Does COVID-19 Cause Non-Dipper Hypertension?

Coronavirus disease 2019 (COVID-19) remains a health problem worldwide. The present study aimed to investigate the effect of blood pressure (BP) on the circadian pattern and prevalence of new-onset non-dipper hypertension in the post-COVID period in patients with known hypertension. This prospective single-center study included 722 patients hospitalized for COVID-19 infection. Ambulatory BP (ABP) data were collected during their initial hospitalization. The ABP data were reassessed 1 month after the patients were discharged. The results were compared with a healthy control group with known hypertension but without COVID-19 infection. After exclusion criteria were applied, the study included 187 patients with COVID-19 and 136 healthy hypertensive controls. Post-COVID ABP showed that patients with COVID-19 had significantly higher mean 24-h systolic and diastolic BP, mean nighttime systolic and diastolic BP, and mean daytime diastolic BP than the control group. In addition, new-onset non-dipper hypertension was significantly higher in patients with COVID-19. This study demonstrated for the first time that the circadian pattern is disturbed and a non-dipper pattern develops in individuals with known hypertension during the post-COVID period.

Prognostic value of R wave peak time in COVID-19 pneumonia.

BACKGROUND: R wave peak time (RWPT) is also known as intrinsicoid deflection time or ventricular activation time. It shows the conduction time from the endocardium in the ventricle to the epicardium. It provides diagnostic and prognostic information for many cardiovascular diseases, such as RWPT prolongation, left ventricular hypertrophy, volume overload, conduction system abnormalities, and myocardial ischemia. Objectives The aim of this study is to investigate the relationship between COVID-19 mortality and RWPT in superficial ECG. METHODS: This study retrospectively examined 640 patients diagnosed with COVID-19 and treated in an intensive care unit at a single center between January 2021 and June 2022. All patients included in the study had clinical and radiological characteristics and signs of COVID-19 pneumonia. RESULTS: 640 patients included in the study were divided into 2 groups: surviving and deceased. There were 510 patients in the surviving group and 130 patients in the deceased group. The deceased group was found to be significantly older. The number of patients with COPD was higher in the deceased group. Troponin, lactate dehydrogenase (LDH), C-reactive protein (CRP), D-dimer and T-peak to T-end interval(Tpe) and RWPT were found to be significantly increased in the deceased group. In binary logistic regression analysis; age, COPD, LDH, CRP, troponin, D-dimer, Tpe interval, RWPT were determined as independent risk factors for mortality. CONCLUSIONS: Prolonged RWPT is useful in risk stratification for COVID-19 pneumonia mortality.

Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options.

PURPOSE: The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. METHODS: We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. RESULTS: Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole ± ß-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. CONCLUSION: This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.

Is interleukin-17 involved in the interaction between polycystic ovary syndrome and gingival inflammation?

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a hormonal disorder of females of reproductive age that impacts their oral and systemic health. The aim of this study is to evaluate interleukin-17A (IL-17A), IL-17F, IL-17A/F, and IL-17E (IL-25) levels in gingival crevicular fluid (GCF), saliva, and serum of non-obese females with PCOS and with either a clinically healthy periodontium or gingivitis. METHODS: Thirty-one females with PCOS, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females participated in the study. Clinical periodontal measurements, body mass index, and Ferriman-Gallwey score (FGS) (a measure of hirsutism in females) were recorded. Circulating levels of sex hormones, cortisol, and insulin were also determined. Levels of IL-17 cytokines were measured by enzyme-linked immunosorbent assay. RESULTS: The general linear model multivariate analysis, adjusting for age or plaque index, showed that the two groups with PCOS had higher concentrations of IL-17A, IL-17F, and IL-17A/F in serum and higher levels of IL-17A and IL-17F in GCF and saliva but lower serum IL-17E than systemically healthy females. Levels of IL-17E were lowest in females with PCOS and gingivitis who also had the highest FGS. Serum IL-17A and IL-17F levels correlated positively with FGS and periodontal probing depth (all ρ >0.33; P <0.005). Serum IL-17E showed the reverse relationship and also correlated negatively with IL-17A (ρ >-0.28; P <0.05). CONCLUSIONS: IL-17 levels are altered in non-obese females with PCOS and may influence gingival inflammation. Additional studies are warranted to clarify the relationship between PCOS and gingivitis.

Is there an interaction between polycystic ovary syndrome and gingival inflammation?

BACKGROUND: The aim of this study is to evaluate the gingival crevicular fluid (GCF), saliva, and serum concentrations of tumor necrosis factor-α (TNF-α), TNF-α receptor-1 (TNF-αR1), TNF-αR2, and interleukin-6 (IL-6) in non-obese females with polycystic ovary syndrome (PCOS) and either clinically healthy periodontium or gingivitis. METHODS: Thirty-one females with PCOS and healthy periodontium, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females were included in the study. GCF, saliva, and serum samples were collected, and clinical periodontal measurements, body mass index, and Ferriman-Gallwey score (FGS) were recorded. Sex hormones, cortisol, and insulin levels were measured. TNF-α, TNF-αR1, TNF-αR2, and IL-6 were determined by enzyme-linked immunosorbent assay. Kruskal-Wallis followed by Bonferroni-corrected post hoc Mann-Whitney U tests were used to analyze the data. RESULTS: The PCOS + gingivitis group revealed significantly higher GCF, saliva, and serum IL-6 concentrations than the PCOS + healthy group (P <0.0001). The two PCOS groups exhibited significantly higher saliva TNF-α concentrations than the control group (P = 0.024 and P = 0.013, respectively). The FGS index was significantly higher in the PCOS + gingivitis group than the PCOS + healthy group (P = 0.030). The PCOS + gingivitis group revealed significantly higher insulin concentration than the PCOS + healthy and control groups (P = 0.014 and P <0.0001, respectively). Serum TNF-α, TNF-αRs, and serum, GCF, and salivary IL-6 levels correlated with the clinical periodontal measurements. CONCLUSIONS: PCOS and gingival inflammation appear to act synergistically on the proinflammatory cytokines IL-6 and TNF-α. Thus, PCOS may have an impact on gingival inflammation or vice versa. Additional studies are warranted to clarify the possible relationship between PCOS and periodontal disease.