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Morais TO, de Medeiros GCBS, de Medeiros KS, Mendes TGDM, Leite-Lais L, Lopes MMGD. Severity of COVID-19 in hospitalized pediatric patients with obesity: A systematic review. J Pediatr Gastroenterol Nutr 2025; 80:783-791. [PMID: 39945077 DOI: 10.1002/jpn3.70017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 01/21/2025] [Accepted: 01/21/2025] [Indexed: 05/13/2025]
Abstract
This review is intended to evaluate the severity of Coronavirus Disease 2019 (COVID-19) in hospitalized pediatric patients with obesity. The increased risk of hospitalization in pediatric patients with obesity highlights the need for a thorough investigation into the impact of COVID-19 in this vulnerable population, given the significant public health challenges obesity presents in this age group. The review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. A systematic search was conducted in the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), LILACS (scientific health information from Latin America and the Caribbean countries), Web of Science, Embase, and Scopus databases for relevant articles published between December 2019 and November 2021. Observational studies (cross-sectional and cohort) involving pediatric patients with obesity who tested positive for COVID-19, were hospitalized, and had outcomes related to disease severity parameters such as intensive care unit (ICU) admission, length of ICU stay, and mechanical ventilation) were included. The quality of evidence from the included studies was assessed using the Newcastle‒Ottawa Scale. Extracted data included the author, year, country, study design, aim, population, outcomes/severity, and primary results. Eight studies were included in the review. A narrative synthesis was conducted to qualitatively summarize the findings, highlighting that obesity is a potential aggravating factor in the clinical presentation of COVID-19 among hospitalized pediatric patients. The findings revealed a positive association between the pediatric population with obesity and COVID-19 severity, particularly among adolescents, who were at greater risk of developing severe illness. This association was also evident in higher rates of ICU admission and increased use of mechanical ventilation.
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Affiliation(s)
| | | | - Kleyton S de Medeiros
- Institute of Education, Research, and Innovation; League Against Cancer, Natal, Brazil
| | - Thayanne G de Medeiros Mendes
- Postgraduate Program in Sciences Applied to Women's Health, Center of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lucia Leite-Lais
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Márcia M G D Lopes
- Department of Nutrition and Postgraduate Program in Sciences Applied to Women's Health, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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Barbão KEG, Pavanello A, Oliveira FM, Santos NQ, Valdés-Badilla P, Marchiori LLM, Franchini E, Branco BHM. Variation in Body Composition Components Across Different Age Groups and Proposal of Age-Specific Normative Tables: A Cross-Sectional Study. Nutrients 2025; 17:1435. [PMID: 40362744 PMCID: PMC12073220 DOI: 10.3390/nu17091435] [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: 02/26/2025] [Revised: 04/16/2025] [Accepted: 04/23/2025] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Utilizing a significative sample, this study aimed to analyze body composition components in different age groups and to develop age-specific normative tables for individuals in southern Brazil. Methods: This observational, descriptive, and cross-sectional study evaluated 8556 individuals of both sexes (54% females) aged 18-49. The hypotheses of the present study are related to declining fat-free mass (FFM), lean mass (LM), and skeletal muscle mass (SMM) and increasing fat mass (FM) and body fat percentage (BFP) during the aging process. Data were collected through bioelectrical impedance analysis (BIA) and stratified by age (18-29, 30-39, and 40-49 years), sex, and body mass index (BMI) classifications (normal weight, overweight, grade I, and grade II obesity). Following the comparison, body composition components were presented in the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles. Results: This study's main findings indicated that FM and BFP increased with age in both sexes. Among overweight and obese individuals, elevated BFP was particularly high in obese females aged 40-49 years and in normal and overweight males. FFM, LM, and SMM were generally lower in the 40-49-year-old group, although obese females over 40 presented higher FFM and LM values. In contrast, males presented lower FFM and LM values but higher values among individuals with higher BMI. SMM was lower in overweight individuals over 40, likely reflecting muscle mass loss associated with aging. Conclusions: Based on these results, lifestyle interventions that combine nutrition and physical exercise may be recommended to mitigate these effects of aging.
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Affiliation(s)
- Kleber E. G. Barbão
- Graduate Program of Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (K.E.G.B.); (A.P.); (F.M.O.); (N.Q.S.); (L.L.M.M.)
- Clinisport Prime, Integrated Rehabilitation and Performance Center, Maringá 87060-350, Brazil
| | - Audrei Pavanello
- Graduate Program of Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (K.E.G.B.); (A.P.); (F.M.O.); (N.Q.S.); (L.L.M.M.)
| | - Fabiano M. Oliveira
- Graduate Program of Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (K.E.G.B.); (A.P.); (F.M.O.); (N.Q.S.); (L.L.M.M.)
- Clinisport Prime, Integrated Rehabilitation and Performance Center, Maringá 87060-350, Brazil
| | - Natalia Q. Santos
- Graduate Program of Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (K.E.G.B.); (A.P.); (F.M.O.); (N.Q.S.); (L.L.M.M.)
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Educational Sciences, Universidad Católica del Maule, Talca 3530000, Chile;
- Sports Coaching Career, School of Education, Universidad Viña del Mar, Viña del Mar 2580022, Chile
| | - Luciana L. M. Marchiori
- Graduate Program of Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (K.E.G.B.); (A.P.); (F.M.O.); (N.Q.S.); (L.L.M.M.)
| | - Emerson Franchini
- School of Physical Education and Sport at the University of São Paulo, São Paulo 05508-030, Brazil
| | - Braulio H. M. Branco
- Graduate Program of Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (K.E.G.B.); (A.P.); (F.M.O.); (N.Q.S.); (L.L.M.M.)
- Clinisport Prime, Integrated Rehabilitation and Performance Center, Maringá 87060-350, Brazil
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Kaczmarczyk K, Płoszczyca K, Jaskulski K, Czuba M. Eight Weeks of Resistance Training Is Not a Sufficient Stimulus to Improve Body Composition in Post-COVID-19 Elderly Adults. J Clin Med 2024; 14:174. [PMID: 39797257 PMCID: PMC11721171 DOI: 10.3390/jcm14010174] [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: 11/28/2024] [Revised: 12/22/2024] [Accepted: 12/28/2024] [Indexed: 01/13/2025] Open
Abstract
Background: This study sought to assess how body mass (BM) and body composition in post-COVID-19 elderly adults were affected by 8 weeks of resistance training. An additional goal was to determine the agreement between Bioelectrical Impedance Analysis (BIA) and Dual Energy X-Ray Absorptiometry (DXA) in elderly people. Methods: Participants were randomly assigned to an intervention Group, which engaged in 8 weeks of resistance training, and a Control Group, which was advised to maintain their usual activity levels. Before and after the intervention, the body composition was analyzed via the BIA and DXA methods. Results: We found no statistically significant changes in BM or body composition following resistance training. BIA was found to overestimate the participants' baseline BM and fat-free mass (FFM) and to underestimate the fat mass (FM), compared to the DXA method. There were no significant differences in intervention-induced changes in FM and FFM measured by BIA and DXA. Conclusions: Moderate intensity resistance training lasting 8 weeks was not found to be a sufficient stimulus to improve BM and body composition in post-COVID-19 elderly adults. We also conclude that BIA may serve as a viable alternative to DXA for measuring longitudinal changes in body composition in elderly people.
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Affiliation(s)
- Katarzyna Kaczmarczyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland; (K.K.); (K.J.)
| | - Kamila Płoszczyca
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland; (K.K.); (K.J.)
| | - Karol Jaskulski
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland; (K.K.); (K.J.)
| | - Miłosz Czuba
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, Licealna 9, 65-417 Zielona Góra, Poland;
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Silva-Lalucci MPDP, Marques DCDS, Ryal JJ, Marques MGDS, Perli VAS, Sordi AF, de Moraes SMF, Valdés-Badilla P, Andreato LV, Branco BHM. Impact of Multi-Professional Intervention on Health-Related Physical Fitness and Biomarkers in Overweight COVID-19 Survivors for 8 and 16 Weeks: A Non-Randomized Clinical Trial. Healthcare (Basel) 2024; 12:2034. [PMID: 39451449 PMCID: PMC11506869 DOI: 10.3390/healthcare12202034] [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: 09/20/2024] [Revised: 10/07/2024] [Accepted: 10/10/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND/OBJECTIVES Considering the diverse symptomatology of COVID-19-ranging from mild to severe cases-multi-professional interventions are crucial for enhancing physical recovery, nutritional status, and mental health outcomes in affected patients. Thus, this study aimed to investigate the effects of such an intervention on health-related physical fitness and biomarkers in overweight COVID-19 survivors with varying degrees of symptom severity after 8 weeks and 16 weeks. METHODS This non-randomized clinical trial included 59 overweight COVID-19 survivors (32 males and 27 females) divided into three groups: mild (n = 31), moderate (n = 13), and severe/critical (n = 15). The participants underwent a multi-professional program and were assessed for anthropometric and body composition (primary outcome), as well as physical fitness and biochemical markers (secondary outcome) 8 and 16 weeks before the intervention. RESULTS After 8 weeks, time effects were observed for the maximum isometric handgrip strength (p < 0.001), maximum isometric lumbar-traction strength (p = 0.01), flexibility (p < 0.001), abdominal strength-endurance (p < 0.001), the sit-and-stand test (p < 0.001), maximum oxygen consumption (p < 0.001), and distance covered in the 6 min walk test (p < 0.001). Additionally, time effects were also observed for fat mass (p = 0.03), body fat percentage (p = 0.02), abdominal circumference (p = 0.01), total cholesterol (p < 0.001), low-density lipoproteins (p < 0.001), and glycated hemoglobin (p < 0.001), with lower values after multi-professional interventions. After 16 weeks, the systolic and diastolic blood pressure showed significant reductions independently of the intervention group (p < 0.001). CONCLUSION These findings suggest that multi-professional interventions can provide substantial benefits for post-COVID-19 patients, regardless of the severity of their initial symptoms.
