scholarly journals SARS-CoV-2 and Obesity: “CoVesity”—a Pandemic Within a Pandemic

2021 ◽  
Author(s):  
Kimberley Zakka ◽  
◽  
Swathikan Chidambaram ◽  
Sami Mansour ◽  
Kamal Mahawar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Viral Load ◽  
Respiratory Failure ◽  
Health Outcomes ◽  
Severe Disease ◽  
Vulnerable Population ◽  
Low Grade ◽  
Obesity Management ◽  
Low Grade Inflammation

AbstractIndividuals who are overweight or suffering from obesity are in a chronic state of low-grade inflammation, making them particularly susceptible to developing severe forms of respiratory failure. Studies conducted in past pandemics link obesity with worse health outcomes. This population is thus of particular concern within the context of the COVID-19 pandemic, considering the cessation of obesity management services. This systematic review highlights [1] the reciprocal link between the obesity and COVID-19 pandemics, [2] obesity as a risk factor for more severe disease in past pandemics, [3] potential mechanisms that make individual’s suffering from obesity more susceptible to severe disease and higher viral load, and [4] the need to safely resume bariatric services as recommended by expert guidelines, in order to mitigate the health outcomes of an already vulnerable population.

scholarly journals SARS-CoV-2 and Obesity: “CoVesity” - A Pandemic Within A Pandemic

2020 ◽  
Author(s):  
Kimberley Zakka ◽  
Swathikan Chidambaram ◽  
Sami Mansour ◽  
Kamal Mahawar ◽  
Paulina Salminen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Viral Load ◽  
Respiratory Failure ◽  
Health Outcomes ◽  
Severe Disease ◽  
Vulnerable Population ◽  
Low Grade ◽  
Obesity Management ◽  
Low Grade Inflammation

Abstract Individuals who are overweight or obese are in a chronic state of low-grade inflammation, making them particularly susceptible to developing severe forms of respiratory failure. Studies conducted in past pandemics link obesity with worse health outcomes. This population is thus of particular concern within the context of the COVID-19 pandemic, considering the cessation of obesity management services. This systematic review highlights (1) the reciprocal link between the obesity and COVID-19 pandemics (2) obesity as a risk factor for more severe disease in past pandemics, (3) potential mechanisms that make obese individuals more susceptible to severe disease and higher viral load, (4) the need to safely resume bariatric services as recommended by expert guidelines, in order to mitigate the health outcomes of an already vulnerable population.

scholarly journals Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Flook ◽  
C. Jackson ◽  
E. Vasileiou ◽  
C. R. Simpson ◽  
M. D. Muckian ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Systematic Review ◽  
At Risk ◽  
Risk Factor ◽  
Disease Severity ◽  
Severe Disease ◽  
Public Health Response ◽  
Wide Range ◽  
Multivariable Analyses

Abstract Background Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. Methods Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. Conclusions The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. Registration This review was registered on PROSPERO as CRD42020177714.

Atopy as a risk factor for subclinical hypothyroidism development in children

2017 ◽  
Vol 30 (8) ◽  
Author(s):  
Marcella Pedullà ◽  
Giuseppina Rosaria Umano ◽  
Vincenzo Fierro ◽  
Francesco Capuano ◽  
Anna Di Sessa ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Concentration ◽  
Subclinical Hypothyroidism ◽  
Significant Risk ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Low Grade ◽  
Work Up ◽  
Low Grade Inflammation ◽  
Serum Tsh

AbstractBackground:Increased thyroid stimulating hormone (TSH) serum concentration can be a marker of subclinical hypothyroidism (SCH) or transient hyperthyrotropinemia. The aim of our study was to evaluate whether high serum TSH concentrations in allergic children could represent true SCH or isolated and transient hyperthyrotropinemia.Methods:We enrolled 620 allergic children (1.11–12.8 years) consecutively attending to our department. They were classified as atopics and non-atopics on the basis of the atopy work-up and, at baseline, they were investigated for thyroid function and low-grade inflammation state. Further, TSH was evaluated after 6 (T1) and 12 (T2) months.Results:Both atopics and non-atopics showed higher SCH prevalence compared to controls (p=0.0055 and p=0.02, respectively), and a significant association between atopy and SCH (OR 10.11, 95% CI 1.36–75.12) was found. Both at T1 and T2, atopics had a significant risk of developing severe SCH compared to non-atopics (RR 1.8, 95% CI 1.39–2.34 and 1.61, 95% CI 1.21–2.14; respectively).Conclusions:Our data may suggest that hyperthyrotropinemia in atopic children could be used as a marker of true SCH.

