Phenome-wide association of 1809 phenotypes and COVID-19 disease progression in the Veterans Health Administration Million Veteran Program

Background The risk factors associated with the stages of Coronavirus Disease-2019 (COVID-19) disease progression are not well known. We aim to identify risk factors specific to each state of COVID-19 progression from SARS-CoV-2 infection through death. Methods and results We included 648,202 participants from the Veteran Affairs Million Veteran Program (2011-). We identified characteristics and 1,809 ICD code-based phenotypes from the electronic health record. We used logistic regression to examine the association of age, sex, body mass index (BMI), race, and prevalent phenotypes to the stages of COVID-19 disease progression: infection, hospitalization, intensive care unit (ICU) admission, and 30-day mortality (separate models for each). Models were adjusted for age, sex, race, ethnicity, number of visit months and ICD codes, state infection rate and controlled for multiple testing using false discovery rate (≤0.1). As of August 10, 2020, 5,929 individuals were SARS-CoV-2 positive and among those, 1,463 (25%) were hospitalized, 579 (10%) were in ICU, and 398 (7%) died. We observed a lower risk in women vs. men for ICU and mortality (Odds Ratio (95% CI): 0.48 (0.30–0.76) and 0.59 (0.31–1.15), respectively) and a higher risk in Black vs. Other race patients for hospitalization and ICU (OR (95%CI): 1.53 (1.32–1.77) and 1.63 (1.32–2.02), respectively). We observed an increased risk of all COVID-19 disease states with older age and BMI ≥35 vs. 20–24 kg/m2. Renal failure, respiratory failure, morbid obesity, acid-base balance disorder, white blood cell diseases, hydronephrosis and bacterial infections were associated with an increased risk of ICU admissions; sepsis, chronic skin ulcers, acid-base balance disorder and acidosis were associated with mortality. Conclusions Older age, higher BMI, males and patients with a history of respiratory, kidney, bacterial or metabolic comorbidities experienced greater COVID-19 severity. Future studies to investigate the underlying mechanisms associated with these phenotype clusters and COVID-19 are warranted.

Download Full-text

A double-blind, placebo-controlled study of the short term effects of a spring water supplemented with magnesium bicarbonate on acid/base balance, bone metabolism and cardiovascular risk factors in postmenopausal women

BMC Research Notes ◽

10.1186/1756-0500-3-180 ◽

2010 ◽

Vol 3 (1) ◽

Cited By ~ 11

Author(s):

Richard O Day ◽

Winston Liauw ◽

Lynette MR Tozer ◽

Patrick McElduff ◽

Russell J Beckett ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Spring Water ◽

Controlled Study ◽

Acid Base Balance ◽

Acid Base ◽

Short Term ◽

Double Blind ◽

Double Blind Placebo ◽

Base Balance

Download Full-text

132. Acid-base Balance Disorder in the Cases of Severe Acute Head Injury

Neurologia medico-chirurgica ◽

10.2176/nmc.9.173b ◽

1967 ◽

Vol 9 ◽

pp. 173b-174

Author(s):

Tetsumi MITANI ◽

Tohru WATANABE ◽

Yuhzo FUJITA

Keyword(s):

Head Injury ◽

Acid Base Balance ◽

Acid Base ◽

Acute Head Injury ◽

Base Balance ◽

Balance Disorder

Download Full-text

Renal problems

10.1093/med/9780199696260.003.0007 ◽

2017 ◽

Author(s):

Sheila Adam ◽

Sue Osborne ◽

John Welch

Keyword(s):

Risk Factors ◽

Functional Anatomy ◽

Kidney Injury ◽

Acid Base Balance ◽

Acid Base ◽

Waste Products ◽

Anatomy And Physiology ◽

Different Types ◽

Base Balance ◽

Life Threatening

The kidneys normally excrete metabolic waste products in urine while maintaining fluid, electrolyte, and acid–base balance. However, critical illness frequently leads to renal impairment, loss of these functions, and potentially life-threatening complications. This chapter describes the functional anatomy and physiology of the renal system, important risk factors for acute kidney injury, and how renal function can be monitored and maintained. The methods, advantages, disadvantages, and practical management of different types of renal replacement therapy are discussed, together with essential aspects of holistic patient care.