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Affiliation(s)
- Marielle Priscila de Paula Silva-Lalucci
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil
| | - Déborah Cristina de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil
| | - Joed Jacinto Ryal
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil
| | - Marilene Ghiraldi de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil
| | - Victor Augusto Santos Perli
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
| | - Ana Flávia Sordi
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
| | | | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile;
- Sports Coach Career, School of Education, Universidad Viña del Mar, Vina del Mar 2520000, Chile
| | - Leonardo Vidal Andreato
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
- Physical Education Course, State University of Amazonas, Barcelos 69700-000, Brazil
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil; (M.P.d.P.S.-L.); (D.C.d.S.M.); (J.J.R.); (M.G.d.S.M.); (V.A.S.P.); (A.F.S.); (L.V.A.)
- Graduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil
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Fisicaro F, Lanza G, Concerto C, Rodolico A, Di Napoli M, Mansueto G, Cortese K, Mogavero MP, Ferri R, Bella R, Pennisi M. COVID-19 and Mental Health: A "Pandemic Within a Pandemic". ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:1-18. [PMID: 39102186 DOI: 10.1007/978-3-031-61943-4_1] [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
The COVID-19 pandemic has brought significant changes in daily life for humanity and has had a profound impact on mental health. As widely acknowledged, the pandemic has led to notable increases in rates of anxiety, depression, distress, and other mental health-related issues, affecting both infected patients and non-infected individuals. COVID-19 patients and survivors face heightened risks for various neurological and psychiatric disorders and complications. Vulnerable populations, including those with pre-existing mental health conditions and individuals living in poverty or frailty, may encounter additional challenges. Tragically, suicide rates have also risen, particularly among young people, due to factors such as unemployment, financial crises, domestic violence, substance abuse, and social isolation. Efforts are underway to address these mental health issues, with healthcare professionals urged to regularly screen both COVID-19 and post-COVID-19 patients and survivors for psychological distress, ensuring rapid and appropriate interventions. Ongoing periodic follow-up and multidimensional, interdisciplinary approaches are essential for individuals experiencing long-term psychiatric sequelae. Preventive strategies must be developed to mitigate mental health problems during both the acute and recovery phases of COVID-19 infection. Vaccination efforts continue to prioritize vulnerable populations, including those with mental health conditions, to prevent future complications. Given the profound implications of mental health problems, including shorter life expectancy, diminished quality of life, heightened distress among caregivers, and substantial economic burden, it is imperative that political and health authorities prioritize the mental well-being of all individuals affected by COVID-19, including infected individuals, non-infected individuals, survivors, and caregivers.
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Affiliation(s)
- Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123, Catania, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgery Specialties, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Via Conte Ruggero 78, 94018, Troina, Italy.
| | - Carmen Concerto
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia 89, 95123, Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Via Santa Sofia 89, 95123, Catania, Italy
| | - Mario Di Napoli
- Neurological Service, SS Annunziata Hospital, Viale Mazzini 100, 67039, Sulmona, L'Aquila, Italy
| | - Gelsomina Mansueto
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
- Clinical Department of Laboratory Services and Public Health-Legal Medicine Unit, University of Campania "Luigi Vanvitelli", Via Luciano Armanni 5, 80138, Naples, Italy
| | - Klizia Cortese
- Department of Educational Sciences, University of Catania, Via Teatro Greco 84, 95124, Catania, Italy
| | - Maria P Mogavero
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Via Conte Ruggero 78, 94018, Troina, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia 87, 95123, Catania, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123, Catania, Italy
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Batista KS, de Albuquerque JG, de Vasconcelos MHA, Bezerra MLR, da Silva Barbalho MB, Pinheiro RO, Aquino JDS. Probiotics and prebiotics: potential prevention and therapeutic target for nutritional management of COVID-19? Nutr Res Rev 2023; 36:181-198. [PMID: 34668465 PMCID: PMC8593414 DOI: 10.1017/s0954422421000317] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 08/21/2021] [Accepted: 10/14/2021] [Indexed: 02/08/2023]
Abstract
Scientists are working to identify prevention/treatment methods and clinical outcomes of coronavirus disease 2019 (COVID-19). Nutritional status and diet have a major impact on the COVID-19 disease process, mainly because of the bidirectional interaction between gut microbiota and lung, that is, the gut-lung axis. Individuals with inadequate nutritional status have a pre-existing imbalance in the gut microbiota and immunity as seen in obesity, diabetes, hypertension and other chronic diseases. Communication between the gut microbiota and lungs or other organs and systems may trigger worse clinical outcomes in viral respiratory infections. Thus, this review addresses new insights into the use of probiotics and prebiotics as a preventive nutritional strategy in managing respiratory infections such as COVID-19 and highlighting their anti-inflammatory effects against the main signs and symptoms associated with COVID-19. Literature search was performed through PubMed, Cochrane Library, Scopus and Web of Science databases; relevant clinical articles were included. Significant randomised clinical trials suggest that specific probiotics and/or prebiotics reduce diarrhoea, abdominal pain, vomiting, headache, cough, sore throat, fever, and viral infection complications such as acute respiratory distress syndrome. These beneficial effects are linked with modulation of the microbiota, products of microbial metabolism with antiviral activity, and immune-regulatory properties of specific probiotics and prebiotics through Treg cell production and function. There is a need to conduct clinical and pre-clinical trials to assess the combined effect of consuming these components and undergoing current therapies for COVID-19.
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Affiliation(s)
- Kamila Sabino Batista
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
- Post Graduate Program in Nutrition Sciences, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
| | - Juliana Gondim de Albuquerque
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
- Post Graduate Program in Nutrition Sciences, Federal University of Pernambuco (UFPE), Cidade Universitária s/n, Recife, Brazil
- Post Graduate in Biotechnology, Division of Biological and Health Sciences, Universidad Autónoma Metropolitana (UAM), Ciudad de Mexico, Mexico
| | - Maria Helena Araújo de Vasconcelos
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
- Post Graduate Program in Nutrition Sciences, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
| | - Maria Luiza Rolim Bezerra
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
- Post Graduate Program in Nutrition Sciences, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
| | - Mariany Bernardino da Silva Barbalho
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
| | - Rafael Oliveira Pinheiro
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
- Post Graduate Program in Nutrition Sciences, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
| | - Jailane de Souza Aquino
- Experimental Nutrition Laboratory, Department of Nutrition, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
- Post Graduate Program in Nutrition Sciences, Federal University of Paraíba (UFPB), Cidade Universitária, s/n-Castelo Branco III, João Pessoa, PB, Brazil
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Chuatrakoon B, Konghakote S, Sa-nguanmoo P, Nantakool S. Long-term impact of SARS-CoV-2 infection on cardiorespiratory fitness: a meta-analysis. Front Public Health 2023; 11:1215486. [PMID: 37920575 PMCID: PMC10619755 DOI: 10.3389/fpubh.2023.1215486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 11/04/2023] Open
Abstract
Background Despite surviving Coronavirus disease 2019 (COVID-19), its long-term impact is of concern. Low cardiorespiratory fitness is a strong predictor of all-cause mortality, and likely affected by multisystem impairments following COVID-19 infection. Accumulating evidence has identified the impact of COVID-19 on cardiorespiratory fitness level. However, the findings have been controversial. Conclusive evidence is still needed. Objectives This review aimed to systematically summarize and synthesize whether the SARS-CoV-2 infection diminishes cardiorespiratory fitness in COVID-19 survivors. Design The study design was a systematic review and meta-analysis. Methods A search was carried out using PubMed, CINAHL, Scopus, Embase and the Cochrane Library, together with reference lists (searching from their inception to January 2023). Observational studies investigating the impact of COVID-19 on outcomes relevant to cardiorespiratory fitness (i.e., peak oxygen uptake) were included. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to identify a pooled effect estimate. Use of a random effects model was considered as the main method. Grading of Recommendation Assessment, Development and Evaluation approach was employed to determine the certainty of evidence. This meta-analysis was registered with PROSPERO (registration number: CRD42023393108). Results Seven eligible studies (4 cross-sectional, 2 cohort, and 1 case-control studies) involving 4,773 participants were included in this meta-analysis. A pooled effect estimates showed that patients in the surviving COVID-19 group had a significant reduction in peak oxygen uptake when compared to their counterparts in the non-COVID-19 group (WMD -6.70, 95%CI -9.34 to -4.06, low certainty). A subgroup analysis by age found that COVID-19 survivors in the young- to middle-aged and middle- to older-aged subgroups had significant reductions in peak oxygen uptake when compared to their counterparts in the non-COVID-19 group (WMD -5.31, 95%CI -7.69 to -2.94, low certainty; WMD -15.63, 95%CI -28.50 to -2.75, very low certainty, respectively). Subgroup analyses by symptom found that patients with moderate to severe symptoms in the surviving COVID-19 group had significantly lower peak oxygen uptake than their counterparts in the non-COVID-19 group (WMD -15.63, 95%CI -28.50 to -2.75, very low certainty). Conclusion The current meta-analysis concluded that patients in the COVID-19 survivors had poorer cardiorespiratory fitness than their counterparts in the non-COVID-19 group, but there is considerable uncertainty of evidence. Poorer cardiorespiratory fitness is likely to be more pronounced in COVID-19 survivors who are getting older and had severe symptoms, but it is uncertain whether such finding has a valuable in clinical context. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, CRD42023393108.
