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1.
Nutrients ; 13(6)2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34064175

RESUMEN

CONTEXT: Calcifediol has been proposed as a potential treatment for COVID-19 patients. OBJECTIVE: To compare the administration or not of oral calcifediol on mortality risk of patients hospitalized because of COVID-19. DESIGN: Retrospective, multicenter, open, non-randomized cohort study. SETTINGS: Hospitalized care. PATIENTS: Patients with laboratory-confirmed COVID-19 between 5 February and 5 May 2020 in five hospitals in the South of Spain. INTERVENTION: Patients received calcifediol (25-hydroxyvitamin D3) treatment (0.266 mg/capsule, 2 capsules on entry and then one capsule on day 3, 7, 14, 21, and 28) or not. MAIN OUTCOME MEASURE: In-hospital mortality during the first 30 days after admission. RESULTS: A total of 537 patients were hospitalized with COVID-19 (317 males (59%), median age, 70 years), and 79 (14.7%) received calcifediol treatment. Overall, in-hospital mortality during the first 30 days was 17.5%. The OR of death for patients receiving calcifediol (mortality rate of 5%) was 0.22 (95% CI, 0.08 to 0.61) compared to patients not receiving such treatment (mortality rate of 20%; p < 0.01). Patients who received calcifediol after admission were more likely than those not receiving treatment to have comorbidity and a lower rate of CURB-65 score for pneumonia severity ≥ 3 (one point for each of confusion, urea > 7 mmol/L, respiratory rate ≥ 30/min, systolic blood pressure < 90 mm Hg or diastolic blood pressure ≤ 60 mm Hg, and age ≥ 65 years), acute respiratory distress syndrome (moderate or severe), c-reactive protein, chronic kidney disease, and blood urea nitrogen. In a multivariable logistic regression model, adjusting for confounders, there were significant differences in mortality for patients receiving calcifediol compared with patients not receiving it (OR = 0.16 (95% CI 0.03 to 0.80). CONCLUSION: Among patients hospitalized with COVID-19, treatment with calcifediol, compared with those not receiving calcifediol, was significantly associated with lower in-hospital mortality during the first 30 days. The observational design and sample size may limit the interpretation of these findings.


Asunto(s)
59585/tratamiento farmacológico , Calcifediol/administración & dosificación , Mortalidad Hospitalaria , 59565/metabolismo , Anciano , Anciano de 80 o más Años , 59585/sangre , 59585/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
2.
Cells ; 10(5)2021 05 04.
Artículo en Inglés | MEDLINE | ID: mdl-34064487

RESUMEN

Liver injury in COVID-19 patients has progressively emerged, even in those without a history of liver disease, yet the mechanism of liver pathogenicity is still controversial. COVID-19 is frequently associated with increased serum ferritin levels, and hyperferritinemia was shown to correlate with illness severity. The liver is the major site for iron storage, and conditions of iron overload have been established to have a pathogenic role in development of liver diseases. We presented here six patients who developed severe COVID-19, with biochemical evidence of liver failure. Three cases were survived patients, who underwent liver biopsy; the other three were deceased patients, who were autopsied. None of the patients suffered underlying liver pathologies. Histopathological and ultrastructural analyses were performed. The most striking finding we demonstrated in all patients was iron accumulation into hepatocytes, associated with degenerative changes. Abundant ferritin particles were found enclosed in siderosomes, and large aggregates of hemosiderin were found, often in close contact with damaged mitochondria. Iron-caused oxidative stress may be responsible for mitochondria metabolic dysfunction. In agreement with this, association between mitochondria and lipid droplets was also found. Overall, our data suggest that hepatic iron overload could be the pathogenic trigger of liver injury associated to COVID-19.