scholarly journals Smoking and Comorbidities in Covid-19: A Systematic Review

2020 ◽  
Vol 9 (2) ◽  
pp. 117-125
Author(s):  
Andri Nugraha ◽  
Ernawati Ernawati ◽  
Tuti Anggriani Utama ◽  
Santi Rinjani
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
High Risk ◽  
Full Text ◽  
Severe Disease ◽  
Severe Illness ◽  
Severe Infections

COVID-19 is highly contagious, causing pneumonia, respiratory failure, death, and becoming a pandemic. Patients with severe infections must be treated in the Intensive Care Unit (ICU) with a ventilator. Ventilator facilities in the ICU are limited; it must take precautions by knowing the characteristics of patients at high risk of severe disease in COVID-19, one of which was smoking or comorbidity. The purpose of this study was to assess the risk of comorbidity and smoking in COVID-19. This study used systematic review by searching for articles from the ScienceDirect and Medline databases with journals published on January 1, 2019 - March 31, 2020. The results of the study showed that there were 12 relevant articles full text in English and were analysed. The conclusion was that patients with COVID-19 who were smoking or had comorbidities were more susceptible to COVID-19 infection, more severe illness, and causing death.

scholarly journals Systematic review and patient-level meta-analysis of SARS-CoV-2 viral dynamics to model response to antiviral therapies

2020 ◽  
Author(s):  
Silke Gastine ◽  
Juanita Pang ◽  
Florencia A.T. Boshier ◽  
Simon J Carter ◽  
Dagan O. Lonsdale ◽  
...  
Keyword(s):  
Systematic Review ◽  
Viral Load ◽  
Case Reports ◽  
Meta Analysis ◽  
Severe Disease ◽  
Case Series ◽  
Viral Clearance ◽  
Viral Dynamics ◽  
Viral Loads ◽  
Patient Level

Background: SARS-CoV-2 viral loads change rapidly following symptom onset so to assess antivirals it is important to understand the natural history and patient factors influencing this. We undertook an individual patient-level meta-analysis of SARS-CoV-2 viral dynamics in humans to describe viral dynamics and estimate the effects of antivirals used to-date. Methods: This systematic review identified case reports, case series and clinical trial data from publications between 1/1/2020 and 31/5/2020 following PRISMA guidelines. A multivariable Cox proportional hazards regression model (Cox-PH) of time to viral clearance was fitted to respiratory and stool samples. A simplified four parameter nonlinear mixed-effects (NLME) model was fitted to viral load trajectories in all sampling sites and covariate modelling of respiratory viral dynamics was performed to quantify time dependent drug effects. Findings: Patient-level data from 645 individuals (age 1 month-100 years) with 6316 viral loads were extracted. Model-based simulations of viral load trajectories in samples from the upper and lower respiratory tract, stool, blood, urine, ocular secretions and breast milk were generated. Cox-PH modelling showed longer time to viral clearance in older patients, males and those with more severe disease. Remdesivir was associated with faster viral clearance (adjusted hazard ratio (AHR) = 9.19, p<0.001), as well as interferon, particularly when combined with ribavirin (AHR = 2.2, p=0.015; AHR = 6.04, p = 0.006). Interpretation: Combination therapy including interferons should be further investigated. A NLME model for designing and analysing viral pharmacodynamics in trials has been established.

scholarly journals Health Benefits of Plant-Based Nutrition: Focus on Beans in Cardiometabolic Diseases

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 519
Author(s):  
Amy P. Mullins ◽  
Bahram H. Arjmandi
Keyword(s):  
Body Weight ◽  
Risk Factor ◽  
Disease Risk ◽  
Excess Body Weight ◽  
Low Grade ◽  
Protective Effects ◽  
Related Disease ◽  
Dietary Strategy ◽  
Health And Disease ◽  
Low Grade Inflammation