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Affiliation(s)
- Busaba Chuatrakoon
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Supatcha Konghakote
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Piangkwan Sa-nguanmoo
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sothida Nantakool
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Periasamy P, Suganthi V, Chandrabose A, Subha KC, Gunasekaran S. Knowledge, beliefs, and practices about COVID-19 among students and the general public in Tamil Nadu: A cross-sectional study. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_93_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Abd El-Kader AI. A Nurses' Guide for Egyptian Women Regarding Female Sexual Function During COVID-19 Pandemic: A Quasi -Experimental Study. SAGE Open Nurs 2023; 9:23779608231186023. [PMID: 37425284 PMCID: PMC10328161 DOI: 10.1177/23779608231186023] [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: 07/14/2022] [Revised: 05/19/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The pandemic of coronavirus disease 2019 (COVID-19) is still affecting individuals all over the world. Restrictions resulting from lifestyle changes have been demonstrated to cause mental and sexual health issues. Objectives This research was performed to assess the effect of the COVID-19 pandemic on female sexual function in Egypt and also to assess the knowledge and information for those with sexual dysfunction before and after the administration of nursing guidelines. Methods A quasi-experimental research design was carried out for women diagnosed with positive COVID-19 at Isolation Hospital in Heart and Chest Hospital-Zagazig University. The study comprised a purposive sample of 496 women who were active COVID-19 patients. A structured interviewing form and a female sexual function index would be utilized to collect data. The nursing guidelines were designed by the researcher and given to women with positive COVID-19 after assessment of their knowledge and information concerning sexual health during this pandemic. Results According to the findings of this study, the incidence of normal sexual function and sexual dysfunction was 62.7% and 37.3%, respectively. Nearly half of the participating women (46.7%) were 25-34 years of age. 63.7% of them were residing in rural areas. Before guidelines administration: poor knowledge (23.5%), fair knowledge (68.4%), and good knowledge (8.1%); and after intervention: poor knowledge (0.0%), fair knowledge (29.4%), and good knowledge (70.6%) were recorded. Conclusion Women with sexual dysfunction had statistically higher accurate information following the administration of nursing guidelines regarding sexual function.
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Affiliation(s)
- Azza Ibrahim Abd El-Kader
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
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10
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García-Suárez PC, Canton-Martínez E, Rentería I, Moura Antunes B, Machado-Parra JP, Aburto-Corona JA, Gómez-Miranda LM, Jiménez-Maldonado A. Remote, Whole-Body Interval Training Improves Muscular Endurance and Cardiac Autonomic Control in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13897. [PMID: 36360775 PMCID: PMC9657792 DOI: 10.3390/ijerph192113897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
High-intensity interval training (HIIT) is an exercise modality acknowledged to maintain physical fitness with more engagement in an active lifestyle compared with other traditional exercise models. Nevertheless, its effects on cardiac control and physical performance in an online-guided setting are not yet clarified. The present work assessed physical fitness and heart rate variability (HRV) before and after an online, home-based HIIT program in college-age students while pandemic lockdowns were in effect. Twenty university students (age: 21.9 ± 2.4 years.) that were solely enrolled in online classes were distributed into three groups: control-CON-(n = 6), 14 min of HIIT-HIIT-14-(n = 8), and 21 min of HIIT-HIIT-21-(n = 6). A maximal push-up test was employed to assess muscular endurance and performance, and resting HRV signals were collected with wireless heart rate monitors and were processed in Kubios HRV Std. (Kubios Oy, Finland). There was an increase in total push-up capacity compared to CON (p < 0.05 HIIT-21 vs. CON; p < 0.001 HIIT-14 vs. CON) after 8 weeks. A significant interaction was observed in high-frequency and low-frequency spectra ratios after the HIIT-21 intervention (p < 0.05). The current work demonstrated that either short- or mid-volume online, whole-body HIIT improves muscle strength, whereas mid-volume HIIT (HIIT-21) was the only intervention that developed a sympathovagal adaptation. This study showed promising results on muscular endurance and cardiac autonomic modulation through whole-body HIIT practice at home.
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Affiliation(s)
- Patricia Concepción García-Suárez
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Ensenada 22800, Mexico
- Department of Health, Sport and Exercise Sciences, University of Kansas, Lawrence, KS 66045, USA
| | - Ermilo Canton-Martínez
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Ensenada 22800, Mexico
| | - Iván Rentería
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Ensenada 22800, Mexico
| | - Barbara Moura Antunes
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Ensenada 22800, Mexico
| | - Juan Pablo Machado-Parra
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Ensenada 22800, Mexico
| | | | - Luis Mario Gómez-Miranda
- Facultad de Deportes Campus Tijuana, Universidad Autónoma de Baja California, Tijuana 22390, Mexico
| | - Alberto Jiménez-Maldonado
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Ensenada 22800, Mexico
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11
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Lemos MM, Cavalini GR, Pugliese Henrique CR, Perli VAS, de Moraes Marchiori G, Marchiori LLDM, Sordi AF, Franzói de Moraes SM, de Paula Ramos S, Valdés-Badilla P, Mota J, Magnani Branco BH. Body composition and cardiorespiratory fitness in overweight or obese people post COVID-19: A comparative study. Front Physiol 2022; 13:949351. [PMID: 36213222 PMCID: PMC9532828 DOI: 10.3389/fphys.2022.949351] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
The present study aimed to evaluate the body composition and cardiorespiratory fitness of overweight or obese people after COVID-19. 171 volunteers of both sexes (men, n = 93 and women, n = 78) between 19 and 65 years old were allocated into three groups according to the severity of their symptoms of COVID-19: non-hospitalized people/mild symptoms (n = 61), hospitalized (n = 58), and hospitalized in an intensive care unit-ICU (n = 52). Two laboratory visits were carried out 24 h apart. First, a medical consultation was carried out, with subsequent measurement of body weight and height (calculation of body mass index) and body composition assessment via electrical bioimpedance. After 24 h, a cardiorespiratory test was performed using the Bruce protocol, with a direct gas exchange analysis. Hospitalized individuals had significantly higher values for fat mass and body fat percentage than non-hospitalized individuals (p < 0.05). Significantly higher values were found for heart rate (HR) and peak oxygen consumption (VO2peak) for individuals who were not hospitalized when compared to those hospitalized in the ICU (p < 0.05). Significantly higher values for distance, ventilation, and the relationship between respiratory quotient were found for non-hospitalized individuals compared to hospitalized individuals and those in the ICU (p < 0.05). After the cardiorespiratory test, higher values for peripheral oxygen saturation (SpO2) were observed for non-hospitalized individuals than for all hospitalized individuals (p < 0.05). Diastolic blood pressure was significantly higher at the tenth and fifteenth minute post-Bruce test in hospitalized than in non-hospitalized participants (p < 0.05). Based on these results, proposals for cardiopulmonary rehabilitation are indispensable for hospitalized groups considering the responses of blood pressure. Monitoring HR, SpO2, and blood pressure are necessary during rehabilitation to avoid possible physical complications. Volume and intensity of exercise prescription should respect the physiologic adaptation. Given lower physical conditioning among all the groups, proposals for recovering from health conditions are urgent and indispensable for COVID-19 survivors.
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Affiliation(s)
- Maurício Medeiros Lemos
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Postgraduate Program in Health Promotion, Cesumar University, Paraná, Brazil
| | - Gustavo Rocha Cavalini
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
| | - Carlos Renato Pugliese Henrique
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
| | - Victor Augusto Santos Perli
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
| | | | | | - Ana Flávia Sordi
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
| | | | | | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, Chile
| | - Jorge Mota
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sports; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá, Brazil
- Postgraduate Program in Health Promotion, Cesumar University, Paraná, Brazil
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá, Brazil
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sports; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Physiology and Nutrition Department, Clinisport Prime, Maringa, Brazil
- *Correspondence: Braulio Henrique Magnani Branco,
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DHA/EPA supplementation decreases anxiety-like behaviour, but it does not ameliorate metabolic profile in obese male rats. Br J Nutr 2022; 128:964-974. [PMID: 34605386 DOI: 10.1017/s0007114521003998] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Obesity is a major public health problem that predisposes to several diseases and higher mortality in patients with COVID-19. Obesity also generates neuroinflammation, which predisposes to the development of neuropsychiatric diseases. Since there is a lack of effective treatments for obesity, the search for new strategies to reverse its consequences is urgent. In this perspective, the anti-inflammatory properties of omega-3 polyunsaturated fatty acids such as DHA/EPA might reduce the harmful effects of obesity. Here, we used the cafeteria diet (CAF) model to induce obesity in Wistar rats. Animals received ultra-processed food for 20 weeks, and DHA/EPA supplementation (500 mg/kg per d) was performed between the 16th and the 20th week. At the end of the experiment, it was evaluated: body weight, visceral fat deposition, plasma glucose, insulin and triglycerides, and it was also measured the levels of inflammatory cytokines TNF-α and IL-6 in plasma and liver, and TNF-α in the prefrontal cortex. The elevated plus maze test was performed to analyse anxiety-like behaviour. Our results demonstrated that DHA/EPA could not reverse weight and fat gain and did not modify plasma dosages. However, there was a decrease in IL-6 in the liver (DHA/EPA effect: P = 0.023) and TNF-α in the brain (CAF compared with CAF + DHA/EPA, P < 0.05). Also, there was a decrease in the anxiety index in CAF + DHA/EPA compared with the CAF group (P < 0.01). Thus, DHA/EPA supplementation is helpful to reverse the consequences of obesity in the brain.
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13
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Maffetone PB, Laursen PB. COVID-Related Athletic Deaths: Another Perfect Storm? Front Sports Act Living 2022; 4:829093. [PMID: 35498529 PMCID: PMC9039296 DOI: 10.3389/fspor.2022.829093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/02/2022] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Paul B. Laursen
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
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14
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Maffetone PB, Laursen PB. Rethinking COVID-19 and Beyond: Prevention, Remedies, and Recovery. Front Public Health 2022; 10:748498. [PMID: 35284402 PMCID: PMC8904369 DOI: 10.3389/fpubh.2022.748498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
In a relatively short timeframe, millions of deaths and illnesses associated with COVID-19 have been reported, accompanied by substantial economic losses, and overall, negatively impacting society. This experience should serve as a wakeup call to those in public health and healthcare, along with politicians and citizens: COVID-19 is considered a predictable and preventable disaster. While various reactive responses to address the pandemic were implemented, some with adverse effects, proactive measures in the years before COVID-19 were neglected. Predominately this involved the development of a preventable overfat pandemic, which played a key role in both rising rates of chronic disease, the comorbidities that increase the risk for COVID-19, along with associated inflammation and malnutrition. This increased the risk of infection in billions of people worldwide, which, in essence, primed society for high rates of COVID-19 infection. Excess body fat evolves primarily from poor nutrition, particularly the overconsumption of sugar and other refined carbohydrates, which replace the vital nutrients needed for optimal immune function. Sugar and refined carbohydrates must be considered the new tobacco, as these foods are also devoid of nutrients, and underly inflammatory chronic diseases. A balanced diet of nutrient-dense wholefood must be emphasized to combat infectious and inflammatory diseases. Implementing proactive preventive lifestyle changes must begin now, starting with simple, safe, and inexpensive dietary modifications that can quickly lead to a healthier population.