Asunto(s)
59585/diagnóstico , Sobrecarga de Hierro/etiología , Fallo Hepático/etiología , Hígado/patología , Índice de Severidad de la Enfermedad , Adulto , Anciano , Antivirales , Biopsia , 59585/complicaciones , 59585/mortalidad , 59585/terapia , Femenino , Ferritinas/análisis , Hepatocitos/citología , Hepatocitos/patología , Humanos , Hierro/análisis , Hierro/metabolismo , Sobrecarga de Hierro/mortalidad , Sobrecarga de Hierro/patología , Sobrecarga de Hierro/terapia , Hígado/citología , Hígado/metabolismo , Fallo Hepático/mortalidad , Fallo Hepático/patología , Fallo Hepático/terapia , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Mitocondrias/patología , Respiración con Presión Positiva , 59565/aislamiento & purificación
3.
Nutrients ; 13(5)2021 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-34064715

RESUMEN

Lockdowns to contain the spread of the SARS-CoV-2 have disrupted routines and behaviors, which could lead to a worsening of lifestyle and an increase in the burden of non-communicable diseases. This study aimed to describe the changes in physical activity, diet, alcohol drinking, and cigarette smoking during lockdown. A self-administered online survey addressing adults living in a province in northern Italy was advertised through websites and social media. Citizens could access the survey in anonymity from 4 May until 15 June 2020. A total of 1826 adults completed the survey, with a worsening of physical activity (35.1%), diet (17.6%), alcohol drinking (12.5%), and cigarette smoking (7.7%) reported. In contrast, 33.5% reported an improvement in diet, 12.6% in alcohol drinking, 5.3% in physical activity and 4.1% in cigarette smoking. Female sex, young adult age, suspension of work activity, and symptoms of psychological distress were the factors associated with a greater likelihood of change, which was frequently for the worse. Lockdown had an impact on lifestyle, with some net beneficial effects on diet and mostly negative effects on physical activity. Public health measures should be implemented to avoid long-term negative effects of the lockdown, supporting individuals more prone to change for the worse.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , 59585 , Fumar Cigarrillos/epidemiología , Ejercicio Físico , Conducta Alimentaria , Pandemias , Cuarentena , 59565 , Adolescente , Adulto , Factores de Edad , Anciano , 59585/epidemiología , 59585/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Pública , Factores Sexuales
4.
Nutrients ; 13(5)2021 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-34065655

RESUMEN

During the so-called "second wave of the pandemic" in Europe, the authors conducted a cross-sectional online survey that aimed to examine changes in dietary habits and associated practices, as well as physical activity during the COVID-19 pandemic and before the onset of lockdowns in three European countries: Poland, Austria and the United Kingdom. METHODS: The online observational study, both prospective and retrospective, conducted with the use of social media for the distribution of an anonymous online questionnaire, was completed from 1 October to 30 October 2020, during the second wave of the pandemic in Europe. The study encompassed a total of 1071 adults from Poland (n = 407), Austria (n = 353) and the United Kingdom (n = 311). RESULTS: The results of this study indicate that the COVID-19 confinement period influenced eating behavior and the level of physical activity in a group of adult residents of Poland, Austria and the United Kingdom. The general shopping frequency decreased, regardless of the place and manner. However, there was an increased interest in online grocery shopping. The resulting data revealed an increased frequency of the daily consumption of food products such as dairy, grains, fats, vegetables and sweets (p < 0.05). A rise in the frequency of purchasing frozen goods and food with long shelf life has also been observed. The changed workplace and working conditions or unemployment probably affected a perceptible rise in alcohol consumption (p = 0.02). In turn, physical activity levels markedly decreased, which reflected the body mass changes. CONCLUSION: The dietary habits in the studied countries have changed as a result of the pandemic situation. They contribute to the aggravation of the problem of excess body weight and its health consequences.


Asunto(s)
59585/epidemiología , Conducta Alimentaria , Conductas Relacionadas con la Salud , Pandemias , 59565 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
Nutrients ; 13(5)2021 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-34065864

RESUMEN

The COVID-19 (Coronavirus disease 2019) pandemic is posing a threat to communities and healthcare systems worldwide. Malnutrition, in all its forms, may negatively impact the susceptibility and severity of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection in both children and older adults. Both undernutrition and obesity have been evoked as conditions associated with a higher susceptibility to the infection and poor prognosis. In turn, the COVID-19 infection may worsen the nutritional status through highly catabolic conditions, exposing individuals to the risk of malnutrition, muscle wasting, and nutritional deficiencies. Accordingly, the relationship between malnutrition and COVID-19 is likely to be bidirectional. Furthermore, the modification of nutritional behaviors and physical activity, required to limit the spread of the virus, are posing a challenge to health at both the extremes of life. Thus far, even the most advanced healthcare systems have failed to address the alarming consequences of malnutrition posed by this pandemic. If not properly addressed, we may run the risk that new and old generations will experience the consequences of COVID-19 related malnutrition.


