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Muñoz-Carrillo JL, Palomeque-Molina PI, Villacis-Valencia MS, Gutiérrez-Coronado O, Chávez-Ruvalcaba F, Vázquez-Alcaraz SJ, Villalobos-Gutiérrez PT, Palomeque-Molina J. Relationship between periodontitis, type 2 diabetes mellitus and COVID-19 disease: a narrative review. Front Cell Infect Microbiol 2025; 15:1527217. [PMID: 40406515 PMCID: PMC12095153 DOI: 10.3389/fcimb.2025.1527217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Accepted: 04/16/2025] [Indexed: 05/26/2025] Open
Abstract
Inflammation plays a fundamental role in the development and bidirectional association of di-verse diseases, such as periodontitis and type 2 diabetes mellitus (T2DM), which generates important clinical complications, where chronic exposure to high levels of blood glucose affects the repair process of periodontal tissues. Likewise, it has been observed that comorbidity, between these two diseases, influences the development of the COVID-19 disease towards a more severe course. However, there is currently very little scientific evidence on the relationship between periodontitis, T2DM and COVID-19 disease. This narrative review aims to provide an understanding of the current and most relevant aspects of the relationship between periodontitis, T2DM and COVID-19 disease. A narrative review was performed through a systematic search of published studies, without date restrictions, indexed in the electronic databases of PubMed, for the inclusion of articles in English, and LILACS for the inclusion of articles in Spanish. This review included different articles, which addressed the most important aspects to present a current perspective on the relationship and influence between periodontitis, T2DM and COVID-19 disease. Comorbidity between periodontitis and T2DM represents a greater risk of developing a more severe course of COVID-19 disease, because these three diseases share three important axes: a clinicopathological axis; an axis associated with glycemia, and an immunological axis associated with inflammation.
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Affiliation(s)
- José Luis Muñoz-Carrillo
- Laboratorio de Inmunología, Centro Universitario de los Lagos, Universidad de Guadalajara, Lagos de Moreno, Jalisco, Mexico
- Escuela de Odontología, Global University, Aguascalientes, Aguascalientes, Mexico
| | | | | | - Oscar Gutiérrez-Coronado
- Laboratorio de Inmunología, Centro Universitario de los Lagos, Universidad de Guadalajara, Lagos de Moreno, Jalisco, Mexico
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2
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Dei Cas A, Aldigeri R, Eletto E, Ticinesi A, Nouvenne A, Prati B, Vazzana A, Antonini M, Moretti V, Balestreri E, Spigoni V, Fantuzzi F, Schirò S, Ruffini L, Sverzellati N, Meschi T, Bonadonna R. Hyperglycemia in the diabetic range, but not previous diagnosis of diabetes mellitus, is an independent indicator of poor outcome in patients hospitalized for severe COVID-19. Acta Diabetol 2025:10.1007/s00592-025-02507-1. [PMID: 40314776 DOI: 10.1007/s00592-025-02507-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2025] [Accepted: 03/29/2025] [Indexed: 05/03/2025]
Abstract
AIMS Diabetes mellitus (DM) and hyperglycemia are associated with poor outcome(s) in COVID-19 hospitalized patients, but their independent impact on prognosis remains unclear. We aimed to assess the impact of DM and hyperglycemia on COVID-19 outcomes. METHODS Clinical data/records from COVID-19 patients admitted to the Parma University-Hospital (February 23rd to March 31st, 2020) were retrieved and analysed (NCT04550403). Fasting plasma glucose (FPG), inflammatory markers and the main biochemical variables were collected at admission. Patients underwent chest high-resolution CT and arterial blood gas analysis to determine the PaO2/FiO2 ratio (P/F ratio). The primary outcome was a composite of intensive care unit admission and/or death. RESULTS Among 756 subjects, 143 (19%) had DM. These patients were older with higher comorbidity rates. The primary outcome occurred in 61.5% DM patients versus 43.4% without DM (p < 0.001). In multivariable analysis (accuracy UC = 0.93), older age, cardiovascular and kidney diseases, FPG ≥ 126 mg/dl, C-reactive protein, and P/F ratio, but not previous DM, were independent risk indicators. CONCLUSIONS DM indicated poor COVID-19 outcomes, but not when adjusted for other clinical variables/comorbities, suggesting that its impact was mostly driven by concomitant factors. The independent role of fasting hyperglycemia points to the need for further research on its contribution to COVID-19.
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Affiliation(s)
- Alessandra Dei Cas
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Raffaella Aldigeri
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elisa Eletto
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Andrea Ticinesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Antonio Nouvenne
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Beatrice Prati
- Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Angela Vazzana
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Monica Antonini
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Valentina Moretti
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Emanuela Balestreri
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Valentina Spigoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Federica Fantuzzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Silvia Schirò
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Livia Ruffini
- Nuclear Medicine, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Radiological Sciences, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Tiziana Meschi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Care Continuity and Multicomplexity, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Riccardo Bonadonna
- Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy.
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
- Endocrinology, Diabetology and Metabolic Diseases, University of Verona and University Hospital of Verona, Verona, Italy.
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3
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Lingampally A, Truchi M, Shi X, Zhou Y, Vasquez‐Pacheco E, Panagiotidis G, Hadzic S, Koepke J, Vazquez‐Armendariz AI, Herold S, Samakovlis C, Cabrera‐Fuentes HA, Chu X, Seeger W, Zhang J, El Agha E, Mari B, Bellusci S, Chen C. Unraveling Alveolar Fibroblast and Activated Myofibroblast Heterogeneity and Differentiation Trajectories During Lung Fibrosis Development and Resolution in Young and Old Mice. Aging Cell 2025; 24:e14503. [PMID: 39945330 PMCID: PMC12073919 DOI: 10.1111/acel.14503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 01/12/2025] [Accepted: 01/15/2025] [Indexed: 05/15/2025] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is an age-associated disease characterized by the irreversible accumulation of excessive extracellular matrix components by activated myofibroblasts (aMYFs). Following bleomycin administration in young mice, fibrosis formation associated with efficient resolution takes place limiting the clinical relevance of this model for IPF. In this study, we used aged mice in combination with bleomycin administration to trigger enhanced fibrosis formation and delayed resolution as a more relevant model for IPF. Alveolosphere assays were carried out to compare the alveolar resident mesenchymal niche activity for AT2 stem cells in young versus old mice. Lineage tracing of the Acta2+ aMYFs in old mice exposed to bleomycin followed by scRNAseq of the lineage-traced cells isolated during fibrosis formation and resolution was performed to delineate the heterogeneity of aMYFs during fibrosis formation and their fate during resolution. Integration of previously published similar scRNAseq results using young mice was carried out. Our results show that alveolar resident mesenchymal cells from old mice display decreased supporting activity for AT2 stem cells. Our findings suggest that the cellular and molecular mechanisms underlying the aMYFs formation and differentiation towards the Lipofibroblast phenotype are mostly conserved between young and old mice. In addition to persistent fibrotic signaling in aMYF from old mice during resolution, we also identified differences linked to interleukin signaling in old versus young alveolar fibroblast populations before and during bleomycin injury. Importantly, our work confirms the relevance of a subcluster of aMYFs in old mice that is potentially relevant for future management of IPF.
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Affiliation(s)
- Arun Lingampally
- Department of Respiratory and Critical Care MedicineQuzhou People's Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical UniversityQuzhouZhejiangChina
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Department of Medicine V, Internal Medicine, Infectious Diseases and Infection ControlUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Marin Truchi
- UMR CNRS 7275 Inserm 1323, IPMC, FHU‐OncoAge, IHU, RespiERA, Sophia Antipolis, Université Côte d'AzurValbonneFrance
| | - Xianrong Shi
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), School of Pharmaceutical ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Yuqing Zhou
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), School of Pharmaceutical ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Esmeralda Vasquez‐Pacheco
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Georgios‐Dimitrios Panagiotidis
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Stefan Hadzic
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Janine Koepke
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Ana Ivonne Vazquez‐Armendariz
- Transdisciplinary Research Area Life and HealthOrganoid Biology, Life and Medical Sciences Institute, University of BonnBonnGermany
| | - Susanne Herold
- Department of Medicine V, Internal Medicine, Infectious Diseases and Infection ControlUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Christos Samakovlis
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Hector A. Cabrera‐Fuentes
- Centro Interdisciplinario de Investigaciones Biológicas y Humanas (CIINBIOH)Universidad Autónoma Benito Juárez de OaxacaOaxacaMexico
| | - Xuran Chu
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), School of Pharmaceutical ScienceWenzhou Medical UniversityWenzhouZhejiangChina
| | - Werner Seeger
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Department of Medicine V, Internal Medicine, Infectious Diseases and Infection ControlUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Jin‐San Zhang
- Department of Respiratory and Critical Care MedicineQuzhou People's Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical UniversityQuzhouZhejiangChina
| | - Elie El Agha
- Department of Medicine II, Internal Medicine, Pulmonary and Critical CareUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Department of Medicine V, Internal Medicine, Infectious Diseases and Infection ControlUniversities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
- Cardio‐Pulmonary Institute (CPI)GiessenGermany
- Institute for Lung Health (ILH)GiessenGermany
| | - Bernard Mari
- UMR CNRS 7275 Inserm 1323, IPMC, FHU‐OncoAge, IHU, RespiERA, Sophia Antipolis, Université Côte d'AzurValbonneFrance
| | - Saverio Bellusci
- Department of Respiratory and Critical Care MedicineQuzhou People's Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical UniversityQuzhouZhejiangChina
- Laboratory of Extracellular Lung Matrix Remodelling, Department of Internal MedicineCardio‐Pulmonary Institute and Institute for Lung Health, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Justus‐Liebig University GiessenGiessenGermany
| | - Chengshui Chen
- Department of Respiratory and Critical Care MedicineQuzhou People's Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical UniversityQuzhouZhejiangChina
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Blagoeva V, Hodzhev V, Uchikov P, Dobreva-Yatseva B, Stoyanova R, Shterev M, Atiq S, Prasad A, Shankar Babu S. Clinical Course and Mortality Predictors in Adult Hospitalized Patients with COVID-19 Infection-A Retrospective Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:579. [PMID: 40282870 PMCID: PMC12028986 DOI: 10.3390/medicina61040579] [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: 01/20/2025] [Revised: 03/12/2025] [Accepted: 03/19/2025] [Indexed: 04/29/2025]
Abstract
Background and Objectives: Bulgaria had the highest mortality rate of COVID-19 in Europe and the second highest in the world based on statistical data. This study aimed to determine the mortality predictors in 306 adult patients with COVID-19 infection, treated at the COVID-19 Ward of St. George University Hospital in Plovdiv, Bulgaria in the period of August 2021-April 2022. Materials and Methods: All admitted and treated patients had a positive PCR test for SARS-CoV-2. They were assigned in three groups based on the severity rating scale published in NIH COVID-19 Treatment Guidelines by Stat Pearls Publishing, 2022. Demographic, clinical, and laboratory parameters and pre-existing comorbidities were investigated. Parametric and non-parametric methods were used for statistics. Logistic regression was applied for parameters significantly associated with mortality. Results: Data showed that demographic indicators were not significantly associated with poorer outcome. Among comorbidities, cardiovascular, chronic pulmonary and endocrine disorders were found to be related to poor survival rates (p = 0.003, p = 0.003 and p = 0.017 resp.) Clinical symptoms, such as sore throat, dry or productive cough and breathlessness, were determinants of poor outcome (p = 0.027, p = 0.029, p = 0.004 and p = 0.002 resp.). Laboratory parameters linked to mortality were elevated d-dimers (p = 0.015), ferritin (p = 0.009) and creatinine (p = 0.038). p02 < 50 and saturation < 90 also indicated a higher risk of death (p = 0.006 and p = 0021). Conclusions: Logistic regression showed that each stage of disease severity increased the risk of death 3.6 times, chronic pulmonary disorders increased it by 4.1, endocrine by 2.4 and dyspnea by 3.1 times.
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Affiliation(s)
- Vesela Blagoeva
- Pulmonology and Tuberculosis Section, First Department of Internal Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Vladimir Hodzhev
- Pulmonology and Tuberculosis Section, First Department of Internal Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Petar Uchikov
- Department of Special Surgery, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Bistra Dobreva-Yatseva
- First Department of Internal Medicine, Cardiology Section, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Rumyana Stoyanova
- Department of Health Management and Health Economics, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Maritza Shterev
- Medical Faculty, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; (M.S.); (S.A.); (S.S.B.)
| | - Samiya Atiq
- Medical Faculty, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; (M.S.); (S.A.); (S.S.B.)
| | - Akanksha Prasad
- Medical Faculty, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; (M.S.); (S.A.); (S.S.B.)
| | - Sriharini Shankar Babu
- Medical Faculty, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; (M.S.); (S.A.); (S.S.B.)
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5
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Neville J, Foley K, Lacey S, Tuthill A, Kgosidialwa O, O'Riordan M, O'Halloran F, Costelloe SJ. Impact of changes in gestational diabetes mellitus diagnostic criteria during the COVID-19 pandemic. Ir J Med Sci 2025:10.1007/s11845-025-03926-3. [PMID: 40072817 DOI: 10.1007/s11845-025-03926-3] [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: 08/28/2024] [Accepted: 02/19/2025] [Indexed: 03/14/2025]
Abstract
BACKGROUND/AIMS During the COVID-19 pandemic, the Health Service Executive (HSE) and Royal College of Obstetricians and Gynaecologists (RCOG) recommended fasting and random plasma glucose (FPG/RPG) alongside glycated haemoglobin (HbA1c) to replace the oral glucose tolerance test (OGTT) for diagnosing Gestational Diabetes Mellitus (GDM). METHODS The study compared testing patterns and diagnostic rates for GDM before and after implementing the RCOG guidelines (01/05/2020) in pregnancies beginning 01/11/2018 to 31/03/2021. Trends were inspected using Cochrane-Armitage tests. Differences between General Practice (GP) and Secondary Care (SCare) were assessed by chi-square analysis. A significance level of p < 0.05 was used for all analyses. Information on maternal and pregnancy characteristics was accessed where available. RESULTS Data indicated a significant reduction in OGTTs requested by GPs and SCare. Conversely, HbA1c, FPG and RPG test requests increased significantly in both locations. The overall GDM positivity rate increased significantly from 7.4% to 22.0% in GP and 16.9% to 39.0% in SCare following RCOG guideline implementation. CONCLUSIONS The RCOG guidelines appear to have been well adopted by GPs and SCare, with greater adherence in SCare. Using FPG, RPG and HbA1c to a greater extent than the OGTT corresponded with increased GDM diagnostic rates. Given the difficulties with interpreting HbA1c in pregnancy, its routine use in diagnosing GDM requires further careful consideration. Relaying changes in diagnostic protocol during pandemics requires strong communication with all requesting clinicians, including GPs. Comparisons between GP and SCare indicated significant differences in test-requesting practices and GDM positivity rates.
