUSION Among obese patients primarily hospitalized with COVID-19, those with BMI ≥ 40 had significantly increased rates of all-cause in-hospital mortality, need for IMV, mortality associated with IMV, and septic shock. Overall, obese patients had shorter average hospital LOS, however, did not have significantly higher hospitalization charges.
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