Asunto(s)
59585/epidemiología , 59570 , Desnutrición , Estado Nutricional , Pandemias , 59565 , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Desnutrición/epidemiología , Desnutrición/prevención & control , Persona de Mediana Edad
6.
Curr Oncol ; 28(3): 1867-1878, 2021 05 13.
Artículo en Inglés | MEDLINE | ID: mdl-34068441

RESUMEN

Cancer causes substantial emotional and psychosocial distress, which may be exacerbated by delays in treatment. The COVID-19 pandemic has resulted in increased wait times for many patients with cancer. In this study, the psychosocial distress associated with waiting for cancer surgery during the pandemic was investigated. This cross-sectional, convergent mixed-methods study included patients with lower priority disease during the first wave of COVID-19 at an academic, tertiary care hospital in eastern Canada. Participants underwent semi-structured interviews and completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). Qualitative analysis was completed through a thematic analysis approach, with integration achieved through triangulation. Fourteen participants were recruited, with cancer sites including thyroid, kidney, breast, prostate, and a gynecological disorder. Increased anxiety symptoms were found in 36% of patients and depressive symptoms in 14%. Similarly, 64% of patients experienced moderate or high stress. Six key themes were identified, including uncertainty, life changes, coping strategies, communication, experience, and health services. Participants discussed substantial distress associated with lifestyle changes and uncertain treatment timelines. Participants identified quality communication with their healthcare team and individualized coping strategies as being partially protective against such symptoms. Delays in surgery for patients with cancer during the COVID-19 pandemic resulted in extensive psychosocial distress. Patients may be able to mitigate these symptoms partially through various coping mechanisms and improved communication with their healthcare teams.


Asunto(s)
Ansiedad/epidemiología , 59585/prevención & control , Depresión/epidemiología , Neoplasias/cirugía , Tiempo de Tratamiento , Adaptación Psicológica , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/psicología , 59585/epidemiología , 59585/transmisión , Control de Enfermedades Transmisibles/normas , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Nueva Escocia/epidemiología , Pandemias/prevención & control , Distrés Psicológico , Psicometría/estadística & datos numéricos , Investigación Cualitativa , Autoinforme/estadística & datos numéricos , Triaje/normas , Incertidumbre
7.
Nutrients ; 13(5)2021 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-34068446

RESUMEN

We hypothesised that the higher levels of emotion-related predictors (eating motive in the form of affect regulation and COVID-19-related stress) would be associated with higher emotional overeating, after accounting for the effects of demographic variables (gender and BMI) and other eating motives (visual- and attitude-related predictors: liking, pleasure, visual appeal; body- and health-related predictors: need and hunger, health, weight control). Participants (N = 868; Mage = 33.53 years, SD = 11.98) completed: the Eating Motivation Survey, the Emotional Overeating Questionnaire, a COVID-19-related stress measure and a socio-demographic survey. The final step of the regression with emotional overeating was significant; affect regulation and COVID-19-related stress were significantly related to emotional overeating (ΔF p < 0.001, Adj. ΔR2 = 0.13). During the COVID-19 pandemic, eating can, on the one hand, help to cope with the current difficult situation and the negative emotions associated with it; on the other hand, frequent use of this tendency can lead to rigid regulation of affect and use of this mechanism as the dominant mechanism. Therefore, limited social contact, related disruptions in daily activities and stress resulting from COVID-19 should generate appropriate interventions, not necessarily focusing only on emotional eating, but also on the resources of the individual. It is worth encouraging specialists to implement alternative methods of contact with their patients, e.g., online.