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Affiliation(s)
- Jessica Neville
- Department of Clinical Biochemistry, Cork University Hospital (CUH), T12 P928, Wilton, Cork, Ireland.
- Department of Biological Science, Munster Technological University, Bishopstown Campus, T12 P928, Cork, Ireland.
| | - Kelly Foley
- Department of Clinical Biochemistry, Cork University Hospital (CUH), T12 P928, Wilton, Cork, Ireland
| | - Seán Lacey
- Research Integrity & Compliance Officer, Munster Technological University, Rossa Ave, Bishopstown, T12 P928, Cork, Ireland
| | | | | | - Mairead O'Riordan
- Department of Obstetrics and Gynaecology, CUMH, T12 P928, Cork, Ireland
| | - Fiona O'Halloran
- Department of Biological Science, Munster Technological University, Bishopstown Campus, T12 P928, Cork, Ireland
| | - Seán J Costelloe
- Department of Clinical Biochemistry, Cork University Hospital (CUH), T12 P928, Wilton, Cork, Ireland
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Ma Y, Wang J, Cui F, Tang L, Khalid S, Tian Y, Xie J. Independent and combined effects of long-term air pollution exposure and genetic predisposition on COVID-19 severity: A population-based cohort study. Proc Natl Acad Sci U S A 2025; 122:e2421513122. [PMID: 40030018 PMCID: PMC11912415 DOI: 10.1073/pnas.2421513122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 01/13/2025] [Indexed: 03/19/2025] Open
Abstract
The relationships between air pollution, genetic susceptibility, and COVID-19-related outcomes, as well as the potential interplays between air pollution and genetic susceptibility, remain largely unexplored. The Cox proportional hazards model was used to assess associations between long-term exposure to air pollutants and the risk of COVID-19 outcomes (infection, hospitalization, and death) in a COVID-19-naive cohort (n = 458,396). Additionally, associations between air pollutants and the risk of COVID-19 severity (hospitalization and death) were evaluated in a COVID-19 infection cohort (n = 110,216). Furthermore, this study investigated the role of host genetic susceptibility in the relationships between exposure to air pollutants and the development of COVID-19-related outcomes. Long-term exposure to air pollutants was significantly associated with an increased risk of COVID-19-related outcomes in the COVID-19 naive cohort. Similarly, in COVID-19 infection cohort, hazard ratios (HRs) for COVID-19 hospital admission were 1.23 (1.19, 1.27) for PM2.5 and 1.22 (1.17, 1.26) for PM10, whereas HRs for COVID-19 death were 1.28 (1.18, 1.39) for PM2.5 and 1.25 (1.16, 1.36) for PM10. Notably, significant interactions were found between PM2.5/PM10 and genetic susceptibility in COVID-19 death. In COVID-19 infection cohort, participants with both high genetic risk and high air pollutants exposure had 1.86- to 1.97-fold and 1.91- to 2.14-fold higher risk of COVID-19 hospitalization and death compared to those with both low genetic risk and low air pollutants exposure. Exposure to air pollution is significantly associated with an increased burden of severe COVID-19, and air pollution-gene interactions may play a crucial role in the development of COVID-19-related outcomes.
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Affiliation(s)
- Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Jianing Wang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Feipeng Cui
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Linxi Tang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Sara Khalid
- Botnar Research Centre, Nuffield Orthopaedic Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, OxfordOX3 7LD, United Kingdom
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Junqin Xie
- Centre for Statistics in Medicine and National Institute for Health and Care Research Biomedical Research Centre Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OxfordOX3 7LD, United Kingdom
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7
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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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8
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Fetouh HA, Aleem EEA, Mohammed NH, Aldesouky JMAA, Ismail AM. Formulation of new drug delivery systems for insulin from natural bioactive biocompatible polymers. Sci Rep 2025; 15:3941. [PMID: 39890852 PMCID: PMC11785760 DOI: 10.1038/s41598-025-86938-4] [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: 07/06/2024] [Accepted: 01/15/2025] [Indexed: 02/03/2025] Open
Abstract
New insulin drug delivery systems (IDDs): insulin@chitin; insulin@chitin-grafted (g)-guar gum were prepared by using a modified sol-gel method. Insulin vials were loaded on the safe natural inert bioactive polymers (chitin and chitin-g-GG copolymer) carriers using water green solvent. Traces amount additives were below toxicity limits. Guar gum increased the numbers of the functional groups of the polymer carrier. Insulin release monitored at 37 ± 0.5 °C and buffer solutions of pH (1.2, 6.8 and 7.4) simulating physiological body fluids: stomach, intestine colon and blood stream. Insulin released from insulin@chitin only at pH 7.4. No release observed at pH 1.2, 6.8 due strong bonding to acetyl group of chitin. Insulin@chitin-GG system showed sustained targeting insulin-release at pH: 6.8 > 7.4 > 1.2. Release data obeyed pseudo second order kinetic model indicating that IDDs is heterogeneous solid surface of energetically different active sites. Each insulin molecule occupied two active sites. The slow release at pH 1.2 indicated protection against stomach juice. Release kinetic depend on physicochemical characteristics (porosity, swelling ratio as well as peptide and amino acid sequence). Both IDDs showed negative zeta potential indicating stability against aggregation. Gaur gum improved particle size distribution and insulin release.
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Affiliation(s)
- Howida A Fetouh
- Chemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt.
| | - Engy E A Aleem
- Chemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Najiyah H Mohammed
- Chemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | | | - Amel M Ismail
- Chemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
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9
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Kumari P, Singh HP, Singh S. Mathematical model for understanding the relationship between diabetes and novel coronavirus. Gene 2025; 934:148970. [PMID: 39357581 DOI: 10.1016/j.gene.2024.148970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 09/15/2024] [Accepted: 09/25/2024] [Indexed: 10/04/2024]
Abstract
A new model is proposed to explore interactions between diabetes and novel coronavirus. The model accounted for both the omicron variant and variants varying from omicron. The model investigated compartments such as hospitalization, diabetes, co-infection, omicron variant, and quarantine. Additionally, the impact of different vaccination doses is assessed. Sensitivity analysis is carried out to determine disease prevalence and control options, emphasizing the significance of knowing epidemics and their characteristics. The model is validated using actual data from Japan. The parameters are fitted with the help of "Least Square Curve Fitting" method to describe the dynamic behavior of the proposed model. Simulation results and theoretical findings demonstrate the dynamic behavior of novel coronavirus and diabetes mellitus (DM). Biological illustrations that illustrate impact of model parameters are evaluated. Furthermore, effect of vaccine efficacy and vaccination rates for the vaccine's first, second, and booster doses is conducted. The impact of various preventive measures, such as hospitalization rate, quarantine or self-isolation rate, vaccine dose-1, dose-2, and booster dose, is considered for diabetic individuals in contact with symptomatic or asymptomatic COVID-19 infectious people in the proposed model. The findings demonstrate the significance of vaccine doses on people with diabetes and individuals infectious with omicron variant. The proposed work helps with subsequent prevention efforts and the design of a vaccination policy to mitigate the effect of the novel coronavirus.
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Affiliation(s)
- Preety Kumari
- Faculty of Mathematical Science, University of Delhi, Delhi 110007, India; School of Engineering & Technology, Central University of Haryana, Mahendergarh 123031, India.
| | | | - Swarn Singh
- Sri Venkateswara College, University of Delhi, Delhi 110021, India.
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10
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Mtambo TR, Machaba KE, Chellan N, Ramharack P, Muller CJF, Mhlongo NN, Hlengwa N. The Effect of Metformin and Hydrochlorothiazide on Cytochrome P450 3A4 Metabolism of Ivermectin: Insights from In Silico Experimentation. Int J Mol Sci 2024; 25:12089. [PMID: 39596155 PMCID: PMC11594981 DOI: 10.3390/ijms252212089] [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: 09/20/2024] [Revised: 11/01/2024] [Accepted: 11/04/2024] [Indexed: 11/28/2024] Open
Abstract
The spread of SARS-CoV-2 has led to an interest in using ivermectin (a potent antiparasitic agent) as an antiviral agent despite the lack of convincing in vivo clinical data for its use against COVID-19. The off-target prophylactic use of ivermectin adds a substantial risk of drug-drug interactions with pharmaceutical medications used to treat chronic conditions like diabetes and hypertension (metformin and hydrochlorothiazide, respectively). Therefore, this study aims to evaluate the potential drug-drug interactions between ivermectin with either metformin or hydrochlorothiazide. In silico experiments and high-throughput screening assays for CYP3A4 were conducted to understand how metformin and hydrochlorothiazide might affect CYP3A4's role in metabolizing ivermectin. The study findings indicated that hydrochlorothiazide is more stable than both ivermectin and metformin. This conclusion was further supported by root mean square fluctuation analysis, which showed that hydrochlorothiazide is more flexible. The variation in the principal component analysis scatter plot across the first three normal modes suggests hydrochlorothiazide has a more mobile conformation than ivermectin and metformin. Additionally, a strong inhibition of CYP3A4 by hydrochlorothiazide was observed, suggesting that hydrochlorothiazide's regulatory effects could significantly impede CYP3A4 activity, potentially leading to a reduced metabolism and clearance of ivermectin in the body. Concurrent administration of these drugs may result in drug-drug interactions and hinder the hepatic metabolism of ivermectin.
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Affiliation(s)
- Thuli R. Mtambo
- Department of Biochemistry and Microbiology, University of Zululand, Kwa-Dlangezwa 3886, South Africa
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Kgothatso E. Machaba
- Department of Biochemistry and Microbiology, University of Zululand, Kwa-Dlangezwa 3886, South Africa
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Nireshni Chellan
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
- Division of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Pritika Ramharack
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Christo J. F. Muller
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
- Division of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa
| | - Ndumiso N. Mhlongo
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Nokulunga Hlengwa
- Department of Biochemistry and Microbiology, University of Zululand, Kwa-Dlangezwa 3886, South Africa
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11
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Moldovan AF, Ghitea TC, Babeș K, Manole F. Long-term Impacts of Long COVID: Increased Incidence of Cardiomyopathies, Joint Diseases, and Psychoanxiety Disorders. In Vivo 2024; 38:3022-3032. [PMID: 39477428 PMCID: PMC11535937 DOI: 10.21873/invivo.13786] [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: 07/10/2024] [Revised: 08/17/2024] [Accepted: 08/25/2024] [Indexed: 11/07/2024]
Abstract
BACKGROUND/AIM The COVID-19 pandemic has intensified inquiries into the interplay between diabetes and disease severity, and the long-term impact of long-COVID. This study specifically explored the implications of different antithrombotic treatments on COVID-19 patients. It aimed to assess the long-term efficacy and safety of Vitamin K antagonists (VKA) and direct oral anticoagulants (DOACs) in mitigating thromboembolic complications in COVID-19 patients. PATIENTS AND METHODS We conducted a study on 157 patients diagnosed with COVID-19 from August 2021 to August 2023. The study evaluated shifts in anticoagulant therapy recommendations, tracking the transition from VKA to DOACs, and analyzed associated health outcomes. RESULTS A significant shift from VKA to DOACs prescriptions was observed, especially in high-risk patients. Despite the change in antithrombotic treatments, incidences of varices and varices with hemorrhoids increased by 2.6% and 3.2%, respectively. Long-COVID was also linked to higher occurrences of diabetes and gastrointestinal diseases. Joint diseases rose by 14%, indicating persistent inflammation. Cardiomyopathies increased by 3.9%, predominantly in high-risk groups, and psychoanxiety disorders surged by 39.5%, highlighting the need for further research. DOAC usage was more common in older age groups, with a 10.2% increase in recommendations among high-risk patients (p<0.05). CONCLUSION The study underscores the evolving landscape of antithrombotic therapy in managing COVID-19 complications. Despite the increased use of DOACs, the rise in various health conditions suggests the necessity for personalized treatment strategies tailored to patient risk profiles.
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Affiliation(s)
| | - Timea Claudia Ghitea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania;
| | - Katalin Babeș
- Doctoral School, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Felicia Manole
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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12
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Li J, Zhang Y, Wu R, Ma G, Sheng L, Feng Y, Han Y, Zhang L, Guo J, Li R. Evaluation of Inflammatory Markers in Patients with COVID-19 Combined with Type 2 Diabetes Mellitus. Risk Manag Healthc Policy 2024; 17:2535-2545. [PMID: 39479559 PMCID: PMC11523978 DOI: 10.2147/rmhp.s490281] [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: 08/06/2024] [Accepted: 10/22/2024] [Indexed: 11/02/2024] Open
Abstract
Purpose To explore the value of different inflammatory markers in predicting the severity of coronavirus disease 2019 (COVID-19) in patients with type 2 diabetes mellitus (T2DM). Patients and Methods A total of 116 patients with COVID-19 in patients with T2DM were collected from December 2022 to March 2023 and were divided into a mild case group (77 cases) and a severe case group (39 cases). The ratio of neutrophil to lymphocyte (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil to lymphocyte × platelet ratio (NLPR), lymphocyte ratio to monocyte (LMR), systemic inflammatory response index (SIRI), systemic inflammatory index (SII), systemic inflammatory composite index (AISI), procalcitonin (PCT), C-reactive protein (CRP) and lactate dehydrogenase (LDH) were compared between the two groups. The screening effect of each variable on the progression of the disease was analyzed using receiver operating characteristic (ROC) curves. Results NLR, PLR, NLPR, MLR, SIRI, SII, AISI, LDH, CRP and PCT in severe case group were higher than those in mild case group (P<0.05), and LMR was lower than those in mild case group (P<0.05). ROC curve analysis further demonstrated the diagnostic performance of these biomarkers, with PCT having the largest area under the ROC curve (AUCROC) of 0.83. Conclusion NLR, PLR, NLPR, SIRI, SII, LDH, CRP and PCT demonstrate greater reliability in diagnostic value and clinical utility for predicting the severity of COVID-19 in patients with T2DM.