Cardiovascular disease (CVD) is the leading cause of death worldwide, claiming over 650,000 American lives annually. Typically not a singular disease, CVD often coexists with dyslipidemia, hypertension, type-2 diabetes (T2D), chronic system-wide inflammation, and obesity. Obesity, an independent risk factor for both CVD and T2D, further worsens the problem, with over 42% of adults and 18.5% of youth in the U.S. categorized as such. Dietary behavior is a most important modifiable risk factor for controlling the onset and progression of obesity and related disease conditions. Plant-based eating patterns that include beans and legumes support health and disease mitigation through nutritional profile and bioactive compounds including phytochemical. This review focuses on the characteristics of beans and ability to improve obesity-related diseases and associated factors including excess body weight, gut microbiome environment, and low-grade inflammation. Additionally, there are growing data that link obesity to compromised immune response and elevated risk for complications from immune-related diseases. Body weight management and nutritional status may improve immune function and possibly prevent disease severity. Inclusion of beans as part of a plant-based dietary strategy imparts cardiovascular, metabolic, and colon protective effects; improves obesity, low-grade inflammation, and may play a role in immune-related disease risk management.

scholarly journals Implication of Aging Related Chronic Neuroinflammation on COVID-19 Pandemic

2020 ◽  
Vol 10 (3) ◽  
pp. 102 ◽  
Author(s):  
Paola Bossù ◽  
Elisa Toppi ◽  
Valentina Sterbini ◽  
Gianfranco Spalletta
Keyword(s):  
Severe Disease ◽  
Severe Case ◽  
Innate Immune ◽  
Low Grade ◽  
Chronic Neuroinflammation ◽  
Low Grade Inflammation ◽  
The Brain ◽  
Neuropsychiatric Conditions

SARS-CoV-2, the virus responsible for the COVID-19 pandemic, leads to a respiratory syndrome and other manifestations. Most affected people show no or mild symptoms, but the risk of severe disease and death increases in older people. Here, we report a narrative review on selected studies targeting aging-related chronic neuroinflammation in the COVID-19 pandemic. A hyperactivation of the innate immune system with elevated levels of pro-inflammatory cytokines occurs during severe COVID-19, pointing to an important role of the innate immune dysregulation in the disease outcome. Aging is characterized by a general condition of low-grade inflammation, also connected to chronic inflammation of the brain (neuroinflammation), which is involved in frailty syndrome and contributes to several age-associated diseases, including neurodegenerative and neuropsychiatric disorders. Since neuroinflammation can be induced or worsened by the virus infection itself, as well as by stressful conditions like those linked to the recent pandemic, the role of neuroinflammatory mechanisms could be central in a vicious circle leading to an increase in the mortality risk in aged COVID-19 patients. Furthermore, triggered neuroinflammatory pathways and consequent neurodegenerative and neuropsychiatric conditions might be potential long-term complications of COVID-19. In order to provide insights to help clinicians in identifying patients who progress to a more severe case of the disease, this review underlines the potential implications of aging-related neuroinflammation in COVID-19 pandemic.

scholarly journals Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

2020 ◽  
Author(s):  
Anton S.M. Dofferhoff ◽  
Ianthe Piscaer ◽  
Leon J. Schurgers ◽  
Jona Walk ◽  
Jody M.W. van den Ouweland ◽  
...  
Keyword(s):  
Risk Factor ◽  
Respiratory Failure ◽  
Severe Acute Respiratory Syndrome ◽  
Vitamin K ◽  
Poor Prognosis ◽  
Severe Disease ◽  
Significant Proportion ◽  
Matrix Gla Protein ◽  
Intervention Trial ◽  
Elastin Degradation

Introduction: Coronavirus 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2. The majority of patients have at most mild symptoms, however, a significant proportion develops respiratory failure. COVID-19 may also progress beyond the lungs. Coagulopathy and thromboembolism are prevalent in severe COVID-19 and relate to decreased survival. Coagulation is an intricate balance between clot promoting and dissolving processes in which vitamin K plays a well-known role. We hypothesized that vitamin K status is reduced in patients with severe COVID-19. Methods: Vitamin K status was assessed by measuring desphospho-uncarboxylated matrix Gla protein (dp-ucMGP; inversely related to vitamin K status) and the rate of elastin degradation by measuring desmosine. We included 123 patients who were admitted with COVID-19 and 184 controls. Results: Dp-ucMGP levels were significantly elevated in COVID-19 patients (1,673&Aring;}1,584 pmol/L) compared to controls (536&plusmn;291 pmol/L; p&lt;0.0005). Dp-ucMGP levels were significantly higher in COVID-19 patients with unfavorable outcome compared to those with less severe disease. Furthermore, dp-ucMGP and desmosine levels were significantly associated (r=0.65; p&lt;0.0005). Conclusions: Vitamin K status was reduced in patients with COVID-19 and related to poor prognosis. Also, low vitamin K status seems to be associated with accelerated elastin degradation. An intervention trial is now needed to assess whether vitamin K administration improves outcome in patients with COVID-19.

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