Asunto(s)
59585/epidemiología , Conducta Alimentaria , Hiperfagia/epidemiología , Pandemias , 59565 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Factores de Riesgo
8.
Nutrients ; 13(5)2021 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-34068656

RESUMEN

BACKGROUND: Micronutrients play roles in strengthening and maintaining immune function, but their supplementation and/or deficiency effects on respiratory tract infections are inconclusive. This review aims to systematically assess the associations between micronutrient supplementation or deficiency, with novel coronavirus incidence and disease severity. METHODS: Systematic literature searches conducted in five electronic databases identified 751 unique studies, of which 33 studies (five supplementation studies, one supplementation and deficiency study, and 27 deficiency studies) were eventually included in this review. Proportions of incidence and severity outcomes in each group, and adjusted summary statistics with their relevant 95% confidence intervaIs (CI) were extracted. Data from 19 studies were pooled in meta-analysis using the generic inverse variance method. FINDINGS: A total of 360,346 patients across 16 countries, with a mean age between 32 and 87.7 years, were involved across 33 studies. All studies were on COVID-19 infections. In individuals without micronutrient deficiency, there was a significant reduction on odds of COVID-19 incidence (pooled OR: 0.37, 95% CI: 0.18, 0.78), and ICU admissions or severe/critical disease onset when combined as a severity outcome (pooled OR: 0.26, 95% CI: 0.08, 0.89). Insignificant protective effects were observed on other outcome measures, namely mortality, ICU admission, progression to respiratory-related complications, severe/critical disease onset or requiring respiratory support and hospitalization rate. CONCLUSION: The absence of micronutrient deficiency significantly reduced COVID-19 incidence and clinical deterioration in hospitalized patients. Usage of micronutrients as prophylaxis and complementary supplement in therapeutic management of COVID-19 patients may be a promising and cost-effective approach warranting in-depth investigation.


Asunto(s)
59585 , Suplementos Dietéticos , Desnutrición , Micronutrientes/deficiencia , 59565 , Adulto , Anciano , 59585/epidemiología , 59585/metabolismo , 59585/patología , Femenino , Humanos , Masculino , Desnutrición/epidemiología , Desnutrición/metabolismo , Desnutrición/patología , Persona de Mediana Edad
9.
Nutrients ; 13(5)2021 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-34068824

RESUMEN

BACKGROUND: Acute and chronic alcohol abuse has adverse impacts on both the innate and adaptive immune response, which may result in reduced resistance to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and promote the progression of coronavirus disease 2019 (COVID-19). However, there are no large population-based data evaluating potential causal associations between alcohol consumption and COVID-19. METHODS: We conducted a Mendelian randomization study using data from UK Biobank to explore the association between alcohol consumption and risk of SARS-CoV-2 infection and serious clinical outcomes in patients with COVID-19. A total of 12,937 participants aged 50-83 who tested for SARS-CoV-2 between 16 March to 27 July 2020 (12.1% tested positive) were included in the analysis. The exposure factor was alcohol consumption. Main outcomes were SARS-CoV-2 positivity and death in COVID-19 patients. We generated allele scores using three genetic variants (rs1229984 (Alcohol Dehydrogenase 1B, ADH1B), rs1260326 (Glucokinase Regulator, GCKR), and rs13107325 (Solute Carrier Family 39 Member 8, SLC39A8)) and applied the allele scores as the instrumental variables to assess the effect of alcohol consumption on outcomes. Analyses were conducted separately for white participants with and without obesity. RESULTS: Of the 12,937 participants, 4496 were never or infrequent drinkers and 8441 were frequent drinkers. Both logistic regression and Mendelian randomization analyses found no evidence that alcohol consumption was associated with risk of SARS-CoV-2 infection in participants either with or without obesity (All q > 0.10). However, frequent drinking, especially heavy drinking (HR = 2.07, 95%CI 1.24-3.47; q = 0.054), was associated with higher risk of death in patients with obesity and COVID-19, but not in patients without obesity. Notably, the risk of death in frequent drinkers with obesity increased slightly with the average amount of alcohol consumed weekly (All q < 0.10). CONCLUSIONS: Our findings suggest that alcohol consumption has adverse effects on the progression of COVID-19 in white participants with obesity, but was not associated with susceptibility to SARS-CoV-2 infection.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Alcohol Deshidrogenasa/genética , Consumo de Bebidas Alcohólicas , Bancos de Muestras Biológicas , 59585 , Proteínas de Transporte de Catión/genética , Obesidad , Polimorfismo de Nucleótido Simple , Virus del SRAS , Anciano , Consumo de Bebidas Alcohólicas/genética , Consumo de Bebidas Alcohólicas/mortalidad , 59585/genética , 59585/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Análisis de la Aleatorización Mendeliana , Persona de Mediana Edad , Obesidad/genética , Obesidad/mortalidad , Tasa de Supervivencia , Reino Unido/epidemiología
10.
Nutrients ; 13(5)2021 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-34069412