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15
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Gu S, Yuan W, Zhang A, Huo G, Jiang M, Han J, Shen N. Online re-examination of postgraduate medical students during the COVID-19 pandemic. BMC MEDICAL EDUCATION 2022; 22:42. [PMID: 35042499 PMCID: PMC8764890 DOI: 10.1186/s12909-022-03100-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Postgraduate entrance examination (the Unified National Graduate Entrance Examination) is the major way for Chinese medical undergraduate student to apply for postgraduate studies. It consists of two stages: the preliminary basic written test and the re-examination in form of both written tests and interviews. With the spread of COVID-19, the traditional on-site re-examination of postgraduates must be changed to online re-examination. By comparing the re-examination process and admission results of online and on-site re-examination, we studied the feasibility of online re-examination for postgraduates and measures to improve it. METHODS This was a retrospective cohort study using data from the Unified National Graduate Entrance Examination. Our sample population was the applicants to Peking University Third Hospital (PUTH) who completed re-examinations. In total, 281 records were successively selected from March 2017 to May 2020. By comparing the re-examination process and admission results of the 2020 online re-examination with those of the 2017-2019 on-site re-examinations, we analyzed the process, difficulties and improvement of online re-examination. RESULTS A total of 281 subjects were included, of whom 77.9% completed an on-site re-examination in 2017-2019 and 22.1% completed the 2020 online re-examination. In the on-site re-examinations, 70.8% of the students were admitted, and in the online re-examination, 74.2% of the students were admitted. There were no significant differences between the students who completed on-site and online re-examinations in terms of gender, recent graduation, cultivation type, graduate from a key university, and admission (P>0.05). The on-site and online re-examination results were very similar among the admitted students. The multivariable logistic regression analysis showed that online re-examination had no effect on student admissions. Students seeking professional degree were less likely to be admitted than those seeking academic degree, and those with a better standardized rank in medicine and a better standardized rank of re-examination score were more likely to be admitted. CONCLUSIONS The online re-examination implemented in 2020 during the COVID-19 pandemic achieved the same selective effect as on-site re-examination. Effective time management, a standardized test question template, well-trained staff and effective technology are the keys to success.
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Affiliation(s)
- Shixian Gu
- Department of Education, Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Wenqing Yuan
- Department of Education, Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Aijing Zhang
- Department of Education, Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Gang Huo
- Department of Education, Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Mengyun Jiang
- Department of Education, Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Jiangli Han
- Department of Education, Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China.
- Department of Cardiology, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China.
| | - Ning Shen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, 38 Xueyuan Road, Haidian District, 100191, Beijing, China.
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16
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Firoozi D, Masoumi SJ, Ranjbar S, Shivappa N, Hebert JR, Zare M, Poustchi H, Hoseini FS. The Association between Energy-Adjusted Dietary Inflammatory Index, Body Composition, and Anthropometric Indices in COVID-19-Infected Patients: A Case-Control Study in Shiraz, Iran. Int J Clin Pract 2022; 2022:5452488. [PMID: 35685606 PMCID: PMC9159238 DOI: 10.1155/2022/5452488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIMS Inflammation is strongly associated with the severity and mortality rate of SARS-CoV-2 disease (COVID-19). Dietary factors have a crucial role in preventing chronic and systemic inflammation. This study aimed to evaluate the association between energy-adjusted dietary inflammatory index (E-DII) scores and body composition parameters in COVID-19-infected patients compared to noninfected controls. METHODS A total of 133 COVID-19-infected patients and 322 noninfected controls were selected and enrolled from the Cohort Study of Employees of Shiraz University of Medical Sciences. E-DII score was calculated based on a validated food frequency questionnaire (FFQ) and body composition was measured using In-Body 770 equipment. Logistic regression models were utilized to estimate the odds ratio (OR). RESULTS In the control group, the mean E-DII score was significantly lower than the case group (-2.05 vs. -0.30, P ≤ 0.001), indicating that the diet of COVID-19-infected subjects was more proinflammatory than the controls. For every 1 unit increase in E-DII score, the odds of infection with COVID-19 was nearly triple (OR: 2.86, CI: 2.30, 3.35, P ≤ 0.001). Moreover, for each unit increase in body mass index (BMI), the odds of infection to COVID-19 increased by 7% (OR: 1.07, CI: 1.01, 1.13, P = 0.02). No significant difference was observed for other anthropometric parameters. CONCLUSION The findings revealed that obese people and those consuming a more proinflammatory diet were more susceptible to coronavirus infection. Therefore, maintaining ideal body weight and consuming a more anti-inflammatory diet can decrease the probability of COVID-19 infection.
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Affiliation(s)
- Donya Firoozi
- Student Research Committee, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Jalil Masoumi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Shiraz, Iran
- Center for Cohort Study of SUMS Employees' Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Ranjbar
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Shiraz, Iran
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R. Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Morteza Zare
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Shiraz, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Sadat Hoseini
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Belikina DV, Malysheva ES, Petrov AV, Nekrasova TA, Nekaeva ES, Lavrova AE, Zarubina DG, Atduev KA, Magomedova DM, Strongin LG. COVID-19 in Patients with Diabetes: Clinical Course, Metabolic Status, Inflammation, and Coagulation Disorder. Sovrem Tekhnologii Med 2021; 12:6-16. [PMID: 34796000 PMCID: PMC8596266 DOI: 10.17691/stm2020.12.5.01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Indexed: 01/08/2023] Open
Abstract
The aim of the investigation was to study the clinical course of COVID-19 in the presence of diabetes mellitus (DM) and elucidate possible mechanisms of their mutual aggravation. Materials and Methods The study included 64 patients with COVID-19; of them, 32 were with DM (main group) and 32 were DM-free (control group). The groups were formed according to the "case-control" principle. During hospitalization, the dynamics of clinical, glycemic, and coagulation parameters, markers of systemic inflammation, as well as kidney and liver functions were monitored and compared. Results Among patients with DM, the course of viral pneumonia was more severe, as evidenced by a 2.2-fold higher number of people with extensive (>50%) lung damage (p=0.05), an increased risk of death according to the CURB-65 algorithm (1.3-fold, p=0.043), and a longer duration of insufficient blood oxygen saturation (p=0.0004). With the combination of COVID-19 and DM, hyperglycemia is persistent, without pronounced variability (MAGE - 1.5±0.6 mmol/L), the levels of C-reactive protein (p=0.028), creatinine (p=0.035), and fibrinogen (p=0.013) are higher, manifestations of hypercoagulability persist longer, including slower normalization of antithrombin III (p=0.012), fibrinogen (p=0.037), and D-dimer (p=0.035). Conclusion The course of COVID-19 in patients with DM is associated with a high severity and extension of pneumonia, persistent decrease in oxygen supply, high hyperglycemia, accelerated renal dysfunction, systemic inflammation, and hypercoagulability.
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Affiliation(s)
- D V Belikina
- PhD Student, Department of Endocrinology and Internal Medicine; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E S Malysheva
- Assistant, Department of Endocrinology and Internal Medicine; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A V Petrov
- Associate Professor, Department of Endocrinology and Internal Medicine; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - T A Nekrasova
- Professor, Department of Endocrinology and Internal Medicine; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E S Nekaeva
- Head of the Emergency Department; Infection Hospital for Patients with Novel Coronavirus Infection (COVID-19) at the Institute of Pediatrics of the University Hospital, Privolzhsky Research Medical University, 22, Bldg 1, Semashko St., Nizhny Novgorod, 603950, Russia
| | - A E Lavrova
- Head of the Department of Pediatrics; Infection Hospital for Patients with Novel Coronavirus Infection (COVID-19) at the Institute of Pediatrics of the University Hospital, Privolzhsky Research Medical University, 22, Bldg 1, Semashko St., Nizhny Novgorod, 603950, Russia
| | - D G Zarubina
- Student, Medical Faculty;Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - K A Atduev
- Student, Medical Faculty;Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - D M Magomedova
- Student, Medical Faculty;Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - L G Strongin
- Professor, Head of the Department of Endocrinology and Internal Medicine Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
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18
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Putri C, Arisa J, Hananto JE, Hariyanto TI, Kurniawan A. Psychiatric sequelae in COVID-19 survivors: A narrative review. World J Psychiatry 2021; 11:821-829. [PMID: 34733644 PMCID: PMC8546765 DOI: 10.5498/wjp.v11.i10.821] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/13/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
In December 2019, a novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was initially reported in Wuhan, China. Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals. Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients, although long term psychiatric sequelae are predicted, there are only few review studies about the long term psychiatry outcome in COVID-19 survivors. Clinically significant post-traumatic stress disorder, anxiety, and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis. Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up, early convalescence, and at 1 mo follow-up. Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis. The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism, immune response to SARS-CoV-2, hypothalamo-pituitary-adrenal axis hyperactivity, disrupted neuronal circuits in several brain regions, increased stress levels, neuroinflammation, and neuronal death. This study will review the psychiatric sequelae in previous coronavirus pandemics, current studies, risk factors, and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.