Download Full-text

Keseimbangan asam-basa tubuh dan kejadian sindrom metabolik pada remaja obesitas

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.24811 ◽

2017 ◽

Vol 14 (1) ◽

pp. 36

Author(s):

Firdananda Fikri Jauharany ◽

Nurmasari Widyastuti

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Acid Base Balance ◽

Acid Base ◽

Dietary Acid Load ◽

Base Balance ◽

Dietary Acid ◽

Acid Load

Background: The prevalence of metabolic syndrome increased in young population, indicated by the rise in obesity among children and adolescent. The Western dietary pattern was one of the causes. A Western diet rich in animal protein can produce acid during the metabolic process and may cause an acid-excess in the body (dietary acid load). This process was contributed to acid-base balance through the metabolism of sulfur-containing amino acids (cysteine and methionine) which produce H+ ions as well as lowering the pH.Objective: To examine the association between acid-base balance and components of metabolic syndrome among obese adolescent.Method: A cross-sectional study was conducted on 40 obese adolescents in Semarang high school. We measured Potential Renal Acid Load (PRAL) score and pH urine as an acid-base indicator. MetS are defined ≥ 3 following risk factors: waist circumference ≥90th percentile, blood pressure ≥90th percentile, triglycerides ≥110 mg/dl, HDL levels ≤40 mg/dl, and fasting blood glucose levels ≥110 mg/dl. Normality test used the Shapiro-Wilk test (n <50). The bivariate analysis used Pearson test, Rank-Spearman test, and Chi-Square test. The multivariate analysis used Multivariate Linear Regression analysis of Backward.Results: PRAL score was associated with waist circumference (r=0,347; p=0,028), sistolic blood pressure (r=0,590; p=<0,001), diastolic blood pressure (r=0,668; p=<0,001), and triglyceride levels (r=0,362; p=0,022). pH urin was not associated with any risk factors of MetS.Conclusion: High dietary acid load may be a risk factor for the development of MetS.

Download Full-text

Metabolic Acidosis: Diagnostics and Treatment

Педиатрическая фармакология ◽

10.15690/pf.v13i4.1612 ◽

2016 ◽

Vol 13 (4) ◽

pp. 384-389 ◽

Cited By ~ 2

Author(s):

R. F. Tepaev ◽

V. V. Lastovka ◽

A. V. Pytal ◽

J. V. Savluk

Keyword(s):

Metabolic Acidosis ◽

Lipid Metabolism ◽

Disease Course ◽

Acid Base Balance ◽

Acid Base ◽

Physiological Basis ◽

Wide Range ◽

Base Balance ◽

Life Threatening ◽

Balance Disorder

Metabolic acidosis is the most common child acid-base balance disorder. This condition accompanies a variety of diseases, and the degree of its severity correlates with the patients’ survival: although not a separate disease in itself, metabolic acidosis, however, can worsen the disease course and even lead to death. The pathology causes are various (in connection with life-threatening changes in various organs and systems — lungs, heart and blood vessels, kidneys, and also due to a violation of lipid metabolism, in case of diabetes, poisoning, etc.), which determines the fact that a wide range of specialists are interested in the issue. Approaches to the diagnosis simplify the search for the etiology of metabolic acidosis. This study presents data on the physiological basis of acid-base balance regulation, and its etiology and pathophysiology; the principles of therapy are observed.

Download Full-text

Higher Dietary Acidity is Associated with Lower Bone Mineral Density in Postmenopausal Iranian Women, Independent of Dietary Calcium Intake

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000207 ◽

2014 ◽

Vol 84 (3-4) ◽

pp. 0206-0217 ◽

Cited By ~ 8

Author(s):

Seyedeh-Elaheh Shariati-Bafghi ◽

Elaheh Nosrat-Mirshekarlou ◽

Mohsen Karamati ◽

Bahram Rashidkhani

Keyword(s):

Calcium Intake ◽

Dietary Calcium ◽

Dietary Calcium Intake ◽

Dietary Intakes ◽

Iranian Women ◽

Acid Base Balance ◽

Mineral Density ◽

Acid Base ◽

Base Balance ◽

Dietary Acid

Findings of studies on the link between dietary acid-base balance and bone mass are relatively mixed. We examined the association between dietary acid-base balance and bone mineral density (BMD) in a sample of Iranian women, hypothesizing that a higher dietary acidity would be inversely associated with BMD, even when dietary calcium intake is adequate. In this cross-sectional study, lumbar spine and femoral neck BMDs of 151 postmenopausal women aged 50 - 85 years were measured using dual-energy x-ray absorptiometry. Dietary intakes were assessed using a validated food frequency questionnaire. Renal net acid excretion (RNAE), an estimate of acid-base balance, was then calculated indirectly from the diet using the formulae of Remer (based on dietary intakes of protein, phosphorus, potassium, and magnesium; RNAERemer) and Frassetto (based on dietary intakes of protein and potassium; RNAEFrassetto), and was energy adjusted by the residual method. After adjusting for potential confounders, multivariable adjusted means of the lumbar spine BMD of women in the highest tertiles of RNAERemer and RNAEFrassetto were significantly lower than those in the lowest tertiles (for RNAERemer: mean difference -0.084 g/cm2; P=0.007 and for RNAEFrassetto: mean difference - 0.088 g/cm2; P=0.004). Similar results were observed in a subgroup analysis of subjects with dietary calcium intake of >800 mg/day. In conclusion, a higher RNAE (i. e. more dietary acidity), which is associated with greater intake of acid-generating foods and lower intake of alkali-generating foods, may be involved in deteriorating the bone health of postmenopausal Iranian women, even in the context of adequate dietary calcium intake.

Download Full-text