RESUMEN

Insufficient blood levels of the neurohormone vitamin D are associated with increased risk of COVID-19 severity and mortality. Despite the global rollout of vaccinations and promising preliminary results, the focus remains on additional preventive measures to manage COVID-19. Results conflict on vitamin D's plausible role in preventing and treating COVID-19. We examined the relation between vitamin D status and COVID-19 severity and mortality among the multiethnic population of the United Arab Emirates. Our observational study used data for 522 participants who tested positive for SARS-CoV-2 at one of the main hospitals in Abu Dhabi and Dubai. Only 464 of those patients were included for data analysis. Demographic and clinical data were retrospectively analyzed. Serum samples immediately drawn at the first hospital visit were used to measure serum 25-hydroxyvitamin D [25(OH)D] concentrations through automated electrochemiluminescence. Levels < 12 ng/mL were significantly associated with higher risk of severe COVID-19 infection and of death. Age was the only other independent risk factor, whereas comorbidities and smoking did not contribute to the outcomes upon adjustment. Sex of patients was not an important predictor for severity or death. Our study is the first conducted in the UAE to measure 25(OH)D levels in SARS-CoV-2-positive patients and confirm the association of levels < 12 ng/mL with COVID-19 severity and mortality.


Asunto(s)
59585 , 59565/metabolismo , Índice de Severidad de la Enfermedad , Deficiencia de Vitamina D , Vitamina D/análogos & derivados , Adulto , 59585/sangre , 59585/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tasa de Supervivencia , Emiratos Árabes Unidos/epidemiología , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/mortalidad
11.
Nutrients ; 13(5)2021 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-34069656

RESUMEN

The aim of this observational study was investigating the possible correlation between adherence to the Mediterranean diet (MeD) and SARS-COV-2 infection rates and severity among healthcare professionals (HCPs). An online self-administrated questionnaire (evaluating both MeD adherence and dietary habits) was filled out by HCPs working in Piedmont (Northern Italy) from 15 January to 28 February 2021. Out of the 1206 questionnaires collected, 900 were considered reliable and analyzed. Individuals who reported the SARS-COV-2 infection (n = 148) showed a significantly lower MeD score, with a lower adherence in fruit, vegetables, cereals, and olive oil consumption. In a logistic regression model, the risk of infection was inversely associated with the MeD score (OR = 0.88; 95% CI 0.81-0.97) and the consumption of cereals (OR = 0.64; 0.45-0.90). Asymptomatic individuals with SARS-COV-2 infection reported a lower intake of saturated fats than symptomatic; individuals requiring hospitalization were significantly older and reported worse dietary habits than both asymptomatic and symptomatic individuals. After combining all symptomatic individuals together, age (OR = 1.05; 1.01-1.09) and saturated fats intake (OR = 1.09; 1.01-1.17) were associated with the infection severity. HCPs who reported a SARS-COV-2 infection showed a significantly lower MeD score and cereal consumption. The infection severity was directly associated with higher age and saturated fat intake.