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Affiliation(s)
- Cynthia Putri
- Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
| | - Jessie Arisa
- Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
| | | | | | - Andree Kurniawan
- Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
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Dalamaga M, Christodoulatos GS, Karampela I, Vallianou N, Apovian CM. Understanding the Co-Epidemic of Obesity and COVID-19: Current Evidence, Comparison with Previous Epidemics, Mechanisms, and Preventive and Therapeutic Perspectives. Curr Obes Rep 2021; 10:214-243. [PMID: 33909265 PMCID: PMC8080486 DOI: 10.1007/s13679-021-00436-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW A growing body of evidence suggests that obesity and increased visceral adiposity are strongly and independently linked to adverse outcomes and death due to COVID-19. This review summarizes current epidemiologic data, highlights pathogenetic mechanisms on the association between excess body weight and COVID-19, compares data from previous pandemics, discusses why COVID-19 challenges the "obesity paradox," and presents implications in prevention and treatment as well as future perspectives. RECENT FINDINGS Data from meta-analyses based on recent observational studies have indicated that obesity increases the risks of infection from SARS-CoV-2, severe infection and hospitalization, admission to the ICU and need of invasive mechanical ventilation (IMV), and the risk of mortality, particularly in severe obesity. The risks of IMV and mortality associated with obesity are accentuated in younger individuals (age ≤ 50 years old). The meta-inflammation in obesity intersects with and exacerbates underlying pathogenetic mechanisms in COVID-19 through the following mechanisms and factors: (i) impaired innate and adaptive immune responses; (ii) chronic inflammation and oxidative stress; (iii) endothelial dysfunction, hypercoagulability, and aberrant activation of the complement; (iv) overactivation of the renin-angiotensin-aldosterone system; (v) overexpression of the angiotensin-converting enzyme 2 receptor in the adipose tissue; (vi) associated cardiometabolic comorbidities; (vii) vitamin D deficiency; (viii) gut dysbiosis; and (ix) mechanical and psychological issues. Mechanistic and large epidemiologic studies using big data sources with omics data exploring genetic determinants of risk and disease severity as well as large randomized controlled trials (RCTs) are necessary to shed light on the pathways connecting chronic subclinical inflammation/meta-inflammation with adverse COVID-19 outcomes and establish the ideal preventive and therapeutic approaches for patients with obesity.
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Affiliation(s)
- Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527 Athens, Greece
| | - Gerasimos Socrates Christodoulatos
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527 Athens, Greece
| | - Irene Karampela
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527 Athens, Greece
- Second Department of Critical Care, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini St, Haidari, 12462 Athens, Greece
| | - Natalia Vallianou
- Department of Internal Medicine and Endocrinology, Evangelismos General Hospital of Athens, 45-47 Ypsilantou street, 10676 Athens, Greece
| | - Caroline M. Apovian
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Doctor’s Office Building, 720 Harrison Avenue, Suite, Boston, MA 8100 USA
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20
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Tong ZWM, Grant E, Gras S, Wu M, Smith C, Barrett HL, Gallo LA, Short KR. The role of T-cell immunity in COVID-19 severity amongst people living with type II diabetes. FEBS J 2021; 288:5042-5054. [PMID: 34216102 PMCID: PMC8420365 DOI: 10.1111/febs.16105] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/05/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic has highlighted the vulnerability of people with diabetes mellitus (DM) to respiratory viral infections. Despite the short history of COVID-19, various studies have shown that patients with DM are more likely to have increased hospitalisation and mortality rates as compared to patients without. At present, the mechanisms underlying this susceptibility are unclear. However, prior studies show that the course of COVID-19 disease is linked to the efficacy of the host's T-cell responses. Healthy individuals who can elicit a robust T-cell response are more likely to limit the severity of COVID-19. Here, we investigate the hypothesis that an impaired T-cell response in patients with type 2 diabetes mellitus (T2DM) drives the severity of COVID-19 in this patient population. While there is currently a limited amount of information that specifically addresses T-cell responses in COVID-19 patients with T2DM, there is a wealth of evidence from other infectious diseases that T-cell immunity is impaired in patients with T2DM. The reasons for this are likely multifactorial, including the presence of hyperglycaemia, glycaemic variability and metformin use. This review emphasises the need for further research into T-cell responses of COVID-19 patients with T2DM in order to better inform our response to COVID-19 and future disease outbreaks.
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Affiliation(s)
- Zhen Wei Marcus Tong
- School of Chemistry and Molecular BiosciencesThe University of QueenslandBrisbaneAustralia
| | - Emma Grant
- La Trobe University ‐ La Trobe Institute for Molecular Science (LIMS)MelbourneAustralia
- Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash UniversityClaytonAustralia
| | - Stephanie Gras
- La Trobe University ‐ La Trobe Institute for Molecular Science (LIMS)MelbourneAustralia
- Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash UniversityClaytonAustralia
| | - Melanie Wu
- School of Chemistry and Molecular BiosciencesThe University of QueenslandBrisbaneAustralia
| | - Corey Smith
- QIMR Berghofer Medical Research Institute ‐ QIMR Berghofer Centre for Immunotherapy and Vaccine Development BrisbaneAustralia
| | - Helen L. Barrett
- Department of EndocrinologyMater HealthBrisbaneAustralia
- Mater Research InstituteThe University of QueenslandBrisbaneAustralia
| | - Linda A. Gallo
- School of Biomedical SciencesThe University of QueenslandSt LuciaAustralia
| | - Kirsty R. Short
- School of Chemistry and Molecular BiosciencesThe University of QueenslandBrisbaneAustralia
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21
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Calugi S, Andreoli B, Dametti L, Dalle Grave A, Morandini N, Dalle Grave R. The Impact of COVID-19 Lockdown on Patients with Obesity after Intensive Cognitive Behavioral Therapy-A Case-Control Study. Nutrients 2021; 13:nu13062021. [PMID: 34208391 PMCID: PMC8231218 DOI: 10.3390/nu13062021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/20/2021] [Accepted: 06/09/2021] [Indexed: 01/03/2023] Open
Abstract
Background: The COVID-19 lockdown may have negatively impacted the treatment of obesity. This study aimed to assess the effect of COVID-19 lockdown in patients with obesity treated with intensive residential cognitive behavioral therapy (CBT-OB). Methods: This retrospective case-control study analyzed 129 patients with severe obesity who experienced COVID-19 lockdown in the 6 months after discharge from intensive residential CBT-OB, comparing their outcomes on weight loss, binge-eating episodes, and general health status with those in a sample of patients matched by gender, age, and body mass index given the same treatment before the COVID-19 outbreak as control. Patients were assessed at baseline and by phone interview 6-month follow-up. Results: Both groups had lost more than 9% of their baseline bodyweight and reported a significant decrease in binge-eating episodes and similar general health status at 6-month follow-up. However, control patients achieved a significantly greater weight loss than those who experienced lockdown, although half of lockdown patients reported persisting with CBT-OB procedures after their discharge. Conclusion: Patients with obesity treated with CBT-OB and exposed to COVID-19 lockdown, despite achieving lower weight loss than non-exposed patients, had a healthy weight loss at 6-month follow-up and comparable reduction in binge-eating behaviors.
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22
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Morais AHDA, Aquino JDS, da Silva-Maia JK, Vale SHDL, Maciel BLL, Passos TS. Nutritional status, diet and viral respiratory infections: perspectives for severe acute respiratory syndrome coronavirus 2. Br J Nutr 2021; 125:851-862. [PMID: 32843118 PMCID: PMC7542326 DOI: 10.1017/s0007114520003311] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022]
Abstract
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was recognised by the WHO as a pandemic in 2020. Host preparation to combat the virus is an important strategy to avoid COVID-19 severity. Thus, the relationship between eating habits, nutritional status and their effects on the immune response and further implications in viral respiratory infections is an important topic discussed in this review. Malnutrition causes the most diverse alterations in the immune system, suppressing of the immune response and increasing the susceptibility to infections such as SARS-CoV-2. On the other hand, obesity induces low-grade chronic inflammation caused by excess adiposity, which increases angiotensin-converting enzyme 2. It decreases the immune response favouring SARS-CoV-2 virulence and promoting respiratory distress syndrome. The present review highlights the importance of food choices considering their inflammatory effects, consequently increasing the viral susceptibility observed in malnutrition and obesity. Healthy eating habits, micronutrients, bioactive compounds and probiotics are strategies for COVID-19 prevention. Therefore, a diversified and balanced diet can contribute to the improvement of the immune response to viral infections such as COVID-19.
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Affiliation(s)
- Ana Heloneida de Araújo Morais
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Jailane de Souza Aquino
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Paraíba, João Pessoa, PB58050-085, Brazil
| | - Juliana Kelly da Silva-Maia
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Sancha Helena de Lima Vale
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Bruna Leal Lima Maciel
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Thaís Sousa Passos
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
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Lamadrid P, Alonso-Peña M, San Segundo D, Arias-Loste M, Crespo J, Lopez-Hoyos M. Innate and Adaptive Immunity Alterations in Metabolic Associated Fatty Liver Disease and Its Implication in COVID-19 Severity. Front Immunol 2021; 12:651728. [PMID: 33859644 PMCID: PMC8042647 DOI: 10.3389/fimmu.2021.651728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/08/2021] [Indexed: 12/18/2022] Open
Abstract
The coronavirus infectious disease 2019 (COVID-19) pandemic has hit the world, affecting health, medical care, economies and our society as a whole. Furthermore, COVID-19 pandemic joins the increasing prevalence of metabolic syndrome in western countries. Patients suffering from obesity, type II diabetes mellitus, cardiac involvement and metabolic associated fatty liver disease (MAFLD) have enhanced risk of suffering severe COVID-19 and mortality. Importantly, up to 25% of the population in western countries is susceptible of suffering from both MAFLD and COVID-19, while none approved treatment is currently available for any of them. Moreover, it is well known that exacerbated innate immune responses are key in the development of the most severe stages of MAFLD and COVID-19. In this review, we focus on the role of the immune system in the establishment and progression of MAFLD and discuss its potential implication in the development of severe COVID-19 in MAFLD patients. As a result, we hope to clarify their common pathology, but also uncover new potential therapeutic targets and prognostic biomarkers for further research.