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Affiliation(s)
- Jingjing Li
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Yu Zhang
- Department of Dermatology and Venereology, Hohhot, Inner Mongolia Autonomous Region People’s Hospital, 010000, People’s Republic of China
| | - Rui Wu
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Guodong Ma
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Li Sheng
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Yun Feng
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Yang Han
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Lina Zhang
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Janfeng Guo
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
| | - Rongbo Li
- Department of Infectious Diseases, Hohhot First Hospital, Hohhot, Inner Mongolia Autonomous Region, 010000, People’s Republic of China
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Antoniou T, McCormack D, Tadrous M, Gomes T. Alpha-1 adrenergic antagonists and the risk of hospitalization or death in non-hospitalized patients with COVID-19: A population-based study. Fundam Clin Pharmacol 2024; 38:998-1007. [PMID: 38575851 DOI: 10.1111/fcp.13004] [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: 07/05/2023] [Revised: 01/29/2024] [Accepted: 03/07/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Alpha-1 receptor antagonists may interfere with IL-6 signaling and could therefore be a potential treatment for COVID-19. However, the effectiveness of these drugs in mitigating the risk of clinical deterioration among non-hospitalized patients with COVID-19 is unknown. OBJECTIVES The aim of this study is to examine the association between alpha-1 antagonist exposure and the 30-day risk of a hospital encounter or death in nonhospitalized patients with COVID-19. METHODS We conducted a population-based cohort study of Ontario residents aged 35 years and older who were eligible for public drug coverage and who had a positive test for SARS-CoV-2 between January 1, 2020, and March 1, 2021. We matched each individual receiving an alpha-1 antagonist at the time of their positive test with two non-exposed individuals using propensity scores. Our outcome was a composite of a hospital admission, emergency department visit, or death, 1 to 30 days following the positive test. RESULTS We matched 3289 alpha-1 antagonist exposed patients to 6189 unexposed patients. Overall, there was no difference in the 30-day risk of the primary outcome among patients exposed to alpha-1 antagonists at the time of their diagnosis relative to unexposed individuals (28.8% vs. 28.0%; OR 1.00, 95% CI 0.91 to 1.11). In a secondary analysis, individuals exposed to alpha-1 antagonists had a lower risk of death in the 30 days following a COVID diagnosis (OR 0.79; 95% CI 0.66 to 0.93). CONCLUSION Alpha-1 antagonists did not mitigate the 30-day risk of clinical deterioration in non-hospitalized patients with COVID-19. Our findings do not support the general repurposing of alpha-1 antagonists as a treatment for such patients, although there may be subgroups of patients in whom further research is warranted.
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Affiliation(s)
- Tony Antoniou
- Department of Family and Community Medicine, Unity Health Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Daniel McCormack
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Mina Tadrous
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
| | - Tara Gomes
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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14
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Esteve LMA, Padilla BI, Pichardo-Lowden A, Granados I, Carlson S, Corsino L. A pilot study testing a new transition of care model from hospital to the community for Hispanic/Latino adults with diabetes to reduce emergency department visits and hospital re-admissions. Pilot Feasibility Stud 2024; 10:122. [PMID: 39342332 PMCID: PMC11438034 DOI: 10.1186/s40814-024-01534-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 07/29/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Hispanic/Latino populations have the second highest prevalence of diabetes (12.5%) among ethnic minority groups in the USA. They also have higher rates of uncontrolled diabetes and diabetes-related complications. Approximately 29% of diabetes care costs are attributed to inpatient hospital care. To reduce hospital length of stay and re-admission rates for diabetes, the American Diabetes Association (ADA) recommends a "structured discharge plan tailored to the individual patient with diabetes." However, limited research exists on the feasibility and applicability of a transition of care model specifically tailored for the Hispanic/Latino population. METHODS We conducted a 2-year pilot study to develop a practical, patient-centered, and culturally competent transition of care (TOC) model for Hispanic/Latino adults with diabetes discharged from the hospital to the community. Feasibility outcomes included recruitment rates, questionnaire completion rates, adherence to a 30-day post-discharge phone call, and resource needs and utilization for study implementation. Participant-centered outcomes included 30-day post-discharge emergency department (ED) visits, 30-day post-discharge unplanned re-admissions, follow-up visits within 2 weeks of discharge, and patient satisfaction with the TOC model. RESULTS Twelve participants were enrolled over the study period, with weekly enrollment ranging from 0 to 4 participants. Participants' average age in years was 47 (± 11.6); the majority were male (85%), and 75% had type 2 diabetes. Recruitment involved the support of 4 bilingual staff. The estimated time to review the chart, approach participants, obtain informed consent, complete questionnaires, and provide discharge instructions was approximately 2.5 h. Of the 10 participants who completed the 30-day post-discharge phone call, none had ED visits or unplanned hospital re-admissions within 30 days post-discharge, and all had a follow-up with a medical provider within 2 weeks. CONCLUSIONS Implementing a patient-centered and culturally competent TOC model for Hispanic/Latino adults with diabetes discharged from the hospital to the community is feasible when considering key resources for success. These include a bilingual team with dedicated and funded time, alignment with existing discharge process and integration into the Electronic Medical Record (EMR) systems.
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Affiliation(s)
- Lucy Marie Alice Esteve
- Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA
| | - Blanca Iris Padilla
- Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Nursing, Durham, NC, USA
| | - Ariana Pichardo-Lowden
- Departments of Medicine & Public Health Sciences, Division of Endocrinology, Diabetes and Metabolism, Penn State College of Medicine, Hershey, PA, USA
| | - Isa Granados
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Scott Carlson
- Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA
| | - Leonor Corsino
- Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA.
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15
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Baagar K, Alessa T, Abu-Farha M, Abubaker J, Alhumaidi H, Franco Ceruto JA, Hamad MK, Omrani A, Abdelrahman S, Zaka-Ul Haq M, Safi AW, Alhariri B, Barman M, Abdelmajid A, Cancio HVD, Elmekaty E, Al-Khairi I, Cherian P, Jayyousi L, Ahmed M, Qaddoumi M, Hajji S, Esmaeel A, Al-Andaleeb A, Channanath A, Devarajan S, Ali H, Thanaraj TA, Al-Sabah S, Al-Mulla F, Abdul-Ghani M, Jayyousi A. Effect of pioglitazone on inflammatory response and clinical outcome in T2DM patients with COVID-19: a randomized multicenter double-blind clinical trial. Front Immunol 2024; 15:1369918. [PMID: 39308871 PMCID: PMC11412854 DOI: 10.3389/fimmu.2024.1369918] [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: 01/13/2024] [Accepted: 08/12/2024] [Indexed: 09/25/2024] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) caused by the coronavirus SARS-CoV-2, has emerged as a rapidly spreading contagious disease across the globe. Recent studies showed that people with diabetes mellitus, severe obesity, and cardiovascular disease are at higher risk of mortality from COVID-19. It has been suggested that the increased risk is due to the chronic inflammatory state associated with type 2 diabetes. This study aimed to evaluate the efficacy of pioglitazone, a strong insulin sensitizer with anti-inflammatory properties, in improving the clinical outcomes of patients with type 2 diabetes admitted with moderate-severe COVID-19. Method We enrolled 350 patients with type 2 diabetes who were admitted to hospitals in Qatar and Kuwait with COVID-19. Patients were randomized to receive, in a double-blind fashion, pioglitazone (n = 189) or a matching placebo (n = 161) for 28 days. The study had two primary outcomes: (1) the incidence of a composite outcome composed of (a) the requirement for mechanical ventilation, (b) death, and (c) myocardial damage; and (2) an increase in C-reactive protein (CRP) levels. Results The first primary outcome occurred in 28 participants (8%), and the secondary outcome occurred in 17. Treatment with pioglitazone showed a significant reduction in interleukin (IL)-3 levels compared with placebo treatment (mean (SD) 2.73 (± 2.14) [95% CI: 0.02, 1.1], p = 0.043 vs. 2.28 (± 1.67) [95% CI: - 0.23, 0.86], p = 0.3, respectively), with no effect seen in the levels of other inflammatory markers. Even though not significant, a few of the patients on pioglitazone exhibited serum troponin levels > 3 times higher than the normal range seen in patients on placebo. On the other hand, more patients on pioglitazone were admitted to the ICU than those with placebo, and no significant difference in the CRP reduction was observed between the two groups. Conclusion The results of the present study demonstrate that pioglitazone treatment did not independently provide any additional clinical benefit to patients with type 2 diabetes admitted with a COVID-19 infection. Clinical trial registration https://clinicaltrials.gov, identifier NCT04604223.
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Affiliation(s)
- Khaled Baagar
- Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Thamer Alessa
- Jaber AlAhmed Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Department of Translational Research, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jehad Abubaker
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Heba Alhumaidi
- Jaber AlAhmed Hospital, Ministry of Health, Kuwait City, Kuwait
| | | | | | - Ali Omrani
- Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | | | - Manish Barman
- Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Eman Elmekaty
- Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
| | - Irina Al-Khairi
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Preethi Cherian
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Lina Jayyousi
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Manama, Bahrain
| | - Mohammed Ahmed
- Department of Translational Research, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohammed Qaddoumi
- Pharmacology and Therapeutics Department, Faculty of Pharmacy, Kuwait University, Kuwait City, Kuwait
| | - Sulaiman Hajji
- Jaber AlAhmed Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Ahmad Esmaeel
- Jaber AlAhmed Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Ali Al-Andaleeb
- Jaber AlAhmed Hospital, Ministry of Health, Kuwait City, Kuwait
| | | | | | - Hamad Ali
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | - Salman Al-Sabah
- Jaber AlAhmed Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Department of Translational Research, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Muhammad Abdul-Ghani
- Department of Translational Research, Dasman Diabetes Institute, Kuwait City, Kuwait
- Division of Diabetes, University of Texas Health Science Center, San Antonio, TX, United States
| | - Amin Jayyousi
- Medicine Department, Hamad Medical Corporation, Doha, Qatar
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16
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Piza PMDT, de Freitas VM, Aguiar-Brito I, Calsolari-Oliveira BM, Rangel ÉB. Impact of Hyponatremia on COVID-19-Related Outcomes: A Retrospective Analysis. Biomedicines 2024; 12:1997. [PMID: 39335510 PMCID: PMC11444129 DOI: 10.3390/biomedicines12091997] [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: 07/26/2024] [Revised: 08/22/2024] [Accepted: 08/22/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Sodium disturbances are observed in one-third of patients with COVID-19 and result from multifaceted mechanisms. Notably, hyponatremia is associated with disease progression and mortality. AIM We aimed to analyze the impact of hyponatremia on COVID-19 outcomes and its correlation with clinical and laboratory parameters during the first wave. METHODS We evaluated the sodium levels of 558 patients with COVID-19 between 21 March 2020, and 31 July 2020, at a single center. We performed linear regression analyses to explore the correlation of sodium levels with COVID-19-related outcomes, demographic data, signs and symptoms, and laboratory parameters. Next, we conducted Pearson correlation analyses. A p-value < 0.05 was considered significant. RESULTS Hyponatremia was found in 35.3% of hospitalized patients with COVID-19. This was associated with the need for intensive care transfer (B = -1.210, p = 0.009) and invasive mechanical ventilation (B = -1.063, p = 0.032). Hyponatremia was frequently found in oncologic patients (p = 0.002) and solid organ transplant recipients (p < 0.001). Sodium was positively associated with diastolic blood pressure (p = 0.041) and productive cough (p = 0.022) and negatively associated with dry cough (p = 0.032), anorexia (p = 0.004), and nausea/vomiting (p = 0.007). Regarding the correlation of sodium levels with other laboratory parameters, we observed a positive correlation with hematocrit (p = 0.011), lymphocytes (p = 0.010), pCO2 (p < 0.0001), bicarbonate (p = 0.0001), and base excess (p = 0.008) and a negative correlation with the neutrophil-to-lymphocyte ratio (p = 0.009), the platelet-to-lymphocyte ratio (p = 0.033), and arterial blood glucose (p = 0.016). CONCLUSIONS Hyponatremia is a risk factor for adverse outcomes in COVID-19 patients. It is associated with demographic data and clinical and laboratory parameters. Therefore, hyponatremia is an important tool for risk stratification in COVID-19 patients.
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Affiliation(s)
- Pedro Maciel de Toledo Piza
- Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-062, SP, Brazil; (P.M.d.T.P.); (V.M.d.F.); (I.A.-B.); (B.M.C.-O.)
| | - Victor Muniz de Freitas
- Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-062, SP, Brazil; (P.M.d.T.P.); (V.M.d.F.); (I.A.-B.); (B.M.C.-O.)
| | - Isabella Aguiar-Brito
- Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-062, SP, Brazil; (P.M.d.T.P.); (V.M.d.F.); (I.A.-B.); (B.M.C.-O.)
| | - Barbara Monique Calsolari-Oliveira
- Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-062, SP, Brazil; (P.M.d.T.P.); (V.M.d.F.); (I.A.-B.); (B.M.C.-O.)
| | - Érika Bevilaqua Rangel
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo 04038-031, SP, Brazil
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
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17
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Liu JW, Huang X, Wang MK, Yang JS. Diabetes and susceptibility to COVID-19: Risk factors and preventive and therapeutic strategies. World J Diabetes 2024; 15:1663-1671. [PMID: 39192862 PMCID: PMC11346102 DOI: 10.4239/wjd.v15.i8.1663] [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: 03/27/2024] [Revised: 05/22/2024] [Accepted: 06/05/2024] [Indexed: 07/25/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious disease caused by a novel human coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes is a well-known risk factor for infectious diseases with high prevalence and increased severity. Here, we elucidated the possible factors for the increased vulnerability of diabetic patients to SARS-CoV-2 infection and the more severe COVID-19 illness. The worsened prognosis of patients with both COVID-19 and diabetes may be attributable to host receptor angiotensin-converting enzyme 2-assisted viral uptake. Moreover, insulin resistance is often associated with impaired mucosal and skin barrier integrity, resulting in mic-robiota dysbiosis, which increases susceptibility to viral infections. It may also be associated with higher levels of pro-inflammatory cytokines resulting from an impaired immune system in diabetics, inducing a cytokine storm and excessive inflammation. This review describes diabetes mellitus and its complications, explains the risk factors, such as disease characteristics and patient lifestyle, which may contribute to the high susceptibility of diabetic patients to COVID-19, and discusses preventive and therapeutic strategies for COVID-19-positive diabetic patients.