Asunto(s)
59585/epidemiología , Dieta Mediterránea , 59565 , Encuestas y Cuestionarios , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prueba de Estudio Conceptual , Estudios Retrospectivos , Factores de Riesgo
12.
Cells ; 10(6)2021 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-34071149

RESUMEN

The dysregulation of both the innate and adaptive responses to SARS-CoV-2 have an impact on the course of COVID-19, and play a role in the clinical outcome of the disease. Here, we performed a comprehensive analysis of peripheral blood lymphocyte subpopulations in 82 patients with COVID-19, including 31 patients with a critical course of the disease. In COVID-19 patients who required hospitalization we analyzed T cell subsets, including Treg cells, as well as TCRα/ß and γ/δ, NK cells, and B cells, during the first two weeks after admission to hospital due to the SARS-CoV-2 infection, with marked reductions in leukocytes subpopulations, especially in critically ill COVID-19 patients. We showed decreased levels of Th, Ts cells, Treg cells (both naïve and induced), TCRα/ß and γ/δ cells, as well as CD16+CD56+NK cells in ICU compared to non-ICU COVID-19 patients. We observed impaired function of T and NK cells in critically ill COVID-19 patients with extremely low levels of secreted cytokines. We found that the IL-2/INFγ ratio was the strongest indicator of a critical course of COVID-19, and was associated with fatal outcomes. Our findings showed markedly impaired innate and adaptive responses in critically ill COVID-19 patients, and suggest that the immunosuppressive state in the case of a critical course of SARS-CoV-2 infection might reflect subsequent clinical deterioration and predict a fatal outcome.


Asunto(s)
59585/inmunología , Tolerancia Inmunológica , Subgrupos Linfocitarios/inmunología , 59565/inmunología , Índice de Severidad de la Enfermedad , Inmunidad Adaptativa , Anciano , 59585/diagnóstico , 59585/mortalidad , 59585/virología , Deterioro Clínico , Enfermedad Crítica , Femenino , Mortalidad Hospitalaria , Hospitalización , Humanos , Inmunidad Innata , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Estudios Prospectivos , Medición de Riesgo/métodos
13.
Nutrients ; 13(6)2021 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-34072977

RESUMEN

The trace element copper (Cu) is part of our nutrition and essentially needed for several cuproenzymes that control redox status and support the immune system. In blood, the ferroxidase ceruloplasmin (CP) accounts for the majority of circulating Cu and serves as transport protein. Both Cu and CP behave as positive, whereas serum selenium (Se) and its transporter selenoprotein P (SELENOP) behave as negative acute phase reactants. In view that coronavirus disease (COVID-19) causes systemic inflammation, we hypothesized that biomarkers of Cu and Se status are regulated inversely, in relation to disease severity and mortality risk. Serum samples from COVID-19 patients were analysed for Cu by total reflection X-ray fluorescence and CP was quantified by a validated sandwich ELISA. The two Cu biomarkers correlated positively in serum from patients with COVID-19 (R = 0.42, p < 0.001). Surviving patients showed higher mean serum Cu and CP concentrations in comparison to non-survivors ([mean+/-SEM], Cu; 1475.9+/-22.7 vs. 1317.9+/-43.9 µg/L; p < 0.001, CP; 547.2.5 +/- 19.5 vs. 438.8+/-32.9 mg/L, p = 0.086). In contrast to expectations, total serum Cu and Se concentrations displayed a positive linear correlation in the patient samples analysed (R = 0.23, p = 0.003). Serum CP and SELENOP levels were not interrelated. Applying receiver operating characteristics (ROC) curve analysis, the combination of Cu and SELENOP with age outperformed other combinations of parameters for predicting risk of death, yielding an AUC of 95.0%. We conclude that the alterations in serum biomarkers of Cu and Se status in COVID-19 are not compatible with a simple acute phase response, and that serum Cu and SELENOP levels contribute to a good prediction of survival. Adjuvant supplementation in patients with diagnostically proven deficits in Cu or Se may positively influence disease course, as both increase in survivors and are of crucial importance for the immune response and antioxidative defence systems.