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Affiliation(s)
- Patricia Lamadrid
- Transplant and Autoimmunity Group, Research Institute Marques de Valdecilla (IDIVAL), Santander, Spain
| | - Marta Alonso-Peña
- Clinical and Translational Research in Digestive Pathology Group, Research Institute Marques de Valdecilla (IDIVAL), Santander, Spain
| | - David San Segundo
- Transplant and Autoimmunity Group, Research Institute Marques de Valdecilla (IDIVAL), Santander, Spain.,Immunology Department, Marques de Valdecilla University Hospital, Santander, Spain
| | - Mayte Arias-Loste
- Clinical and Translational Research in Digestive Pathology Group, Research Institute Marques de Valdecilla (IDIVAL), Santander, Spain.,Gastroenterology and Hepatology Department, Marques de Valdecilla University Hospital, Santander, Spain
| | - Javier Crespo
- Clinical and Translational Research in Digestive Pathology Group, Research Institute Marques de Valdecilla (IDIVAL), Santander, Spain.,Gastroenterology and Hepatology Department, Marques de Valdecilla University Hospital, Santander, Spain
| | - Marcos Lopez-Hoyos
- Transplant and Autoimmunity Group, Research Institute Marques de Valdecilla (IDIVAL), Santander, Spain.,Immunology Department, Marques de Valdecilla University Hospital, Santander, Spain
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24
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Androutsos O, Perperidi M, Georgiou C, Chouliaras G. Lifestyle Changes and Determinants of Children's and Adolescents' Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study. Nutrients 2021; 13:nu13030930. [PMID: 33805678 PMCID: PMC7998995 DOI: 10.3390/nu13030930] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/05/2021] [Accepted: 03/10/2021] [Indexed: 01/31/2023] Open
Abstract
Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participants’ lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in April–May 2020. Parents self-reported changes of their children’s lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, children’s/adolescents’ sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in children’s and adolescents’ lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns.
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Affiliation(s)
- Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
- Correspondence: ; Tel.: +30-24310-47108
| | - Maria Perperidi
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
| | - Christos Georgiou
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece; (M.P.); (C.G.)
| | - Giorgos Chouliaras
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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25
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Ali A, Sohaib M, Iqbal S, Hayat K, Khan AU, Rasool MF. Evaluation of COVID-19 Disease Awareness and Its Relation to Mental Health, Dietary Habits, and Physical Activity: A Cross-Sectional Study from Pakistan. Am J Trop Med Hyg 2021; 104:1687-1693. [PMID: 33690156 PMCID: PMC8103453 DOI: 10.4269/ajtmh.20-1451] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/28/2021] [Indexed: 12/17/2022] Open
Abstract
Coronavirus infection (COVID-19) has significantly increased the mortality and morbidity rates worldwide. The present study was conducted to assess the general public's awareness of COVID-19 and its association with mental health, dietary habits, and physical activity. A web-based survey was conducted to gather information about demographics, knowledge about COVID-19, dietary habits, mental health, and anthropometry among the general public of Pakistan. Descriptive statistics, chi-square test, and multiple logistic regression were used for data analysis. The majority of the participants were suffering from anxiety (71.0%) and depression (52.0%) during the COVID-19 pandemic; 32.4% of participants had poor COVID-19-related knowledge. COVID-19 lockdown reduced the physical activity of 66.9% of participants and increased weight of 38.8% of the survey participants. Demographic variables, including age, gender, ethnicity, education, employment, family type, and geographical location, were significantly associated with knowledge about COVID-19 (P < 0.05). Depression was inversely associated with COVID-19 knowledge (P < 0.05). Healthy changes in dietary habits including decreased consumption of fast foods, soft and cola drinks, fruit drinks, cooked meat (outside the home), sugar, and fats, and were associated with increased knowledge of COVID-19. Vitamin C and immunity-boosting supplement consumption were significantly associated with increased knowledge regarding COVID-19 (< 0.05). Inadequate knowledge about COVID-19 and the presence of anxiety and depression were found among most of the study participants. There is a need to conduct educational seminars to limit the health consequences resulting from COVID-19 lockdown.
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Affiliation(s)
- Ahmad Ali
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Sohaib
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Sanaullah Iqbal
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Azmat Ullah Khan
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
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26
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Perry BL, Aronson B, Pescosolido BA. Pandemic precarity: COVID-19 is exposing and exacerbating inequalities in the American heartland. Proc Natl Acad Sci U S A 2021; 118:e2020685118. [PMID: 33547252 PMCID: PMC7923675 DOI: 10.1073/pnas.2020685118] [Citation(s) in RCA: 164] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Crises lay bare the social fault lines of society. In the United States, race, gender, age, and education have affected vulnerability to COVID-19 infection. Yet, consequences likely extend far beyond morbidity and mortality. Temporarily closing the economy sent shock waves through communities, raising the possibility that social inequities, preexisting and current, have weakened economic resiliency and reinforced disadvantage, especially among groups most devastated by the Great Recession. We address pandemic precarity, or risk for material and financial insecurity, in Indiana, where manufacturing loss is high, metro areas ranked among the hardest hit by the Great Recession nationally, and health indicators stand in the bottom quintile. Using longitudinal data (n = 994) from the Person to Person Health Interview Study, fielded in 2019-2020 and again during Indiana's initial stay-at-home order, we provide a representative, probability-based assessment of adverse economic outcomes of the pandemic. Survey-weighted multivariate regressions, controlling for preexisting inequality, find Black adults over 3 times as likely as Whites to report food insecurity, being laid off, or being unemployed. Residents without a college degree are twice as likely to report food insecurity (compared to some college), while those not completing high school (compared to bachelor's degree) are 4 times as likely to do so. Younger adults and women were also more likely to report economic hardships. Together, the results support contentions of a Matthew Effect, where pandemic precarity disproportionately affects historically disadvantaged groups, widening inequality. Strategically deployed relief efforts and longer-term policy reforms are needed to challenge the perennial and unequal impact of disasters.
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Affiliation(s)
- Brea L Perry
- Department of Sociology, Indiana University, Bloomington, IN 47405
| | - Brian Aronson
- Department of Sociology, Indiana University, Bloomington, IN 47405
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Christensen RAG, Sturrock SL, Arneja J, Brooks JD. Measures of Adiposity and Risk of Testing Positive for SARS-CoV-2 in the UK Biobank Study. J Obes 2021; 2021:8837319. [PMID: 33542836 PMCID: PMC7841447 DOI: 10.1155/2021/8837319] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/17/2020] [Accepted: 01/12/2021] [Indexed: 12/31/2022] Open
Abstract
Objective To assess if body mass index (BMI) and high waist circumference (HWC) are associated with testing positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods 9,386 UK Biobank study participants tested for SARS-CoV-2 from March 16th 2020 to June 29th 2020 were analyzed. A forward model building approach was used to estimate adjusted risk ratios (RR) and 95% confidence intervals (95% CI). Analyses were stratified by age due to a significant first-order interaction between age and HWC. Results Approximately 17% (n = 1,577) of participants tested positive for SARS-CoV-2. BMI category had a linear association with testing positive for SARS-CoV-2 among participants <65 years (RR = 1.09, 95% CI 1.02-1.17). For participants ≥65 years, only obesity class II (RR = 1.38, 95% CI 1.10-1.74) had a significantly greater risk of testing positive for SARS-CoV-2 than those who were underweight/normal weight. While HWC was not associated with testing positive for SARS-CoV-2 in those <65 years, having an HWC was associated with an increased risk of testing positive for SARS-CoV-2 in participants ≥65 years (RR = 1.12, 95% CI 1.00-1.27). Conclusion The associations of BMI and HWC with testing positive for SARS-CoV-2 differed by age. Notably, HWC was associated with testing positive in those ≥65 years, but not those who were younger, independent of BMI. This suggests that measures of adiposity in addition to BMI may be used to identify older individuals at greater risk of testing positive for SARS-CoV-2.
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Affiliation(s)
| | - Shelby L. Sturrock
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jasleen Arneja
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jennifer D. Brooks
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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28
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Bajaj V, Gadi N, Spihlman AP, Wu SC, Choi CH, Moulton VR. Aging, Immunity, and COVID-19: How Age Influences the Host Immune Response to Coronavirus Infections? Front Physiol 2021; 11:571416. [PMID: 33510644 PMCID: PMC7835928 DOI: 10.3389/fphys.2020.571416] [Citation(s) in RCA: 273] [Impact Index Per Article: 68.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/16/2020] [Indexed: 01/08/2023] Open
Abstract
The novel coronavirus severe acute respiratory syndrome coronavirus 2 causing the Coronavirus disease (COVID-19) pandemic has ravaged the world with over 72 million total cases and over 1.6 million deaths worldwide as of early December 2020. An overwhelming preponderance of cases and deaths is observed within the elderly population, and especially in those with pre-existing conditions and comorbidities. Aging causes numerous biological changes in the immune system, which are linked to age-related illnesses and susceptibility to infectious diseases. Age-related changes influence the host immune response and therefore not only weaken the ability to fight respiratory infections but also to mount effective responses to vaccines. Immunosenescence and inflamm-aging are considered key features of the aging immune system wherein accumulation of senescent immune cells contribute to its decline and simultaneously increased inflammatory phenotypes cause immune dysfunction. Age-related quantitative and qualitative changes in the immune system affect cells and soluble mediators of both the innate and adaptive immune responses within lymphoid and non-lymphoid peripheral tissues. These changes determine not only the susceptibility to infections, but also disease progression and clinical outcomes thereafter. Furthermore, the response to therapeutics and the immune response to vaccines are influenced by age-related changes within the immune system. Therefore, better understanding of the pathophysiology of aging and the immune response will not only help understand age-related diseases but also guide targeted management strategies for deadly infectious diseases like COVID-19.