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Affiliation(s)
- Jing-Wen Liu
- School of Pharmacy, Bengbu Medical University, Bengbu 233000, Anhui Province, China
- Naval Medical Center, Naval Medical University, Shanghai 200052, China
| | - Xiao Huang
- Naval Medical Center, Naval Medical University, Shanghai 200052, China
| | - Ming-Ke Wang
- Naval Medical Center, Naval Medical University, Shanghai 200052, China
| | - Ji-Shun Yang
- Naval Medical Center, Naval Medical University, Shanghai 200052, China
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18
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Tisch C, Xourgia E, Exadaktylos A, Ziaka M. Potential use of sodium glucose co-transporter 2 inhibitors during acute illness: a systematic review based on COVID-19. Endocrine 2024; 85:660-675. [PMID: 38448675 PMCID: PMC11291544 DOI: 10.1007/s12020-024-03758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE SGLT-2i are increasingly recognized for their benefits in patients with cardiometabolic risk factors. Additionally, emerging evidence suggests potential applications in acute illnesses, including COVID-19. This systematic review aims to evaluate the effects of SGLT-2i in patients facing acute illness, particularly focusing on SARS-CoV-2 infection. METHODS Following PRISMA guidelines, a systematic search of PubMed, Scopus, medRxiv, Research Square, and Google Scholar identified 22 studies meeting inclusion criteria, including randomized controlled trials and observational studies. Data extraction and quality assessment were conducted independently. RESULTS Out of the 22 studies included in the review, six reported reduced mortality in DM-2 patients taking SGLT-2i, while two found a decreased risk of hospitalization. Moreover, one study demonstrated a lower in-hospital mortality rate in DM-2 patients under combined therapy of metformin plus SGLT-2i. However, three studies showed a neutral effect on the risk of hospitalization. No increased risk of developing COVID-19 was associated with SGLT-2i use in DM-2 patients. Prior use of SGLT-2i was not associated with ICU admission and need for MV. The risk of acute kidney injury showed variability, with inconsistent evidence regarding diabetic ketoacidosis. CONCLUSION Our systematic review reveals mixed findings on the efficacy of SGLT-2i use in COVID-19 patients with cardiometabolic risk factors. While some studies suggest potential benefits in reducing mortality and hospitalizations, others report inconclusive results. Further research is needed to clarify optimal usage and mitigate associated risks, emphasizing caution in clinical interpretation.
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Affiliation(s)
- Carmen Tisch
- Department of Internal Medicine, Thun General Hospital, Thun, Switzerland
| | - Eleni Xourgia
- Department of Cardiology, Inselspital, University Hospital, University of Bern, 3008, Bern, Switzerland
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Aristomenis Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Mairi Ziaka
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
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19
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Hermányi Z, Menyhárt A, Körei AE, Istenes I, Lao-Kan GA, Csiki V, Benhamida A, Kozlovszky M, Berey A, Markovich P, Kempler P. A comprehensive analysis of diabetic patient data before and during the COVID-19 pandemic - Lessons from the MÉRY diabetes database (MDD). J Diabetes Complications 2024; 38:108799. [PMID: 38897066 DOI: 10.1016/j.jdiacomp.2024.108799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
AIMS Our study examined changes in average blood glucose levels (ABG), measurement frequency (MF), and data uploading (DU) before and during the COVID-19 pandemic in 882-day spans, which were divided into further 20-week intervals to highlight the pandemic's impact. METHODS T-Tests assessed the statistical significance of blood glucose data from 26,655/20,936 patients and 19.5/16.6 million records during pre-COVID/COVID. RESULTS During COVID, patients had significantly lower ABG levels (9.1/8.9 mmol/L, p < 0.001). Weekly DU decreased (155,945/128,445, p < 0.05), while daily MF increased (0.83/0.87, p < 0.001). Comparing the last 20 weeks pre-COVID to the first 20 weeks during COVID, ABG levels were lower (9.0 /8.9, p < 0.01), MF increased (0.83 /0.99, p < 0.001), and DU decreased (153,133/145,381, p < 0.05). In the initial 20 weeks of COVID compared to the second 20 weeks of COVID, ABG increased (8.9/9.1, p < 0.01), MF decreased (0.99/0.95, p < 0.001), and DU decreased (145,381/140,166, p < 0.05). Our most striking observation was the temporary dramatic fall in glucose uploads during the first few weeks of COVID. The changes of ABG and MF values were statistically significant, but were not deemed clinically relevant. CONCLUSIONS Despite COVID's prolonged impact, diabetic patients showed improved attitudes. A significant drop in data uploads occurred during the first 20 weeks of COVID; home office and lockdowns apparently disrupted patient routines.
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Affiliation(s)
- Zsolt Hermányi
- Bajcsy-Zsilinszky Hospital and Clinic, 1106 Budapest, Maglódi út 89-91, Hungary.
| | - Adrienn Menyhárt
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Anna Erzsébet Körei
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Ildikó Istenes
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Genevieve Arany Lao-Kan
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Vanda Csiki
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Üllői út 78/A, Hungary
| | - Abdallah Benhamida
- BioTech Research Center, Obuda University, Bécsi út 96/b. 1034, Hungary.
| | - Miklos Kozlovszky
- BioTech Research Center, Obuda University, Bécsi út 96/b. 1034, Hungary; Di-Care Zrt., 1119 Budapest, Mérnök utca 12-14, Hungary.
| | - Attila Berey
- Medical Device Research Group, LPDS, MTA-SZTAKI, 1111 Budapest, Lágymányosi út 11, Hungary.
| | - Peter Markovich
- Medical Device Research Group, LPDS, MTA-SZTAKI, 1111 Budapest, Lágymányosi út 11, Hungary.
| | - Péter Kempler
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary.
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20
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Qureshi A, Syed Sulaiman SA, Rajpoot PL, Mohammed Sahli M, Kumar N, Bhurgri S, Daud NAA. Impact of Long-Term Non-Communicable Diseases on SARS-COV-2 Hospitalized Patients Supported by Radiological Imaging in Southern Pakistan. Cureus 2024; 16:e67110. [PMID: 39290932 PMCID: PMC11406398 DOI: 10.7759/cureus.67110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2024] [Indexed: 09/19/2024] Open
Abstract
COVID-19 patients with already existing chronic medical conditions are more likely to develop severe complications and, ultimately, a higher risk of mortality. This study analyzes the impacts of pre-existing chronic illnesses such as diabetes (DM), hypertension, and cardiovascular diseases (CVDs) on COVID-19 cases by using radiological chest imaging. The data of laboratory-confirmed COVID-19-infected hospitalized patients were analyzed from March 2020 to December 2020. Chest X-ray images were included to further identify the differences in X-ray patterns of patients with co-morbid conditions and without any co-morbidity. The Pearson chi-square test checks the significance of the association between co-morbidities and mortality. The magnitude and dimension of the association were calibrated by the odds ratio (OR) at a 95% confidence interval (95% CI) over the patients' status (mortality and discharged cases). A univariate binary logistic regression model was applied to examine the impact of co-morbidities on death cases independently. A multivariate binary logistic regression model was applied for the adjusted effects of possible confounders. For the sensitivity analysis of the model, receiver operating characteristic (ROC) was applied. Patients with different comorbidities, including diabetes (OR = 33.4, 95% CI: 20.31-54.78, p < 0.001), cardiovascular conditions (OR = 24.14, 95% CI: 10.18-57.73, p < 0.001), and hypertension (OR = 16.9, 95% CI: 10.20-27.33, p < 0.001), showed strong and significant associations. The opacities present in various zones of the lungs clearly show that COVID-19 patients with chronic illnesses such as diabetes, hypertension, cardiovascular disease, and obesity experience significantly worse outcomes, as evidenced by chest X-rays showing increased pneumonia and deterioration. Therefore, stringent precautions and a global public health campaign are crucial to reducing mortality in these high-risk groups.
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Affiliation(s)
- Ali Qureshi
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
| | - Pushp Lata Rajpoot
- Department of Health Education and Promotion, College of Public Health Education and Tropical Medicine, Jazan University, Jazan, SAU
| | - Maryam Mohammed Sahli
- Department of Health Education and Promotion, College of Public Health Education and Tropical Medicine, Jazan University, Jazan, SAU
| | - Narendar Kumar
- Department of Clinical Pharmacy, University of Sindh, Jamshoro, Jamshoro, PAK
| | - Shireen Bhurgri
- College of Pharmacy, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Nur Aizati Athirah Daud
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, MYS
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21
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Okon-Umoren A, Yaphe S, Smith A, Passalacqua KD, Budzynska K. Transient Hyperglycemia in a Patient With Type 2 Diabetes After COVID-19 Messenger RNA Vaccination: A Case Report. Cureus 2024; 16:e63983. [PMID: 39105031 PMCID: PMC11299958 DOI: 10.7759/cureus.63983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2024] [Indexed: 08/07/2024] Open
Abstract
The development of new vaccines against the SARS-CoV-2 virus in response to the COVID-19 pandemic represents a milestone in the history of public health. However, due to the rapid development and short duration of these new vaccines, the full spectrum of side effects is not yet known. A 76-year-old man presented to the clinic for follow-up after being discharged from the emergency department for hyperglycemia. His medical history included well-controlled type 2 diabetes for two years, hypertension, and hyperlipidemia. He had recently noticed high home blood glucose readings over 400 mg/dL, and his hemoglobin A1c (mean 90-day glucose level) had increased from 6.5% to 12.6%. Notably, the patient reported having excellent health behaviors, including daily exercise, a closely monitored healthy diet, and regular blood glucose testing. After extensive endocrinology workup, the rapid change in blood glucose was thought to be due to his having recently received the COVID-19 messenger RNA (mRNA) vaccine. He was started on long- and short-acting insulin and a glucagon-like peptide-1 agonist (novel injectable type 2 diabetes medication), with improvement in blood glucose. He was tapered off all medications and remains on metformin 1,000 mg twice daily after one year.Whether the new COVID-19 mRNA vaccines directly incur hyperglycemia within certain groups of patients with diabetes is not known; thus, studies exploring the relationship between vaccine antigen binding and pancreatic function are needed.
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Affiliation(s)
| | - Sean Yaphe
- Family Medicine, Henry Ford Health System, Detroit, USA
| | - Andrea Smith
- Family Medicine, Henry Ford Health System, Detroit, USA
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22
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Liang P, Wei Z, Li R, Zhou E, Chen Z. Predictive value of hematocrit, serum albumin level difference, and fibrinogen-to-albumin ratio for COVID-19-associated acute respiratory failure. Heliyon 2024; 10:e33326. [PMID: 39021974 PMCID: PMC11253537 DOI: 10.1016/j.heliyon.2024.e33326] [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: 08/08/2023] [Revised: 06/16/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background Acute respiratory failure is the main clinical manifestation and a major cause of death in patients with COVID-19. However, few reports on its prevention and control have been published because of the need for laboratory predictive indicators. This study aimed to evaluate the predictive value of hematocrit level, serum albumin level difference, and fibrinogen-to-albumin ratio for COVID-19-associated acute respiratory failure. Material and methods A total of 120 patients with COVID-19 from the First Affiliated Hospital of Anhui Medical University were selected between December 2022 and March 2023. Patients were divided into acute respiratory failure and non-acute respiratory failure groups and compared patient-related indicators between them using univariate and multivariate logistic regression analyses. Receiver operating characteristic analysis was performed to determine the discrimination accuracy. Results In total, 48 and 72 patients were enrolled in the acute respiratory failure and non-acute respiratory failure groups, respectively. The Quick COVID-19 Severity Index scores, fibrinogen-to-albumin ratio, hematocrit and serum albumin level difference, fibrinogen, and hematocrit levels were significantly higher in the acute respiratory failure group than in the non-acute respiratory failure group. A Quick COVID-19 Severity Index >7, fibrinogen-to-albumin ratio >0.265, and hematocrit and serum albumin level difference >12.792 had a 96.14 % positive predictive rate and a 94.06 % negative predictive rate. Conclusion Both fibrinogen-to-albumin ratio and hematocrit and serum albumin level difference are risk factors for COVID-19-associated acute respiratory failure. The Quick COVID-19 Severity Index score combined with fibrinogen-to-albumin ratio, and hematocrit and serum albumin level difference predict high and low risks with better efficacy and sensitivity than those of the Quick COVID-19 Severity Index score alone; therefore, these parameters can be used collectively as a risk stratification method for assessing patients with COVID-19.
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Affiliation(s)
| | | | | | - Enze Zhou
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of AnHui Medical University, 218 JiXi Avenue, Hefei, 230022, Anhui, China
| | - Zheng Chen
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of AnHui Medical University, 218 JiXi Avenue, Hefei, 230022, Anhui, China
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23
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Younes S. The role of nutrition on the treatment of Covid 19. HUMAN NUTRITION & METABOLISM 2024; 36:200255. [DOI: 10.1016/j.hnm.2024.200255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2024]
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24
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Hu J, Ouyang L, Li J, Li X, Zhong Y, Hou C. Mean Blood Glucose Level During ICU Hospitalization is a Strong Predictor of the Mortality of COVID-19. Diabetes Metab Syndr Obes 2024; 17:1903-1909. [PMID: 38706805 PMCID: PMC11070158 DOI: 10.2147/dmso.s450489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/16/2024] [Indexed: 05/07/2024] Open
Abstract
OBJECTIVE To investigate the potential prognostic value of mean blood glucose (MBG) in hospital for prognosis of COVID-19 adult patients in the intensive unit care unit (ICU). METHODS A single-site and retrospective study enrolled 107 patients diagnosed as COVID-19 from department of critical care medicine in the Second Xiangya Hospital between October 2022 and June 2023. Demographic information including glucose during ICU hospitalization, comorbidity, clinical data, types of medications and treatment, and clinical outcome were collected. The multivariate logistic and cox regression was used to explore the relationship between blood glucose changes and clinical outcomes of COVID-19 during ICU stay. RESULTS In total, 107 adult patients confirmed with COVID-19 were included. Multivariate logistic regression results showed an increase in MBG was associated with ICU mortality rate. Compared with normal glucose group (MBG <= 7.8 mmol/L), the risk of ICU mortality, 7-day mortality and 28-day mortality from COVID-19 were significantly increased in high glucose group (MBG >7.8mmol/L). CONCLUSION MBG level during ICU hospitalization was strongly correlated to all-cause mortality and co-infection in COVID-19 patients. These findings further emphasize the importance of overall glucose management in severe cases of COVID-19.
