Could the presence of adrenal incidentaloma negatively affect COVID 19 outcomes?

BACKGROUND AND OBJECTIVE: Adrenal incidentalomas (AIs) are lesions larger than 1 cm that are incidentally detected in the adrenal glands. Chest computed tomography (CCT) is widely used in the first evaluation of patients with suspected coronavirus disease (COVID-19) that resulted in many incidental findings in the thorax and upper abdomen. In this study, we aimed to investigate the frequency of AI and their effects on the course and outcome of COVID-19 regardless of functional status. MATERIAL AND METHODS: We included 2493 patients aged between 18 and 99 years and whose adrenal glands were clearly visible in CCT images. They were divided into two groups: those with AI (AI group) and without AI (Control group). RESULTS: AI was detected in 148 (5.93%) patients and 80 (54.1%) of them were male. There was no difference in sex distribution between the groups, but the median age of patients with AI was significantly higher than those without AI [54.5 (20-94 years) vs. 42 (18-99 years); p < 0.001)]. In addition, in the AI group, both hospitalizations due to COVID-19-related conditions (30.4 vs. 21.2%, p = 0.008) and the mortality rate experienced during this time was significantly higher (14.7 vs. 7%, p < 0.001) diseases. The AI group had a significantly higher comorbidity rate than the control group (61.5 vs. 41.9%, p < 0.001). The most common comorbid diseases were hypertension, cardiovascular diseases, diabetes mellitus, respiratory system diseases, and hyperlipidaemia. Advanced age and male gender in terms of mortality, advanced age and covid 19 positivity in terms of hospitalization were determined as significant risk factors. CONCLUSIONS: The presence of AI may increase the morbidity and mortality rates associated with COVID-19, regardless of their functional status. Therefore, patients subjected to CCT imaging for COVID-19-related lung diseases should also be evaluated for AI. Careful follow-up of patients with COVID-19 and AI is necessary to monitor the progression of COVID-19.

Demographic, clinical and laboratory characteristics of adult-onset minimal change disease in Turkey: Turkish Society of Nephrology-Glomerular Diseases (TSN-GOLD) Working Group.

PURPOSE: In our study, diagnostic and demographic characteristics of patients diagnosed with minimal change disease (MCD) by biopsy, clinical and laboratory findings in our country were investigated. METHODS: Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented are cross-sectional and includes application data for the biopsy period. RESULTS: Of 3875 patients, 233 patients with MCD (median age 35.0 years) were included in the study, which constitutes 6.0% of the total glomerulonephritis database. Renal biopsy was performed in 196 (84.1%) patients due to nephrotic syndrome. Median serum creatinine was 0.7 (0.6-1.0) mg/dl, mean eGFR was 104 ± 33 ml/min/1.73 m2 and median proteinuria 6000 mg/day. The number of patients under the age of 40 years was 139 (59.7%) (Group A), and the number of patients aged 40 years and over was 94 (40.3%) (Group B). Compared to Group A, global sclerotic glomeruli (24 vs. 43, p < 0.001) interstitial inflammation (15 vs. 34, p < 0.001), interstitial fibrosis (20 vs. 31, p = 0.001, vascular changes (10 vs. 25, p < 0.001) and tubular atrophy (18 vs. 30, p < 0.001) were found to be significantly higher in Group B. There was no difference in immunofluorescent staining properties between the two groups. CONCLUSION: Our data are generally compatible with the literature. Chronic histopathological changes were more common in patients aged 40 years and older than younger patients. Studies investigating the effects of these different features on renal survival are needed.

Food Addiction Correlates with Psychosocial Functioning More Than Metabolic Parameters in Patients with Obesity.

Aim: To investigate the association of food addiction (FA) with the psychosocial functioning and metabolic parameters in obese patients seeking weight-loss treatment. Methods: Two hundred twenty-four obese patients (male/female: 28/196) with a mean age of 44.5 ± 13.4 years and body mass index (BMI) of 41.6 ± 7.2 were included in the study. After receiving sociodemographic data and medical history, detailed physical examination, including anthropometric measurements, was performed by an experienced physician. Blood samples were taken after 8-12 hr of fasting. The presence of FA was evaluated by using Yale Food Addiction Scale (YFAS). Psychological evaluation was performed by using a self-reported Patient Health Questionnaire-9 (PHQ-9) and health-related quality of life using the 36-item short-form health survey (SF-36). Results: Seventy-two of 224 (32.1%) patients met the criteria for FA, according to YFAS. The mean age of patients with FA was younger compared with patients without FA (P < 0.001). There was no statistically significant difference between the patients with and without FA in terms of BMI, fat percentage, and waist circumference (P = 0.440, P = 0.644, and P = 0.144, respectively). The depression frequency was significantly higher (61.1%, P < 0.001), while the SF-36 score of mental health was lower (P = 0.027) in patients with FA than in the patients without FA. Age- and sex-adjusted mean fasting plasma glucose level was lower in patients with FA (P = 0.021), but serum insulin levels, HOMA-IR (homeostasis model assessment of insulin resistance), HbA1c (hemoglobin A1c), lipid parameters, and vascular adiposity index were comparable. Conclusions: We found that FA frequency was very high in obese patients seeking treatment for weight loss, and it correlates with psychosocial functioning more than metabolic parameters.