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Affiliation(s)
- Varnica Bajaj
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- School of Medicine, Boston University, Boston, MA, United States
| | - Nirupa Gadi
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- School of Medicine, Boston University, Boston, MA, United States
| | - Allison P. Spihlman
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- School of Medicine, Boston University, Boston, MA, United States
| | - Samantha C. Wu
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- School of Medicine, Boston University, Boston, MA, United States
| | - Christopher H. Choi
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
- School of Medicine, Boston University, Boston, MA, United States
| | - Vaishali R. Moulton
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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29
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Biesalski HK. Obesity, vitamin D deficiency and old age a serious combination with respect to coronavirus disease-2019 severity and outcome. Curr Opin Clin Nutr Metab Care 2021; 24:18-24. [PMID: 32941186 DOI: 10.1097/mco.0000000000000700] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Old age, obesity and vitamin D deficiency are considered as independent risk factors for severe courses of COVID-19. The aim of the review is to discuss common features of these risk factors and the impact of vitamin D. RECENT FINDINGS The recently discovered relationship between vitamin D and the infection pathway of the virus via the renin--angiotensin system (RAS) and the adipokines leptin and adiponectin play an important role. The frequency of studies showing a relationship between a low vitamin D status in comorbidities and severe COVID-19 courses makes an impact of vitamin D effects likely. SUMMARY There is a direct relationship between vitamin D, body fat and age in COVID-19 courses. With age, the ability of the skin to synthesize vitamin D decreases, and leads to vitamin D-deficits. If the skin is insufficiently exposed to sunlight, severe deficits can develop. As vitamin D plays an important role not only in the immune system but also in the RAS, and thus at the point where the virus attacks, a good vitamin D supply is an important basis for reducing the risk of severe COVID-19 processes. Treatment with vitamin D supplements should be based on severity of the vitamin D deficiency.
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30
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Cipryan L, Dostal T, Plews DJ, Hofmann P, Laursen PB. Adiponectin/leptin ratio increases after a 12-week very low-carbohydrate, high-fat diet, and exercise training in healthy individuals: A non-randomized, parallel design study. Nutr Res 2020; 87:22-30. [PMID: 33596508 DOI: 10.1016/j.nutres.2020.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/16/2020] [Accepted: 12/03/2020] [Indexed: 12/12/2022]
Abstract
This study aimed to investigate the effect of a 12-week very low-carbohydrate, high-fat (VLCHF) diet and exercise on biomarkers of inflammation in healthy individuals. Since the anti-inflammatory effects of a ketogenic diet have been established, we hypothesized that the VLCHF diet, along with exercise, would have an additional favorable effect on biomarkers of inflammation. Twenty-four healthy individuals were allocated to the VLCHF diet (VLCHF: N = 12, age 25.3 ± 2.0 years, body mass 66.7 ± 9.8 kg, fat mass 21.5% ± 4.9%), or habitual diet (HD: N = 12, age 23.9 ± 3.8 years, body mass 72.7 ± 15.0 kg, fat mass 23.4 ± 8.4 %) group. Biomarkers of inflammation (adiponectin, leptin, and high-sensitive interleukin-6 [hs-IL-6]) and substrate metabolism (glycated hemoglobin, fasting glucose, triacylglycerides, and cholesterol) were analyzed from blood at baseline and after 12 weeks. The adiponectin-leptin ratio significantly increased in the VLCHF group after the intervention period (ES [95% CL]: -0.90 [-0.96, -0.77], P ≤ .001, BF10 = 22.15). The adiponectin-leptin ratio changes were associated with both a significant increase in adiponectin (-0.79 [-0.91, -0.54], P ≤ .001, BF10 = 9.43) and a significant decrease in leptin (0.58 [0.19, 0.81], P = .014, BF10 = 2.70). There was moderate evidence of changes in total cholesterol (-1.15 [-2.01, -0.27], P = .010, BF10 = 5.20), and LDL cholesterol (-1.12 [-2.01, -0.21], P = .016, BF10 = 4.56) in the VLCHF group. Body weight (kg) and fat mass (%) decreased in the VLCHF group by 5.4% and 14.9%, respectively. We found that in healthy young individuals, consuming a VLCHF diet while performing regular exercise over a 12-week period produced favorable changes in body weight and fat mass along with beneficial changes in serum adiponectin and leptin concentrations. These data support the use of a VLCHF diet strategy for the primary prevention of chronic diseases associated with systemic low-grade inflammation.
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Affiliation(s)
- Lukas Cipryan
- Department of Human Movement Studies and Human Motion Diagnostic Centre, The University of Ostrava, Ostrava, Czech Republic.
| | - Tomas Dostal
- Department of Human Movement Studies and Human Motion Diagnostic Centre, The University of Ostrava, Ostrava, Czech Republic.
| | - Daniel J Plews
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand.
| | - Peter Hofmann
- Institute of Human Movement Science, Sport and Health; Exercise Physiology, Training and Training Therapy Research Group, University of Graz, Graz, Austria.
| | - Paul B Laursen
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand.
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31
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Constitutional thinness: body fat metabolism and skeletal muscle are important factors. Br J Nutr 2020; 124:998. [PMID: 32539872 DOI: 10.1017/s0007114520002147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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32
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Huizinga GP, Singer BH, Singer K. The Collision of Meta-Inflammation and SARS-CoV-2 Pandemic Infection. Endocrinology 2020; 161:bqaa154. [PMID: 32880654 PMCID: PMC7499583 DOI: 10.1210/endocr/bqaa154] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has forced us to consider the physiologic role of obesity in the response to infectious disease. There are significant disparities in morbidity and mortality by sex, weight, and diabetes status. Numerous endocrine changes might drive these varied responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, including hormone and immune mediators, hyperglycemia, leukocyte responses, cytokine secretion, and tissue dysfunction. Studies of patients with severe COVID-19 disease have revealed the importance of innate immune responses in driving immunopathology and tissue injury. In this review we will describe the impact of the metabolically induced inflammation (meta-inflammation) that characterizes obesity on innate immunity. We consider that obesity-driven dysregulation of innate immune responses may drive organ injury in the development of severe COVID-19 and impair viral clearance.
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Affiliation(s)
- Gabrielle P Huizinga
- Graduate Program in Immunology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Benjamin H Singer
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
- Michigan Center for Integrative Research in Critical Care, University of Michigan Medical School, Ann Arbor, Michigan
| | - Kanakadurga Singer
- Department of Pediatrics and Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan
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33
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Covid-19: Fat, Obesity, Inflammation, Ethnicity, and Sex Differences. Pathogens 2020; 9:pathogens9110887. [PMID: 33114495 PMCID: PMC7692736 DOI: 10.3390/pathogens9110887] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023] Open
Abstract
Although obesity is known to be a risk factor for COVID-19 severity, there is an urgent need to distinguish between different kinds of fat—visceral and subcutaneous fat—and their inflammation status in COVID-19. These different fat types have partially diverging biochemical roles in the human body, and they are differentially associated with SARS-CoV-2, which targets the angiotensin-converting enzyme 2 (ACE2) for cell entry. ACE2 is highly expressed in adipose tissue, especially in visceral fat, suggesting an important role for this tissue in determining COVID-19 disease severity. In this perspective article, we discuss group differences in the amount of visceral fat levels and the extent of inflammation in adipocytes of visceral fat tissue, which may, in part, drive population, cross-national, ethnic, and sex differences in COVID-19 disease. It is vital to steer the scientific community’s attention to the effects of visceral fat in creating individual and population differences in COVID-19 severity. This can help researchers unravel the reasons for the reported population, ethnic, and sex differences in COVID-19 severity and mortality.
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34
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Bourdas DI, Zacharakis ED. Impact of COVID-19 Lockdown on Physical Activity in a Sample of Greek Adults. Sports (Basel) 2020; 8:E139. [PMID: 33096721 PMCID: PMC7589063 DOI: 10.3390/sports8100139] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023] Open
Abstract
It is well known that physical inactivity increases the risk of global death; however, the impact of the coronavirus disease 2019 (COVID-19) lockdown strategy on physical activity (PA) remains unclear. This study compared PA-i.e., daily occupation, transportation to and from daily occupation, leisure time activities, and regular sporting activities-prior (PRE) and during (POST) the on-going COVID-19 outbreak in the Greece lockdown environment. A Greek version of the web-based Active-Q questionnaire was used to access PA. The questionnaire was filled out twice (once each for the PRE and POST conditions) by 8495 participants (age = 37.2 ± 0.2 years (95% confidence interval (CI), 36.9-37.5); males = 38.3% (95%CI, 36.7-40.0); females = 61.7% (95%CI, 60.4-63.0). The relative frequency of overall sporting activities, which, prior to lockdown, occurred at least once per month, and overall participation in competitive sports was significantly reduced (8.6% (95%CI, 7.9-9.3) and 84.7% (95%CI, 82.9-86.6) respectively). With the exception of overall leisure time activities, which were significantly increased in the POST condition, daily occupational, transportation, and sporting activities significant reduced (p < 0.05). Overall PA was reduced in all genders, age, body mass index (BMI) and PA level subgroups in the POST condition, and an interaction between the males and High PA subgroups was observed. The change in overall PA (from PRE to POST conditions) was -16.3% (95%CI, -17.3 to -15.4), while in daily occupational, transportation, and sporting activities, it was -52.9% (95%CI, -54.8-51.0), -41.1% (95%CI, -42.8-39.5) and -23.9% (95%CI, -25.1-22.8), respectively. Thus, the lockdown period is highly associated with a negative change in overall PA. During lockdown, inactivity increased dramatically, with males and the high PA population affected significantly more. The decline in PA is a great concern due to possible long-term consequences on public health and healthcare system.