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Affiliation(s)
- Jie Hu
- Critical Care Medicine Center, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology, Key Laboratory Diseases Immunology, Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| | - Lin Ouyang
- Department of Critical Care Medicine Center, Guilin Hospital of the Second Xiangya Hospital, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| | - Jinxiu Li
- Critical Care Medicine Center, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Xia Li
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology, Key Laboratory Diseases Immunology, Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| | - Yanjun Zhong
- Critical Care Medicine Center, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Can Hou
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology, Key Laboratory Diseases Immunology, Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
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25
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Wang Y, Li K, Mo S, Yao P, Zeng J, Lu S, Qin S. Identification of common genes and pathways between type 2 diabetes and COVID-19. Front Genet 2024; 15:1249501. [PMID: 38699234 PMCID: PMC11063347 DOI: 10.3389/fgene.2024.1249501] [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: 06/28/2023] [Accepted: 03/21/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Numerous studies have reported a high incidence and risk of severe illness due to coronavirus disease 2019 (COVID-19) in patients with type 2 diabetes (T2DM). COVID-19 patients may experience elevated or decreased blood sugar levels and may even develop diabetes. However, the molecular mechanisms linking these two diseases remain unclear. This study aimed to identify the common genes and pathways between T2DM and COVID-19. METHODS Two public datasets from the Gene Expression Omnibus (GEO) database (GSE95849 and GSE164805) were analyzed to identify differentially expressed genes (DEGs) in blood between people with and without T2DM and COVID-19. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the common DEGs. A protein-protein interaction (PPI) network was constructed to identify common genes, and their diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis. Validation was performed on the GSE213313 and GSE15932 datasets. A gene co-expression network was constructed using the GeneMANIA database to explore interactions among core DEGs and their co-expressed genes. Finally, a microRNA (miRNA)-transcription factor (TF)-messenger RNA (mRNA) regulatory network was constructed based on the common feature genes. RESULTS In the GSE95849 and GSE164805 datasets, 81 upregulated genes and 140 downregulated genes were identified. GO and KEGG enrichment analyses revealed that these DEGs were closely related to the negative regulation of phosphate metabolic processes, the positive regulation of mitotic nuclear division, T-cell co-stimulation, and lymphocyte co-stimulation. Four upregulated common genes (DHX15, USP14, COPS3, TYK2) and one downregulated common feature gene (RIOK2) were identified and showed good diagnostic accuracy for T2DM and COVID-19. The AUC values of DHX15, USP14, COPS3, TYK2, and RIOK2 in T2DM diagnosis were 0.931, 0.917, 0.986, 0.903, and 0.917, respectively. In COVID-19 diagnosis, the AUC values were 0.960, 0.860, 1.0, 0.9, and 0.90, respectively. Validation in the GSE213313 and GSE15932 datasets confirmed these results. The miRNA-TF-mRNA regulatory network showed that TYH2 was targeted by PITX1, PITX2, CRX, NFYA, SREBF1, RELB, NR1L2, and CEBP, whereas miR-124-3p regulates THK2, RIOK2, and USP14. CONCLUSION We identified five common feature genes (DHX15, USP14, COPS3, TYK2, and RIOK2) and their co-regulatory pathways between T2DM and COVID-19, which may provide new insights for further molecular mechanism studies.
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Affiliation(s)
- Ya Wang
- Gastroenterology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Endocrinology Department, Liuzhou Peoples’ Hospital Affiliated to Guangxi Medical University, Liuzhou, China
| | - Kai Li
- Orthopedics Department, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Shuangyang Mo
- Gastroenterology Department, Liuzhou Peoples’ Hospital Affiliated to Guangxi Medical University, Liuzhou, China
| | - Peishan Yao
- Gastroenterology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiaxing Zeng
- Department of Traumatic Surgery, Microsurgery, and Hand Surgery, Guangxi Zhuang Autonomous Region People’s Hospital, Nanning, Guangxi, China
| | - Shunyu Lu
- Department of Pharmacy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shanyu Qin
- Gastroenterology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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26
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Petramala L, Milito C, Sarlo F, Servello A, Circosta F, Marino L, Sardella G, Trapani P, D'aguanno G, Cimo' A, Galardo G, Letizia C. Clinical impact of transient lymphopenia. Clin Exp Med 2024; 24:77. [PMID: 38630321 PMCID: PMC11023980 DOI: 10.1007/s10238-024-01340-0] [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: 01/23/2024] [Accepted: 03/27/2024] [Indexed: 04/19/2024]
Abstract
Transient or persistent immunosuppression is a known risk factor for morbidity and mortality in critically ill patients. Aim of the present study is to evaluate the lymphopenia in patients admitted to the Emergency Unit of AOU Policlinico Umberto I, to investigate its prevalence at admission and the persistence during hospitalization until discharge. Possible correlations were evaluated between lymphopenia, diagnosis of admission, comorbidities and chronic treatments. In this study, 240 patients (142 men; 98 female; mean age 75.1 ± 15.1) were enrolled. Patients were divided into two groups according to the lymphocytes count at hospital admission, namely "Group A" with lymphopenia and "Group B" with values in the normal range. Moreover, the patients in group A were distinguished in relation to the regression or persistence of the lymphopenia assessed at the time of hospital discharge (Group A1: persistence; Group A2: normalization). Prevalence of lymphopenia at admission was 57%; Group A showed higher mean age and percentage of patients over 65 years of age; and none differences were observed regarding gender. Prevalence of lymphopenia at admission was 57%; Group A showed higher mean age and percentage of patients over 65 years of age; no differences were observed regarding gender. All subsets of the lymphocytes (CD4+, CD8+, NK) were equally reduced. Persistent lymphopenia was found in 19% of patients. Lymphopenia should be valued at the time of hospital admission as a factor influencing the prognosis, the management and the treatment of these patients.
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Affiliation(s)
- Luigi Petramala
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Cinzia Milito
- Department of Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Francesca Sarlo
- UOC Chimica, Biochimica E Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S, Rome, Italy
| | - Adriana Servello
- Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Policlinico "Umberto I", Rome, Italy
| | - Francesco Circosta
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Luca Marino
- Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Policlinico "Umberto I", Rome, Italy.
- Department of Mechanical and Aerospace Engineering, "Sapienza" University of Rome, Rome, Italy.
| | - Germano Sardella
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Piero Trapani
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Giulio D'aguanno
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Antonino Cimo'
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Gioacchino Galardo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
| | - Claudio Letizia
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- General Surgery Unit, ICOT Hospital, Latina, Italy
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Naveed N, Ahmad K, Majeed H, Qureshi K, Ahmad I, Awan MF, Iftikhar T, Ahmad S, Noreen F, Amin MA, Batool H. The Global Impact of COVID-19: A Comprehensive Analysis of Its Effects on Various Aspects of Life. Toxicol Res (Camb) 2024; 13:tfae045. [PMID: 38545435 PMCID: PMC10964844 DOI: 10.1093/toxres/tfae045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 11/10/2024] Open
Abstract
In this study COVID-19 effects on different aspects of life that how this virus created a mess in every discipline of life starting from a small tuck shop of a street to a huge business with a chain between different countries; and some preventive measures are also suggested. Not only mental healthiness as well as physical health of people was also disturbed to a large extent. People being quarantined did not do any practice and had nothing to do, their boredom made them mentally and physically inactive. For minimization the effect of this pandemic on mental healthiness, interventions were practiced and psychological support systems were developed to help mentally effected people; on the other hand, to improve physical health the hospital workers worked day and night in return they got affected too either mentally or physically. Many of the youngsters started alcohol consumption during quarantine. Because of the closure of educational institutes, the students were sent back to their homes where there was no proper guidance for them and they lost their interests in studies; and in a sense educational impact of COVID-19 was also unbearable. Agricultural system was affected badly and the whole world passed through a huge economic loss. The flights and traffic were blocked throughout the world, and it is the only positive impact that COVID-19 led to the environment by improving water and air quality as there was a remarkable reduction in the emission of greenhouse gases.
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Affiliation(s)
- Nabiha Naveed
- Department of Chemistry, University of Management and Technology (UMT), Sialkot Campus 51310, Pakistan
| | - Khalil Ahmad
- Department of Chemistry, Emerson University Multan (EUM), Multan 60000, Pakistan
| | - Hammad Majeed
- Department of Chemistry, University of Management and Technology (UMT), Sialkot Campus 51310, Pakistan
| | - Khizar Qureshi
- Department of Chemistry, University of Management and Technology (UMT), Sialkot Campus 51310, Pakistan
| | - Irfan Ahmad
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 62529-Abha, Saudi Arabia
| | - Mudassar Fareed Awan
- Department of Biotechnology, Knowledge Unit of Science, University of Management and Technology, Sialkot Campus-51310, Pakistan
| | - Tehreema Iftikhar
- Department of Botany, Government College University (GCU) Lahore, 54000, Pakistan
| | - Shakeel Ahmad
- Faculty of Science, Institute of Zoology, Bahauddin Zakariya University Multan, 60800, Pakistan
| | - Fozia Noreen
- Department of Chemistry, University of Management and Technology (UMT), Sialkot Campus 51310, Pakistan
| | - Muhammad Awais Amin
- Department of Chemistry, University of Management and Technology (UMT), Sialkot Campus 51310, Pakistan
| | - Hifza Batool
- Department of Chemistry, University of Management and Technology (UMT), Sialkot Campus 51310, Pakistan
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Damasceno DFO, Cavalcante TF, Andrade LKA, de Oliveira FBB, de Oliveira Lopes MV, Moreira RP, Morais HCC. Etiological factors of chronic pain syndrome in young adults with post-coronavirus disease 2019 condition. Int J Nurs Knowl 2024; 35:152-162. [PMID: 37243313 DOI: 10.1111/2047-3095.12428] [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: 02/03/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions. METHODS This was a case-control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS. FINDINGS This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS. CONCLUSIONS A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS. IMPLICATIONS FOR NURSING PRACTICE The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy.
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Affiliation(s)
| | - Tahissa Frota Cavalcante
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceará, Brazil
| | - Larissa Katlyn Alves Andrade
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceará, Brazil
| | | | | | - Rafaella Pessoa Moreira
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceará, Brazil
| | - Huana Carolina Candido Morais
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceará, Brazil
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Abuyousef S, Alnaimi S, Omar NE, Elajez R, Elmekaty E, Abdelfattah-Arafa E, Barazi R, Ghasoub R, Rahhal A, Hamou F, Al-Amri M, Karawia A, Ajaj F, Alkhawaja R, Kardousha A, Awaisu A, Abou-Ali A, Khatib M, Aboukamar M, Al-Hail M. Early predictors of intensive care unit admission among COVID-19 patients in Qatar. Front Public Health 2024; 12:1278046. [PMID: 38572008 PMCID: PMC10987715 DOI: 10.3389/fpubh.2024.1278046] [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: 08/15/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Background COVID-19 is associated with significant morbidity and mortality. This study aimed to explore the early predictors of intensive care unit (ICU) admission among patients with COVID-19. Methods This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29-May 29, 2020. For each case enrolled, one control was matched by age and gender. Results A total of 1,560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range = 18). Predictors independently associated with ICU admission were cardiovascular disease (adjusted odds ratio (aOR) = 1.64, 95% confidence interval (CI): 1.16-2.32, p = 0.005), diabetes (aOR = 1.52, 95% CI: 1.08-2.13, p = 0.016), obesity (aOR = 1.46, 95% CI: 1.03-2.08, p = 0.034), lymphopenia (aOR = 2.69, 95% CI: 1.80-4.02, p < 0.001), high AST (aOR = 2.59, 95% CI: 1.53-4.36, p < 0.001), high ferritin (aOR = 1.96, 95% CI: 1.40-2.74, p < 0.001), high CRP (aOR = 4.09, 95% CI: 2.81-5.96, p < 0.001), and dyspnea (aOR = 2.50, 95% CI: 1.77-3.54, p < 0.001). Conclusion Having cardiovascular disease, diabetes, obesity, lymphopenia, dyspnea, and increased AST, ferritin, and CRP were independent predictors for ICU admission in patients with COVID-19.
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Affiliation(s)
- Safae Abuyousef
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Shaikha Alnaimi
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | - Nabil E. Omar
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Health Sciences Program, Clinical and Population Health Research, College of Pharmacy, Qatar University, Doha, Qatar
| | - Reem Elajez
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Eman Elmekaty
- Department of Pharmacy, Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Raja Barazi
- Department of Pharmacy, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rola Ghasoub
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ala Rahhal
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Hamou
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Maha Al-Amri
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Karawia
- Department of Pharmacy, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Ajaj
- Department of Pharmacy, Home Health Care, Hamad Medical Corporation, Doha, Qatar
| | - Raja Alkhawaja
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Kardousha
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Adel Abou-Ali
- Astellas Pharma Global Development, Inc., Northbrook, IL, United States
| | - Mohamad Khatib
- Department of Critical Care, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Aboukamar
- Department of Infectious Disease, Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Moza Al-Hail
- Department of Pharmacy, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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30
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Gamero-de-Luna EJ, Sánchez-Jaén MR. [Genetic factors associated with long COVID]. Semergen 2024; 50:102187. [PMID: 38277732 DOI: 10.1016/j.semerg.2023.102187] [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: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 01/28/2024]
Abstract
INTRODUCTION The variability in expression and evolution of COVID is not completely explained by clinical factors. In fact, genetic factors play an important role. Moreover, it is unknown whether the genetic factor that contribute to susceptibility and severity are also involved in the onset and evolution of long-COVID. The objective of this review is to gather information from literature to understand which genetic factors are involved in the onset of persistent COVID. MATERIAL AND METHODS Systematic review in PubMed and bioRxiv and medRxiv repositories based on MeSH-descriptors and MeSH-terms related to COVID and genetic factors. Using these terms 2715 articles were pooled. An initial screening performed by authors independently, selected 205 articles of interest. A final deeper screening a total of 85 articles were chosen for complete reading and summarized in this review. RESULTS Although ACE2 and TMPSS6 are involved in COVID susceptibility, their involvement in long-COVID has not been found. On the other hand, the severity of the disease and the onset of long-COVID has been associated with different genes involved in the inflammatory and immune response. Particularly interesting has been the association found with the FOXP4 locus. CONCLUSIONS Although studies on long-COVID are insufficient to fully comprehend the cause, it is clear that the current identified genetic factors do not fully explain the progression and onset of long-COVID. Other factors such as polygenic action, pleiotropic genes, the microbiota and epigenetic changes must be considered and studied.
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Affiliation(s)
- E J Gamero-de-Luna
- Medicina Familiar y Comunitaria, Centro de Salud El Juncal, Sevilla, España; GT Medicina Genómica Personalizada y Enfermedades Raras, SEMERGEN, España.
| | - M R Sánchez-Jaén
- GT Medicina Genómica Personalizada y Enfermedades Raras, SEMERGEN, España; Medicina Familiar y Comunitaria, Centro de Salud de Fabero, León, España
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Dughmosh RA, Mahmood S, Othman MM, Abune'meh EA, Islam N, Hamad NA, Al-Jayyousi GF. Evaluation of Diabetes Hotline Service Implemented During the COVID-19 Pandemic: A Dynamic Adaptation. Telemed J E Health 2024; 30:850-857. [PMID: 37851994 DOI: 10.1089/tmj.2023.0080] [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: 10/20/2023] Open
Abstract
Background: The coronavirus disease 19 (COVID-19) pandemic presented major challenges for people living with diabetes. People with diabetes were identified as being at increased risk of serious illness from COVID-19. The lockdown and preventive measures, including social distancing measures, implemented worldwide to limit the spread of COVID-19 had negatively impacted access to diabetes care, including self-management services, challenging the way modern medicine had been practiced for decades. This article aims to shed light on the implementation and evaluation of the Diabetes hotline service run by trained diabetes patient educators during the pandemic in Qatar. Methods: The logic model is utilized to showcase the implemented strategies/activities and the output monitoring process. An online survey among hotline users was undertaken to gather feedback on patients' overall experience of using the service and physician feedback. Results: Of the 464 patients surveyed, over 92% stated that they would recommend the hotline service to others, and over 90% indicated that they considered the hotline a trusted and reliable resource for diabetes education and advice. Conclusion: It is expected that the lessons learned from maintaining health care delivery services during the COVID-19 pandemic have created new ways of providing standard care and meeting the needs of people with diabetes. Future research should study the clinical outcomes for patients who benefited from the hotline services and the impact on the well-being of people with diabetes.
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Affiliation(s)
| | - Sadia Mahmood
- Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Manal M Othman
- Department of Diabetes Education, Hamad Medical Corporation, Doha, Qatar
| | | | - Nazmul Islam
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Noor Ahmed Hamad
- World Innovation Summit for Health, Qatar Foundation, Doha, Qatar
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Kostopoulou E. The Interplay Between COVID-19 and Pediatric Endocrine Disorders. What have we Learned After More than Three Years of the Pandemic? Horm Metab Res 2024; 56:181-192. [PMID: 37673081 DOI: 10.1055/a-2152-4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
As an increased body of COVID-19 related research is now available, it becomes apparent that the effects of COVID-19 extend beyond that of the respiratory system. Among others, the endocrine system is particularly vulnerable to perturbation from the COVID-19 infection. The present scoping review summarizes the bidirectional relationship between COVID-19 and endocrine system in children and adolescents, by describing both the possible susceptibility of children and adolescents without endocrinopathies to endocrine disorders following COVID-19 infection, but also the potential susceptibility to COVID-19 infection and severe infection, or the aggravation of endocrine dysfunction in patients with pre-existing endocrine diseases. Data suggest increased obesity and diabetes rates, as well as increased severity and frequency of diabetic ketoacidosis following COVID-19 infection. Conversely, patients with diabetes and obesity may experience a more severe course of COVID-19 infection. However, in the majority of cases, children and adolescents with well-managed and regulated endocrine disorders do not appear to be at increased risk of infection or severe infection from COVID-19. Thus, adhering to the appropriate "sick day management rules", maintaining adequate supply of medications and supplies, keeping close contact with the therapeutic team and seeking medical help without delay when needed, are the main recommendations for a safe outcome. Additional lessons learnt during the pandemic include the risk for mental health diseases caused by children's disrupted routine due to COVID-19 related protective measures and the importance of adopting alternative communication options, such as telehealth visits, in order to ensure uninterrupted endocrine care.
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Affiliation(s)
- Eirini Kostopoulou
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Patras School of Medicine, Patras, Greece
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33
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Tao LC, Shu H, Wang Y, Hou Q, Li JJ, Huang XL, Hua F. Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19. Front Endocrinol (Lausanne) 2024; 15:1287795. [PMID: 38455656 PMCID: PMC10919215 DOI: 10.3389/fendo.2024.1287795] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Inflammation is a predictor of severe complications in patients with COVID-19 infection under a variety of clinical settings. A few studies suggested that COVID-19 infection was a trigger of hyperglycemic crises including diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS). However, the association between inflammation and hyperglycemic crises in diabetic patients with COVID-19 infection is unclear. METHODS One hundred and twenty-four patients with type 2 diabetes mellitus (T2DM) and COVID-19 infection from January 2023 to March 2023 were retrospectively analyzed. Demographic, clinical, and laboratory data, especially inflammatory markers including white blood cell (WBC), neutrophils, neutrophil-to-lymphocyte ratio (NLR), c-reactive protein (CRP) and procalcitonin (PCT) were collected and compared between patients with or without DKA and/or HHS. Multivariable logistic regression analysis was conducted to explore the association between inflammatory biomarkers and the prevalence of hyperglycemic crises. Patients were followed up 6 months for outcomes. RESULTS Among 124 diabetic patients with COVID-19, 9 were diagnosed with DKA or HHS. Comparing COVID-19 without acute diabetic complications (ADC), patients with DKA or HHS showed elevated levels of c-reactive protein (CRP, P=0.0312) and procalcitonin (PCT, P=0.0270). The power of CRP and PCT to discriminate DKA or HHS with the area under the receiver operating characteristics curve (AUROC) were 0.723 and 0.794, respectively. Multivariate logistic regression indicated 1.95-fold and 1.97-fold increased risk of DKA or HHS with 1-unit increment of CRP and PCT, respectively. However, neither CRP nor PCT could predict poor outcomes in diabetic patients with COVID-19. CONCLUSION In this small sample size study, we firstly found that elevated serum CRP and PCT levels increased the risk of hyperglycemic crises in T2DM patients with COVID-19 infection. More study is needed to confirm our findings.
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Affiliation(s)
- Li-Chan Tao
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Hong Shu
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ying Wang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Qian Hou
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jian-Jun Li
- State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Lin Huang
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fei Hua
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, China
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Naik N, Patel M, Sen R. Developmental Impacts of Epigenetics and Metabolism in COVID-19. J Dev Biol 2024; 12:9. [PMID: 38390960 PMCID: PMC10885083 DOI: 10.3390/jdb12010009] [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: 12/31/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Developmental biology is intricately regulated by epigenetics and metabolism but the mechanisms are not completely understood. The situation becomes even more complicated during diseases where all three phenomena are dysregulated. A salient example is COVID-19, where the death toll exceeded 6.96 million in 4 years, while the virus continues to mutate into different variants and infect people. Early evidence during the pandemic showed that the host's immune and inflammatory responses to COVID-19 (like the cytokine storm) impacted the host's metabolism, causing damage to the host's organs and overall physiology. The involvement of angiotensin-converting enzyme 2 (ACE2), the pivotal host receptor for the SARS-CoV-2 virus, was identified and linked to epigenetic abnormalities along with other contributing factors. Recently, studies have revealed stronger connections between epigenetics and metabolism in COVID-19 that impact development and accelerate aging. Patients manifest systemic toxicity, immune dysfunction and multi-organ failure. Single-cell multiomics and other state-of-the-art high-throughput studies are only just beginning to demonstrate the extent of dysregulation and damage. As epigenetics and metabolism directly impact development, there is a crucial need for research implementing cutting-edge technology, next-generation sequencing, bioinformatics analysis, the identification of biomarkers and clinical trials to help with prevention and therapeutic interventions against similar threats in the future.
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Affiliation(s)
- Noopur Naik
- Department of Molecular, Cellular & Developmental Biology, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Mansi Patel
- Institute of Genomics and Integrative Biology, Delhi 110007, India
| | - Rwik Sen
- Active Motif, Inc., Carlsbad, CA 92008, USA
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35
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Bendetson JG, Baffoe-Bonnie AW. Type 2 Diabetes Status, Diabetes Complication Severity Index Scores, and Their Relationship With COVID-19 Severity: A Retrospective Cohort Study of Hospitalized Patients in a Southwest Virginia Health System. Cureus 2024; 16:e53524. [PMID: 38445145 PMCID: PMC10912820 DOI: 10.7759/cureus.53524] [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] [Accepted: 01/28/2024] [Indexed: 03/07/2024] Open
Abstract
Background Studies have shown that patients with type 2 diabetes mellitus (T2DM) tend to have poorer outcomes associated with COVID-19, including increased rates of hospitalization, ICU admission, need for ventilatory support, and mortality. Methods We performed a retrospective cohort study that included all non-pregnant adult patients who were hospitalized as a result of COVID-19 in a Southwest Virginia health system between March 18, 2020, and August 31, 2022. T2DM status was treated as a binary variable. T2DM severity was assessed using the Diabetes Complications Severity Index (DCSI). Multivariate logistic regression was used to assess the relationship between T2DM status and COVID-19 severity outcomes. Multivariate logistic regression was also used to assess the relationship between DCSI score and COVID-19 severity outcomes among patients with an established diagnosis of T2DM at the time of COVID-19 hospital admission. Results Patients with T2DM had 1.27 times the odds of experiencing a poor COVID-19 clinical outcome (95% CI: 1.13, 1.43) and 1.35 times the odds of in-hospital mortality (95% CI: 1.14, 1.59) compared to patients without diabetes. Among patients with T2DM, increasing DCSI score was significantly associated with increased odds of experiencing a poor COVID-19 clinical outcome and in-hospital mortality. Conclusions Diabetic patients in our sample were at increased odds of experiencing poor COVID-19 clinical outcomes and in-hospital mortality compared to individuals without diabetes. Amongst patients with T2DM, increasing DCSI score was associated with worse COVID-19 outcomes. Clinical decision support tools may be able to utilize DCSI scores as an indicator of COVID-19 severity risk to facilitate decisions regarding treatment aggressiveness and resource allocation.
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Affiliation(s)
- Jesse G Bendetson
- Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA
| | - Anthony W Baffoe-Bonnie
- Section of Infectious Diseases, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA
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36
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Heshmati HM. Interactions between COVID-19 infection and diabetes. Front Endocrinol (Lausanne) 2024; 14:1306290. [PMID: 38292772 PMCID: PMC10826510 DOI: 10.3389/fendo.2023.1306290] [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: 10/03/2023] [Accepted: 11/13/2023] [Indexed: 02/01/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused a major pandemic affecting human health and economy around the world since the beginning of 2020. The virus responsible for the disease is "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). It invades the target cells by binding to angiotensin-converting enzyme 2 (ACE2). ACE2 is expressed in several organs including endocrine glands. Multiple endocrine and metabolic systems including the endocrine pancreas have been impacted by COVID-19 infection/pandemic. COVID-19 pandemic can promote obesity through alterations in lifestyle (e.g., unhealthy diet and reduced physical activity due to confinement and isolation) leading to type 2 diabetes and/or can directly impair the function of the endocrine pancreas particularly through a cytokine storm, promoting or aggravating type 1 or type 2 diabetes. The increased ACE2 receptors of high adiposity commonly associated with type 2 diabetes and the chronic hyperglycemia of diabetes with its negative impact on the immune system can increase the risk of COVID-19 infection and its morbidity/mortality. In conclusion, there are bidirectional interactions between COVID-19 pandemic and diabetes (e.g., COVID-19 infection can impact diabetes and diabetes can impact COVID-19 infection). The services offered by healthcare systems for the management of diabetes have been adapted accordingly.
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Affiliation(s)
- Hassan M. Heshmati
- Endocrinology Metabolism Consulting, LLC, Hassan Heshmati and Valerie Shaw Endocrine Research, Anthem, AZ, United States
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37
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Espiritu AI, Pilapil JCA, Aherrera JAM, Sy MCC, Anlacan VMM, Villanueva EQI, Jamora RDG. Outcomes of patients with COVID-19 and coronary artery disease and heart failure: findings from the Philippine CORONA study. BMC Res Notes 2024; 17:14. [PMID: 38178236 PMCID: PMC10768280 DOI: 10.1186/s13104-023-06677-5] [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: 10/01/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Patients with coronavirus disease 2019 (COVID-19) and coronary artery disease (CAD) or heart failure (HF) are more likely to have poor outcomes. This study aimed to determine the characteristics and outcomes of COVID-19 patients with CAD/HF across various institutions in the Philippines. METHODS We utilized the data from the Philippine CORONA Study and compared the outcomes of admitted COVID-19 patients with CAD/HF versus those without. The Student's t test, Mann-Whitney U test, binary logistic regression and multivariate regression analysis were utilized. Odds ratios (OR) and Kaplan-Meier curves were generated. RESULTS We included a total of 512 patients with COVID-19 had CAD/HF and 10,369 were without. CAD/HF was significantly associated with COVID severity, all-cause mortality, death from cardiac causes, respiratory failure, and prolonged hospitalization. After adjusting for confounders, the presence of CAD/HF was still associated with death from a cardiac cause (OR 2.22, 95% CI 1.49-3.3, p < 0.01). CONCLUSIONS The presence of CAD or HF was significantly associated with severity of COVID disease, all-cause mortality, death from cardiac causes, respiratory failure, and prolonged hospitalization.
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Affiliation(s)
- Adrian I Espiritu
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - John Christopher A Pilapil
- Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jaime Alfonso M Aherrera
- Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Marie Charmaine C Sy
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Veeda Michelle M Anlacan
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Emilio Q Iii Villanueva
- Department of Pathology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Roland Dominic G Jamora
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
- Institute for Neurosciences, St. Luke's Medical Center, Global City, Philippines.
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Engin AB, Engin ED, Engin A. Macrophage Activation Syndrome in Coinciding Pandemics of Obesity and COVID-19: Worse than Bad. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1460:919-954. [PMID: 39287877 DOI: 10.1007/978-3-031-63657-8_31] [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: 09/19/2024]
Abstract
Epigenetic changes have long-lasting impacts, which influence the epigenome and are maintained during cell division. Thus, human genome changes have required a very long timescale to become a major contributor to the current obesity pandemic. Whereas bidirectional effects of coronavirus disease 2019 (COVID-19) and obesity pandemics have given the opportunity to explore, how the viral microribonucleic acids (miRNAs) use the human's transcriptional machinery that regulate gene expression at a posttranscriptional level. Obesity and its related comorbidity, type 2 diabetes (T2D), and new-onset diabetes due to severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) are additional risk factors, which increase the severity of COVID-19 and its related mortality. The higher mortality rate of these patients is dependent on severe cytokine storm, which is the sum of the additional cytokine production by concomitant comorbidities and own cytokine synthesis of COVID-19. Patients with obesity facilitate the SARS-CoV-2 entry to host cell via increasing the host's cell receptor expression and modifying the host cell proteases. After entering the host cells, the SARS-CoV-2 genome directly functions as a messenger ribonucleic acid (mRNA) and encodes a set of nonstructural proteins via processing by the own proteases, main protease (Mpro), and papain-like protease (PLpro) to initiate viral genome replication and transcription. Following viral invasion, SARS-CoV-2 infection reduces insulin secretion via either inducing β-cell apoptosis or reducing intensity of angiotensin-converting enzyme 2 (ACE2) receptors and leads to new-onset diabetes. Since both T2D and severity of COVID-19 are associated with the increased serum levels of pro-inflammatory cytokines, high glucose levels in T2D aggravate SARS-CoV-2 infection. Elevated neopterin (NPT) value due to persistent interferon gamma (IFN-γ)-mediated monocyte-macrophage activation is an indicator of hyperactivated pro-inflammatory phenotype M1 macrophages. Thus, NPT could be a reliable biomarker for the simultaneously occurring COVID-19-, obesity- and T2D-induced cytokine storm. While host miRNAs attack viral RNAs, viral miRNAs target host transcripts. Eventually, the expression rate and type of miRNAs also are different in COVID-19 patients with different viral loads. It is concluded that specific miRNA signatures in macrophage activation phase may provide an opportunity to become aware of the severity of COVID-19 in patients with obesity and obesity-related T2D.