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Affiliation(s)
- Dimitrios I. Bourdas
- Department of Sports Medicine & Biology of Exercise, National and Kapodistrian University of Athens, Ethnikis Antistasis 41, 17237 Dafni, Greece
| | - Emmanouil D. Zacharakis
- School Physical Education and Sport Science, National and Kapodistrian University of Athens, Ethnikis Antistasis 41, 17237 Dafni, Greece;
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35
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Isbill J, Kandiah J, Kružliaková N. Opportunities for Health Promotion: Highlighting Herbs and Spices to Improve Immune Support and Well-being. Integr Med (Encinitas) 2020; 19:30-42. [PMID: 33488303 PMCID: PMC7815254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CONTEXT Consuming a balanced and varied diet is beneficial for health, especially when individuals feel stressed, scared, insecure, unequipped, or disempowered from maintaining their health during the COVID-19 pandemic. Nutrient deficiencies from inadequate intake of healthful foods can contribute to a weakened immune system and greater susceptibility to infection. Including herbs and spices in a balanced and diverse diet is one of the highlights of nutritious eating that supports health and immunity. OBJECTIVE The review intended to examine ways to integrate specific herbs and spices into people's diets and to use them therapeutically in holistic, integrated health promotion. DESIGN The research team performed a narrative review by searching PubMed Central and Google Scholar databases. The team developed a search strategy focused on specific common names of spices and herbs in combination with other terms, such as health benefits, health promotion, immunity, inflammation. SETTING This review was conducted in Muncie and Columbus, Indiana. RESULTS This review uncovered studies documenting the many therapeutic properties of herbs within the lamiaceae family, particularly basil and spearmint, and spices, including cloves, ginger, and turmeric. Substantial evidence suggests that consumption of a healthful diet, inclusive of herbs and spices, may strengthen the body's immune system against diseases including highly contagious viruses. CONCLUSIONS With respect to herbs and spices, the current review's findings can help to inform and support future recommendations for a standard within the professions of health to provide an improved, healthier, and well-educated dietary guidance for individuals. More studies are needed on the consumption of herbs and spices in human trials to elicit evidence beyond preclinical and animal studies.
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36
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Daanen H, Bose-O'Reilly S, Brearley M, Flouris DA, Gerrett NM, Huynen M, Jones HM, Lee JKW, Morris N, Norton I, Nybo L, Oppermann E, Shumake-Guillemot J, Van den Hazel P. COVID-19 and thermoregulation-related problems: Practical recommendations. Temperature (Austin) 2020; 8:1-11. [PMID: 33553500 PMCID: PMC7849778 DOI: 10.1080/23328940.2020.1790971] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic started in the cold months of the year 2020 in the Northern hemisphere. Concerns were raised that the hot season may lead to additional problems as some typical interventions to prevent heat-related illness could potentially conflict with precautions to reduce coronavirus transmission. Therefore, an international research team organized by the Global Health Heat Information Network generated an inventory of the specific concerns about this nexus and began to address the issues. Three key thermal and covid-19 related topics were highlighted: 1) For the general public, going to public cool areas in the hot season interferes with the recommendation to stay at home to reduce the spread of the virus. Conflicting advice makes it necessary to revise national heat plans and alert policymakers of this forecasted issue. 2) For medical personnel working in hot conditions, heat strain is exacerbated due to a reduction in heat loss from wearing personal protective equipment to prevent contamination. To avoid heat-related injuries, medical personnel are recommended to precool and to minimize the increase in body core temperature using adopted work/rest schedules, specific clothing systems, and by drinking cold fluids. 3) Fever, one of the main symptoms of COVID-19, may be difficult to distinguish from heat-induced hyperthermia and a resting period may be necessary prior to measurement to avoid misinterpretation. In summary, heat in combination with the COVID-19 pandemic leads to additional problems; the impact of which can be reduced by revising heat plans and implementing special measures attentive to these compound risks.
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Affiliation(s)
- Hein Daanen
- Department of Human Movement Sciences. Faculty of Behavioral and Movement Sciences. Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany.,Institute for Public Health, Medical Decision Making and HTA, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.,Hospital St. Hedwig of the Order of St. John, Institute and Clinic for Occupational, Social and Environmental Medicine, University Children's Hospital Regensburg (KUNO), University of Regensburg, Regensburg, Munich, Germany
| | - Matt Brearley
- National Critical Care and Trauma Response Centre, Australia
| | - D Andreas Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Greece
| | - Nicola M Gerrett
- Department of Human Movement Sciences. Faculty of Behavioral and Movement Sciences. Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maud Huynen
- Maastricht University Institute (MSI), Maastricht University, Maastricht, The Netherlands
| | - Hunter M Jones
- University Corporation for Atmospheric Research in Service to the U.S. National Oceanic & Atmospheric Administration, Silver Spring, MD, USA
| | - Jason Kai Wei Lee
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Global Asia Institute, National University of Singapore, Singapore.,N.1 Institute for Health, National University of Singapore, Singapore
| | | | - Ian Norton
- Respond Global, Australia.,Previously World Health Organization, Switzerland
| | - Lars Nybo
- University of Copenhagen, Copenhagen, Denmark
| | - Elspeth Oppermann
- Department Für Geographie, Ludwig-Maximilians-Universität München, Germany
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37
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Chatterjee S, Ghosh R, Biswas P, Dubey S, Guria RT, Sharma CB, Kalra S. COVID-19: the endocrine opportunity in a pandemic. MINERVA ENDOCRINOL 2020; 45:204-227. [PMID: 32548995 DOI: 10.23736/s0391-1977.20.03216-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The 2019 Coronavirus disease (COVID-19) pandemic has disrupted the social, economical and medical system worldwide. Although it is strictly an infectious disease, its intricate bidirectional relationship with various non-communicable metabolic diseases and endocrinological factors has been observed. While diabetes, hypertension, obesity have been found to be independent risk factors for COVID-19 disease severity and mortality, more inclination towards sedentary lifestyle, psychosocial stress at this critical time may be the harbingers of metabolic syndrome. Thus, endocrinologists have a great opportunity to play their role to combat this pandemic. This paper examines how various endocrinological disorders influence the dynamics of COVID-19 and vice versa. Moreover, it also intends to review the clinical guidelines to be adopted in practice of endocrinology in this trying time.
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Affiliation(s)
- Subhankar Chatterjee
- Department of General Medicine, Rajendra Institute of Medical Sciences, Ranchi, India -
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India
| | - Payel Biswas
- Department of Radiodiagnosis, Care and Cure Hospital, Barasat, India
| | - Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Rishi T Guria
- Department of General Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Chandra B Sharma
- Department of General Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
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38
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Olaimat AN, Aolymat I, Shahbaz HM, Holley RA. Knowledge and Information Sources About COVID-19 Among University Students in Jordan: A Cross-Sectional Study. Front Public Health 2020; 8:254. [PMID: 32574314 PMCID: PMC7274134 DOI: 10.3389/fpubh.2020.00254] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, and it was officially declared to be a pandemic by the World Health Organization (WHO) on March 11, 2020. Most countries over the entire globe have reported some COVID-19 cases. The current study aimed to assess student knowledge about COVID-19 at different Jordanian universities and determine where they sourced their information. Methods:A cross-sectional study was conducted among 2,083 undergraduate or postgraduate students from different governmental and private universities during the initial stage of the disease in Jordan (March 19–21, 2020) using a validated, structured, self-administered, online questionnaire. The survey was structured to assess their knowledge about viral sources, incubation period, mortality rate, transmission, symptoms and complications as well as the source of information about COVID-19. Results:Overall, 56.5% of the respondents showed good knowledge and almost 40.5% showed moderate knowledge. On the other hand, 3.0% of the participants showed poor knowledge about COVID-19. The average knowledge score of students was 80.1%, which is considered to be within the scale of good knowledge. Both the college of study and educational level significantly (P < 0.05) associated with student knowledge. Students who majored in medical sciences showed the highest mean score of 82.8%, with 69.0% displaying a good knowledge level. Postgraduate students had significantly higher knowledge scores compared to undergraduate students. The majority of students used the internet, social media and mass media as sources of information about COVID-19. Scientific websites and articles were used more commonly by medical and postgraduate students. Conclusions:The COVID-19 pandemic is a major challenge to the health of the world population; therefore, these results assessing students' knowledge provide an important baseline for planning required educational interventions such as contact tracing and self-quarantine. These results may also help public health authorities by engaging communities in implementation of protective health measures, including positive hygienic practices such as hand washing to reduce the risk of COVID-19.
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Affiliation(s)
- Amin N Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Iman Aolymat
- Department of Cellular and Molecular Physiology, Faculty of Health and Life Sciences, School of Medicine, University of Liverpool, Liverpool, United Kingdom.,Department of Basic Medical Sciences, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Hafiz M Shahbaz
- Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Richard A Holley
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
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39
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Raony Í, de Figueiredo CS, Pandolfo P, Giestal-de-Araujo E, Oliveira-Silva Bomfim P, Savino W. Psycho-Neuroendocrine-Immune Interactions in COVID-19: Potential Impacts on Mental Health. Front Immunol 2020; 11:1170. [PMID: 32574266 PMCID: PMC7267025 DOI: 10.3389/fimmu.2020.01170] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The impacts of the disease may be beyond the respiratory system, also affecting mental health. Several factors may be involved in the association between COVID-19 and psychiatric outcomes, such as fear inherent in the pandemic, adverse effects of treatments, as well as financial stress, and social isolation. Herein we discuss the growing evidence suggesting that the relationship between SARS-CoV-2 and host may also trigger changes in brain and behavior. Based on the similarity of SARS-CoV-2 with other coronaviruses, it is conceivable that changes in endocrine and immune response in the periphery or in the central nervous system may be involved in the association between SARS-CoV-2 infection and impaired mental health. This is likely to be further enhanced, since millions of people worldwide are isolated in quarantine to minimize the transmission of SARS-CoV-2 and social isolation can also lead to neuroendocrine-immune changes. Accordingly, we highlight here the hypothesis that neuroendocrine-immune interactions may be involved in negative impacts of SARS-CoV-2 infection and social isolation on psychiatric issues.
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Affiliation(s)
- Ícaro Raony
- School of Medicine, Federal Fluminense University, Niterói, Brazil.,Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Camila Saggioro de Figueiredo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Pablo Pandolfo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil
| | - Elizabeth Giestal-de-Araujo
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation - INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Priscilla Oliveira-Silva Bomfim
- Department of Neurobiology and Program of Neurosciences, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation - INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wilson Savino
- National Institute of Science and Technology on Neuroimmunomodulation - INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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