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Affiliation(s)
- Ayse Basak Engin
- Faculty of Pharmacy, Department of Toxicology, Gazi University, Hipodrom, Ankara, Turkey
| | - Evren Doruk Engin
- Biotechnology Institute, Ankara University, Gumusdere Campus, Gumusdere, Ankara, Turkey
| | - Atilla Engin
- Faculty of Medicine, Department of General Surgery, Gazi University, Besevler, Ankara, Turkey
- Mustafa Kemal Mah. 2137. Sok. 8/14, 06520, Cankaya, Ankara, Turkey
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Gasmi A, Noor S, Menzel A, Khanyk N, Semenova Y, Lysiuk R, Beley N, Bolibrukh L, Gasmi Benahmed A, Storchylo O, Bjørklund G. Potential Drugs in COVID-19 Management. Curr Med Chem 2024; 31:3245-3264. [PMID: 37461346 DOI: 10.2174/0929867331666230717154101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/27/2023] [Accepted: 06/05/2023] [Indexed: 11/18/2023]
Abstract
The SARS-CoV-2 virus first emerged in China in December 2019 and quickly spread worldwide. Despite the absence of a vaccination or authorized drug specifically developed to combat this infection, certain medications recommended for other diseases have shown potential effectiveness in treating COVID-19, although without definitive confirmation. This review aims to evaluate the existing literature on the efficacy of these medications against COVID-19. The review encompasses various potential treatments, including antiviral medications, anti-malaria and anti-rheumatic drugs, vaccines, corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), antipyretic and analgesic medicines, antiparasitic drugs, and statins. The analysis also addresses the potential benefits and drawbacks of these medications, as well as their effects on hypertension and diabetes. Although these therapies hold promise against COVID-19, further research, including suitable product production or clinical testing, is needed to establish their therapeutic efficacy.
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Affiliation(s)
- Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Sadaf Noor
- Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Nataliia Khanyk
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
- CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Yuliya Semenova
- Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Roman Lysiuk
- Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
- CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Nataliya Beley
- I. Ya. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | | | | | - Olha Storchylo
- Medical Chemistry Department, Odessa National Medical University, Odesa, Ukraine
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
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Purvis RS, Moore R, Rojo MO, Riklon S, Alik E, Alik D, Maddison BK, McElfish PA. COVID-19 vaccine hesitancy among Marshallese in Northwest Arkansas (USA). J Public Health Res 2024; 13:22799036241231549. [PMID: 38440055 PMCID: PMC10910884 DOI: 10.1177/22799036241231549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
Background COVID-19 has disproportionately affected Pacific Islander communities, with disparities in the prevalence of infection, serious illness, and death compared to non-Hispanic whites in the US. Marshallese Pacific Islanders face significant COVID-19 disparities. Design and methods This exploratory study aimed to understand Marshallese community attitudes about the COVID-19 vaccine to identify and implement culturally relevant strategies to encourage vaccine uptake. Data were collected from 17 participants in three focus groups. Results Using content analysis, researchers identified two global themes: (1) barriers to vaccination and (2) facilitators of COVID-19 vaccine uptake. Within these themes, participants described fear, lack of knowledge about vaccines, negative perceptions of the COVID-19 vaccine, health concerns, and transportation as barriers to vaccination. Participants described several factors influencing vaccine behavior, including location of and personnel at vaccine clinics, vaccine experiences, the need for trusted information, positive perceptions, cultural leaders, and mandates. Conclusions The qualitative study makes a significant contribution as the first to report community perceptions and experiences related to the COVID-19 vaccine in Marshallese participants' own words. Findings show that cultural influencers and brokers are crucial bridges for public health messaging related to COVID-19 vaccination targeted to this vulnerable and underserved population. Culturally appropriate and effective public health messaging can help achieve vaccine equity and improve COVID-19-related health disparities in the Marshallese community.
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Affiliation(s)
- Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Martha O Rojo
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Eldon Alik
- Republic of the Marshall Islands Consulate, Springdale, AR, USA
| | - Derek Alik
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | | | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
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Shousha HI, Ayman H, Hashem MB. Climate Changes and COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:217-231. [PMID: 39102199 DOI: 10.1007/978-3-031-61943-4_14] [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: 08/06/2024]
Abstract
Climatic change, which influences population growth and land usage, has been theorized to be linked to the emergence and spread of new viruses like the currently unfolding COVID-19 pandemic. In this chapter, we explain how climate change may have altered the beginning, transmission, and maybe even the sickness consequences of the COVID-19 pandemic. Where possible, we also provide mechanistic explanations for how this may have occurred. We have presented evidence that suggests climate change may have had a role in the establishment and transmission of SARS-CoV-2 infection, and most possibly even in some of its clinical effects. Human activities bringing people into closer contact with bats and animals like pangolins that potentially represent the intermediate hosts, and evidence that climate-induced changes in vegetation are the main reservoir source of coronaviruses for human infection, are among the explanations. Although there are still unsubstantiated indications that the first viral pathogen may have escaped from a laboratory, it is possible that this encounter took place in the field or in marketplaces in the instance of COVID-19. We also present the argument that climate change is working to enhance transmission between diseased and uninfected humans, and this is true regardless of the source of the original development of the disease. Changes in temperature and humidity make it easier for viruses to survive, and the impacts of industrial pollution induce people to cough and sneeze, which releases highly infectious aerosols into the air. These three factors combine to make this a more likely scenario than it would otherwise be. We suggest that changes in climate are contributing to create conditions that are favorable for the development of more severe symptoms of illness. It is more difficult to build the argument for this circumstance, and much of it is indirect. However, climate change has caused some communities to adjust their nutritional habits, both in terms of the quantity of food they eat and the quality of the foods they consume. The effects frequently become apparent as a result of alterations that are imposed on the microbiome of the gut, which, in turn, influence the types of immune responses that are produced. The incidence of comorbidities like diabetes and animal vectors like bats that transmit other illnesses that modify vulnerability to SARS-CoV-2 are also two examples of the factors that have been affected by climate change. In order to curb the development of infectious illnesses caused by new viruses, it is necessary to understand the connection between environmental dynamics and the emergence of new coronaviruses. This knowledge should lead to initiatives aimed at reducing global greenhouse gas emissions.
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Affiliation(s)
- Hend Ibrahim Shousha
- Faculty of Medicine, Endemic Medicine and Hepatogastroenterology, Cairo University, Giza, Egypt.
| | - Hedy Ayman
- Faculty of Medicine, Endemic Medicine and Hepatogastroenterology, Cairo University, Giza, Egypt
| | - Mohamed B Hashem
- Faculty of Medicine, Endemic Medicine and Hepatogastroenterology, Cairo University, Giza, Egypt
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Qu D, Liu J, Zhou L, Yang Y, Wu C, Xu X, Zhu Q, Wang C, Zhao X. Association of serum amyloid A and prognosis in people with diabetes and COVID-19: A retrospective cohort study. J Diabetes Investig 2024; 15:44-51. [PMID: 38031656 PMCID: PMC10759722 DOI: 10.1111/jdi.14118] [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: 11/02/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
AIMS/INTRODUCTION Serum amyloid A (SAA) is an acute phase reactive protein that plays a vital role in the early diagnosis, risk prediction, efficacy observation and prognosis evaluation of infectious diseases. This study aimed to assess the association between SAA levels and the prognosis of patients with coronavirus disease 2019 (COVID-19) and diabetes. MATERIALS AND METHODS We carried out this retrospective cohort study from March 2022 to May 2022. The population was stratified by tertiles of SAA levels: low (<8.5 mg/L), medium (8.5-36 mg/L) and high (>36 mg/L). The primary outcome was whether the patient developed severe COVID-19, and secondary outcomes included the need for invasive mechanical ventilation and length of hospital stay. Logistic regression analyses were carried out to identify risk factors affecting the prognosis of patients with COVID-19 and diabetes. RESULTS We analyzed 910 diabetes patients with COVID-19. The median age of the patients was 69 years, and 52.3% were men. As SAA levels increased, the proportion of severe COVID-19 (6.3% vs 7.3% vs 22.8%, P < 0.001) and the proportion of invasive mechanical ventilation also increased among the three groups. Patients with high SAA levels had a longer length of hospital stay compared with patients with medium SAA and low SAA levels. Univariate logistic regression analysis showed that SAA >36 mg/L further increased the odds ratio to 4.423 (P < 0.001) for the development of severe COVID-19 compared with low SAA. Multivariate logistic regression analysis, adjusted for age and sex, confirmed that SAA >36 mg/L remained an independent risk factor for the development of severe COVID-19 (adjusted odds ratio 3.038, P < 0.001). CONCLUSIONS SAA levels are strongly associated with poor prognosis in patients with COVID-19 and diabetes.
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Affiliation(s)
- Duoduo Qu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Jia Liu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Lihua Zhou
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Yaling Yang
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Chenwei Wu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Xinyue Xu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Qin Zhu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Chunhong Wang
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Xiaolong Zhao
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
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Yassin Z, Farid A, Ahmadi S, Emamikhah M, Motamedi O, Jafari M, Goodarzi A. Coronavirus disease 2019 (COVID-19)-associated brain abscesses caused by Pseudomonas aeruginosa and Aspergillus fumigatus: two case and a review of the literature. J Med Case Rep 2023; 17:520. [PMID: 38049820 PMCID: PMC10694943 DOI: 10.1186/s13256-023-04206-3] [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: 05/25/2022] [Accepted: 10/09/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Bacterial and fungal superinfections are commonly reported in patients with coronavirus disease 2019. CASE PRESENTATION We report the first case of brain and intramedullary abscesses caused by Pseudomonas aeruginosa and a rare case of brain abscesses caused by Aspergillus fumigatus in two post-coronavirus disease 2019 patients. The first patient-34-year-old Iranian woman-presented with weakness of the left upper limb, headaches, and lower limb paresthesia. She had a history of undiagnosed diabetes and had received corticosteroid therapy. The second patient-45-year-old Iranian man-presented with right-sided weakness and had a history of intensive care unit admission. Both patients passed away despite appropriate medical therapy. CONCLUSION The immune dysregulation induced by coronavirus disease 2019 and its' treatments can predispose patients, especially immunosuppressed ones, to bacterial and fungal infections with unusual and opportunistic pathogens in the central nervous system. Pseudomonas aeruginosa and Aspergillus fumigatus should be considered as potential causes of brain infection in any coronavirus disease 2019 patient presenting with neurological symptoms and evidence of brain abscess in imaging, regardless of sinonasal involvement. These patients should get started on appropriate antimicrobial therapy as soon as possible, as any delay in diagnosis or treatment can be associated with adverse outcomes.
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Affiliation(s)
- Zeynab Yassin
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Farid
- School of Medicine, Iran University of Medical Sciences, Bisotun Street, 6.1 Alley, No 56, Tehran, 1431644311, Iran
| | - Sayedali Ahmadi
- Department of Neurosurgery, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Ave, Tehran, 1431644311, Iran
| | - Maziar Emamikhah
- Department of Neurosurgery, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Ave, Tehran, 1431644311, Iran
| | - Omid Motamedi
- Department of Radiology, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, 1445613131, Iran
| | - Mohammadamin Jafari
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, 1445613131, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, 1445613131, Iran.
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Sunarwidhi AL, Rahmaniar W, Prasedya ES, Padmi H, Widyastuti S, Pangestu KWJ, Ilhami BTK, Handayani E, Utami NWP, Maulana FA, Ichfa MSM, Hernawan A. In Vitro Anti-Oxidant, In Vivo Anti-Hyperglycemic, and Untargeted Metabolomics-Aided-In Silico Screening of Macroalgae Lipophilic Extracts for Anti-Diabetes Mellitus and Anti-COVID-19 Potential Metabolites. Metabolites 2023; 13:1177. [PMID: 38132859 PMCID: PMC10745437 DOI: 10.3390/metabo13121177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
COVID-19 patients with comorbid DM face more severe outcomes, indicating that hyperglycemic conditions exacerbate SARS-CoV-2 infection. Negative side effects from existing hyperglycemia treatments have urged the need for safer compounds. Therefore, sourcing potential compounds from marine resources becomes a new potential approach. Algal lipids are known to possess beneficial activities for human health. However, due to limitations in analyzing large amounts of potential anti-hyperglycemic and anti-COVID-19-related marine metabolites, there is an increasing need for new approaches to reduce risks and costs. Therefore, the main aim of this study was to identify potential compounds in macroalgae Sargassum cristaefolium, Tricleocarpa cylindrica, and Ulva lactuca lipophilic extracts for treating DM and COVID-19 by an integrated approach utilizing in vitro anti-oxidant, in vivo anti-hyperglycemic, and metabolomic-integrated in silico approaches. Among them, S. cristaefolium and T. cylindrica showed potential anti-hyperglycemic activity, with S. cristaefolium showing the highest anti-oxidant activity. A GC-MS-based untargeted metabolomic analysis was used to profile the lipophilic compounds in the extracts followed by an in silico molecular docking analysis to examine the binding affinity of the compounds to anti-DM and anti-COVID-19 targets, e.g., α-amylase, α-glucosidase, ACE2, and TMPRSS2. Notably, this study reveals for the first time that steroid-derived compounds in the macroalgae T. cylindrica had higher binding activity than known ligands for all the targets mentioned. Studies on drug likeliness indicate that these compounds possess favorable drug properties. These findings suggest the potential for these compounds to be further developed to treat COVID-19 patients with comorbid DM. The information in this study would be a basis for further in vitro and in vivo analysis. It would also be useful for the development of these candidate compounds into drug formulations.
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Affiliation(s)
- Anggit Listyacahyani Sunarwidhi
- Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram 83115, Indonesia
- Bioscience and Biotechnology Research Centre, University of Mataram, Mataram 83115, Indonesia
| | - Wahyu Rahmaniar
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 226-8503, Japan
| | - Eka Sunarwidhi Prasedya
- Bioscience and Biotechnology Research Centre, University of Mataram, Mataram 83115, Indonesia
- Department of Biology, Faculty of Mathematics and Natural Sciences, University of Mataram, Mataram 83115, Indonesia
| | - Hasriaton Padmi
- Bioscience and Biotechnology Research Centre, University of Mataram, Mataram 83115, Indonesia
| | - Sri Widyastuti
- Faculty of Food Technology and Agroindustry, University of Mataram, Mataram 83115, Indonesia
| | | | - Bq Tri Khairina Ilhami
- Bioscience and Biotechnology Research Centre, University of Mataram, Mataram 83115, Indonesia
| | - Ervina Handayani
- Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram 83115, Indonesia
| | - Ni Wayan Putri Utami
- Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram 83115, Indonesia
| | - Farreh Alan Maulana
- Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram 83115, Indonesia
| | | | - Ari Hernawan
- Department of Informatics Engineering, Faculty of Engineering, University of Mataram, Mataram 83115, Indonesia
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Turdybekova YG, Kopobayeva IL, Kamyshanskiy YK, Turmukhambetova AA. Comparative clinical and placental pathologic characteristics in pregnancies with and without SARS-CoV-2 infection. J Perinat Med 2023; 51:1179-1188. [PMID: 37475693 DOI: 10.1515/jpm-2022-0371] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 06/11/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES To compare the clinical and morphological characteristics of the "mother-placenta-fetus" system in high risk pregnant women of three groups: no SARS-CoV-2 infection, mild SARS-CoV-2 infection, and severe SARS-CoV-2 infection. METHODS A case-control study was performed for all deliveries, at 28 weeks' gestation or greater, who had standard indications for placental pathologic examination. Three groups were formed: (1) control group (no SARS-CoV-2 infection), (2) mild SARS-CoV-2 infection, (3) severe SARS-CoV-2 infection. High-risk pregnancies were registered in all cases in the study groups. The examination of the placenta and the selection of fragments of placental tissue were carried out in accordance with the consensus recommendations of the Amsterdam Placental Workshop Group. The sections were subjected to standard processing and stained with hematoxylin and eosin according to the standard protocol. All cases were reviewed by two pathologists, which did not know any information on pregnancy outcome and clinical data. Statistical analysis was performed using SPSS, p<0.05 was considered statistically significant. RESULTS Women with severe SARS-CoV-2 infection had an increased rate of multimorbidity including diabetes, chronic hypertension and obesity (p<0.01) compared with the other groups. Placentas at severe COVID-19 course were damaged by both chronic and acute injuries, in comparison to the mild and control groups (p<0.001). Also an important finding in severe COVID-19 was diffuse necrosis of the villous trophoblast - homogenization, diffuse circular eosinophilic masses surrounding the chorionic villi. CONCLUSIONS Women with multimorbidity are an "at-risk" subgroup for severe SARS-CoV-2 infection and greater likelihood of both placental damage and perinatal hypoxic-ischemic events. These results suggest that patient education, SARS-CoV-2 disease monitoring and preventive measures would be of benefit to this group.
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Gomaa AF, Elghmary RM, Sharafeddin MA, Mohamed SY, Elsayed AF. COVID-19 Infection and Diabetes. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023; 31:1-6. [DOI: 10.1097/ipc.0000000000001295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2025]
Abstract
Abstract
Background
Hyperglycemia is one of the most important independent risk factors that affect the prognosis and outcome of COVID-19 patients. Coronavirus disease 2019 infection is associated with poor glycemic control. This study's objectives were to determine the effect of hyperglycemia on the prognosis and outcome of COVID-19 patients and to detect whether COVID-19 infection can induce new-onset diabetes.
Patients and Methods
This cohort study was carried out on 240 hospitalized Egyptian COVID-19 patients, at Zagazig University Hospital isolation intensive care unit, between March 2020 and March 2021. They compared patients with diabetes and uncontrolled hyperglycemia against each other and COVID-19 patients without diabetes or uncontrolled hyperglycemia. Baseline demographic data, clinical features, and laboratory analysis were collected. Clinical outcome was evaluated via hospital stay and survival rate. Patients with uncontrolled hyperglycemia and nondiabetic patients were followed up 1 year after the hospital discharge to detect the development of new-onset diabetes.
Result
The diabetic group had the highest creatinine level, and the nondiabetic group had a minor C-reactive protein and D-dimer. The difference is significant between diabetic and nondiabetic groups concerning hospital stay. The nondiabetic group had the shortest hospital stay. There is a statistically substantial relationship between mortality and the glycosylated hemoglobin, serum creatinine, C-reactive protein, D-dimer, and serum ferritin. A total of 46.6% of survivors in the uncontrolled hyperglycemic group and 3.4% in the nondiabetic group developed diabetes mellitus during follow-up. There is a statistically significant relationship between new-onset diabetes mellitus and D-dimer.
Conclusions
Coronavirus disease 2019 can induce diabetes mellitus in vulnerable patients (presented with uncontrolled hyperglycemia at admission). In addition, COVID-19 patients with diabetes or uncontrolled hyperglycemia have worse outcomes and poor prognoses.
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Affiliation(s)
| | - Reda M. Elghmary
- Pulmonology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Piarulli F, Carollo M, Ragazzi E, Benacchio L, Piovanello F, Simoncello I, Lapolla A. Association of COVID-19 outcomes with diabetes in the Veneto region (north-east italy): Epidemiological insights for the endemic phase? Nutr Metab Cardiovasc Dis 2023; 33:2141-2150. [PMID: 37543520 PMCID: PMC10290544 DOI: 10.1016/j.numecd.2023.06.016] [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: 03/09/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND AND AIMS Diabetes mellitus is a prevalent chronic disease in patients who die of COVID-19. The aim of this study was to investigate the clinical and metabolic characteristics of diabetic patients with COVID-19 during the pre-vaccination phase. METHODS AND RESULTS A retrospective cohort study was conducted from February 2020 to February 2021 to examine the clinical and metabolic profiles of unvaccinated diabetic patients affected by COVID-19. Data were collected from claim databases, hospital discharge records, and clinical records within a healthcare district located in northeastern Italy with a population of 936,000. Potential prognostic indicators including sex, age, Body Mass Index (BMI), duration and type of diabetes, metabolic control, and the use of antidiabetic, antihypertensive, lipid-lowering, and antiplatelet therapies were investigated. For hospitalized patients, additional variables were recorded, such as length of hospital stay, blood pressure at admission, comorbidities, D-dimer levels, blood glucose (BG), in-hospital insulin and corticosteroid therapies, requirement for mechanical ventilation (i.e., orotracheal or tracheostomy), admission to the Intensive Care Unit (ICU), and mortality. Diabetic patients hospitalized for COVID-19 with a poorer prognosis were characterized by advanced age, longer diabetes duration, hypertension, higher usage of sulfonylureas, and lower usage of dietotherapy alone, metformin, Glucagon-Like Peptide-1 Receptor agonists (GLP1-Ra), and Renin-Angiotensin-Aldosterone System inhibitors (RAAS-i). CONCLUSION Considering the potential for COVID-19 to become endemic, special care should be taken in managing older diabetic patients' treatments.
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Affiliation(s)
| | - Massimo Carollo
- Department of Medicine, University of Padova, 35128, Padova, Italy.
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences (DSF), University of Padova School of Medicine and Surgery, 35131, Padova, Italy.
| | | | | | - Ivana Simoncello
- Public Health Department, Padua Local Health Unit, Padua, Italy.
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de Souza E, Meneses-Santos D, Santos JC, Aidar FJ, Carvalho CRDO, dos Santos JL, Marçal AC. "Does Physical Exercise Promote Health Benefits for Diabetic Patients during the COVID-19 Pandemic?": A Systematic Review. Sports (Basel) 2023; 11:192. [PMID: 37888519 PMCID: PMC10610946 DOI: 10.3390/sports11100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/28/2023] Open
Abstract
Patients affected by COVID-19 are prone to facing disorders in multiple systems and organs, which can lead to deleterious diseases; in addition, people with pre-existing diseases may be more prone to the worst outcomes, and the most vulnerable are patients with type 1 and type 2 diabetes mellitus. The aim of this systematic review was to evaluate the effects of physical activity and/or physical exercise prescribed to individuals with diabetes on the maintenance of plasma glucose and glycated hemoglobin during the COVID-19 pandemic. Studies were found by searching PubMed, SCOPUS, Embase, Web of Science, SciELO, LILACS, SportDiscus, Bireme/BVS and Google Scholar databases. The inclusion criteria were articles that addressed only patients with type 1 or type 2 diabetes (T1D and T2D) who had evaluated the level of physical activity or physical exercise and described the effects on plasma glucose and/or glycated hemoglobin in cross-sectional, retrospective, and observational studies, meeting the main criteria established by GRADE. The PICO and GRADE strategies were used to select and assess the methodological quality of studies. Two reviewers searched and selected the articles in databases independently and blindly, during which oppositions and disagreements about the inclusion of articles were discussed and resolved by a third reviewer. Evidence corroborates that levels of physical activity were reduced due to the lockdown, leading to increased body weight and worse glycemic control. On the other hand, individuals with diabetes mellitus (DM) (T1D and T2D) who maintained and/or increased levels of physical activity or physical exercise showed reduced plasma glucose and glycated hemoglobin (HbA1c) levels. Adequate levels of physical exercise and physical activity are beneficial for glucose and HbA1c control in diabetic patients (type 1 or type 2). In addition, maintaining adequate levels of physical activity can contribute to reducing health problems when these patients are infected with COVID-19.
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Affiliation(s)
- Erivaldo de Souza
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Daniela Meneses-Santos
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil;
| | - Josué Cruz Santos
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Felipe J. Aidar
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil
| | | | - Jymmys Lopes dos Santos
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Anderson Carlos Marçal
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil;
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Kyprianidou M, Konstantinou P, Alvarez-Galvez J, Ceccarelli L, Gruszczyńska E, Mierzejewska-Floreani D, Loumba N, Montagni I, Tavoschi L, Karekla M, Kassianos AP. Profiling Hesitancy to COVID-19 Vaccinations in Six European Countries: Behavioral, Attitudinal and Demographic Determinants. Behav Med 2023; 49:362-373. [PMID: 35546258 DOI: 10.1080/08964289.2022.2071198] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/06/2022] [Accepted: 04/22/2022] [Indexed: 11/02/2022]
Abstract
Vaccination hesitancy is an important barrier for the effective control of the COVID-19 pandemic. Identifying determinants of COVID-19 vaccination hesitancy is essential in order to reduce mortality rates. Further, given the variability of the factors and the different recommendations used in each country, it is important to conduct cross-country research to profile individuals who are hesitant toward COVID-19 vaccinations. This cross-sectional study aimed to examine cross-country differences and the behavioral, attitudinal and demographic characteristics of vaccine hesitant individuals. Adults living in six European countries (Cyprus, France, Germany, Italy, Poland, and Spain) were eligible to participate. A total of 832 individuals completed the online survey, with 17.9% reporting being hesitant to COVID-19 vaccination. Vaccine accepters were significantly older (M = 38.9, SD = 14.3), more educated (master/postgraduate studies) and lived in a place with a higher number of residents (>500,000 people) compared to those hesitant to COVID-19 vaccination. Discriminant analysis confirmed that the hesitant profile includes a person of younger age, living alone in smaller communities, and without children. Additionally, hesitant participants reported COVID-19-specific characteristics such as lower institutional trust, less adherence to COVID-19 protective behaviors and higher pandemic fatigue. When tackling COVID-19 vaccination hesitancy both socio-demographic and behavioral/attitudinal aspects should be taken into account. Stakeholders are advised to implement targeted vaccination programs while at the same time building trust with population illness cognitions addressed in order to reduce hesitancy rates. Further, stakeholders and public health authorities in each country are suggested to target interventions according to different population characteristics as behavioral and attitudinal determinants of COVID-19 vaccination hesitancy differed between countries.
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Affiliation(s)
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | - Luca Ceccarelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Ewa Gruszczyńska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | | | - Ilaria Montagni
- Bordeaux Population Health Research Center UMRS1219, University of Bordeaux - Inserm, Bordeaux, France
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Applied Health Research, UCL, London, UK
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Masuda S, Yamada T, Hanzawa N. Impact of prediabetes with a high risk of diabetes stratified by glycated hemoglobin level on the severity of coronavirus disease 2019 during admission. Diabetol Int 2023; 14:372-380. [PMID: 37781471 PMCID: PMC10533434 DOI: 10.1007/s13340-023-00643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/30/2023] [Indexed: 10/03/2023]
Abstract
Objective Prediabetes with a glycated hemoglobin (HbA1c) level of 5.7 - 6.4% is associated with a poor prognosis of coronavirus disease 2019 (COVID-19), but whether the degree of glycemic control is associated with COVID-19 severity is unknown. The aim of this study was to evaluate the association between the degree of glycemic control and COVID-19 severity in patients with prediabetes. Materials and methods We reviewed 254 patients with COVID-19 admitted to our hospital between April 2020 and September 2021. Based on their HbA1c level, patients were classified into low (HbA1c level < 5.7%), moderate (HbA1c level, 5.7 - 5.9%), and high risk of diabetes (HbA1c level, 6.0 - 6.4%). The association between risk of diabetes and the worst COVID-19 symptom in terms of severity during admission was evaluated using binary logistic regression analysis. Results Seventy-one and 88 patients had moderate and high risks of diabetes, respectively. Sixty-three and seven patients presented severe (requiring non-invasive oxygen therapy) or critical (intensive care unit admission or artificial respiratory management) COVID-19. The multivariate logistic regression analysis showed that a high risk of diabetes was correlated with severe COVID-19 (P = 0.01) after adjusting for baseline characteristics, whereas a moderate risk of diabetes was not (P = 0.17). Conclusion Prediabetes with a high risk of diabetes is associated with the worst COVID-19 symptom in terms of severity during admission. Our findings could aid in more efficient allocation of healthcare resources to a narrower population of prediabetic patients. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-023-00643-z.
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Affiliation(s)
- Seizaburo Masuda
- Department of Diabetes and Endocrinology, National Hospital Organization Disaster Medical Center of Japan, 3256, Midoricho, Tachikawa-shi, Tokyo 190-0014 Japan
| | - Tetsuya Yamada
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510 Japan
| | - Nozomi Hanzawa
- Department of Diabetes and Endocrinology, National Hospital Organization Disaster Medical Center of Japan, 3256, Midoricho, Tachikawa-shi, Tokyo 190-0014 Japan
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