Asunto(s)
59585/sangre , 59585/mortalidad , Cobre/sangre , 59565/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Estudios Transversales , Supervivencia sin Enfermedad , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Selenio/sangre , Selenoproteína P/sangre , Tasa de Supervivencia
14.
J Orthop Surg Res ; 16(1): 356, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-34074300

RESUMEN

BACKGROUND: The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. METHODS: A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. RESULTS: The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. CONCLUSIONS: A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care.


Asunto(s)
Artroplastia de Reemplazo/tendencias , 59585/epidemiología , Ensayos Clínicos Controlados no Aleatorios como Asunto/tendencias , Procedimientos Ortopédicos/tendencias , Centros de Atención Terciaria/tendencias , Cuidado de Transición/tendencias , Anciano , Artroplastia de Reemplazo/métodos , Artroplastia de Reemplazo/rehabilitación , Beijing/epidemiología , 59585/prevención & control , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados no Aleatorios como Asunto/métodos , Procedimientos Ortopédicos/métodos , Procedimientos Ortopédicos/rehabilitación , Pandemias , Resultado del Tratamiento
15.
Sci Rep ; 11(1): 11462, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34075090

RESUMEN

An excessive immune response known as cytokine storm is the hallmark of severe COVID-19. The cause of this cytokine rampage is yet not known. Based on recent epidemiological evidence, we hypothesized that CD80/86 signaling is essential for this hyperinflammation, and that blocking this proinflammatory axis could be an effective therapeutic approach to protect against severe COVID-19. Here we provide exploratory evidence that abatacept, a drug that blocks CD80/86 co-stimulation, produces changes at the systemic level that are highly antagonistic of the proinflammatory processes elicited by COVID-19. Using RNA-seq from blood samples from a longitudinal cohort of n = 38 rheumatic patients treated with abatacept, we determined the immunological processes that are significantly regulated by this treatment. We then analyzed available blood RNA-seq from two COVID19 patient cohorts, a very early cohort from the epicenter of the pandemic in China (n = 3 COVID-19 cases and n = 3 controls), and a recent and larger cohort from the USA (n = 49 severe and n = 51 mild COVD-19 patients). We found a highly significant antagonism between SARS-CoV-2 infection and COVID-19 severity with the systemic response to abatacept. Analysis of previous single-cell RNA-seq data from bronchoalveolar lavage fluid from mild and severe COVID-19 patients and controls, reinforce the implication of the CD80/86 proinflammatory axis. Our functional results further support abatacept as a candidate therapeutic approach to prevent severe COVID-19.


Asunto(s)
Abatacept/farmacología , 59585/tratamiento farmacológico , Síndrome de Liberación de Citoquinas/prevención & control , Inmunosupresores/farmacología , 59565/inmunología , Transducción de Señal/efectos de los fármacos , Abatacept/uso terapéutico , Anciano , Artritis Reumatoide/sangre , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/inmunología , Antígeno B7-1/metabolismo , Antígeno B7-2/metabolismo , Líquido del Lavado Bronquioalveolar/citología , 59585/sangre , 59585/complicaciones , 59585/inmunología , China , Síndrome de Liberación de Citoquinas/inmunología , Síndrome de Liberación de Citoquinas/virología , Femenino , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Estudios Observacionales como Asunto , RNA-Seq , Índice de Severidad de la Enfermedad , Transducción de Señal/inmunología , Análisis de la Célula Individual , España , Estados Unidos , Regulación hacia Arriba/efectos de los fármacos , Regulación hacia Arriba/inmunología
16.
Sci Rep ; 11(1): 11524, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34075155

RESUMEN

Nearly 5% of patients suffering from COVID-19 develop acute respiratory distress syndrome (ARDS). Extravascular lung water index (EVLWI) is a marker of pulmonary oedema which is associated with mortality in ARDS. In this study, we evaluate whether EVLWI is higher in patients with COVID-19 associated ARDS as compared to COVID-19 negative, ventilated patients with ARDS and whether EVLWI has the potential to monitor disease progression. EVLWI and cardiac function were monitored by transpulmonary thermodilution in 25 patients with COVID-19 ARDS subsequent to intubation and compared to a control group of 49 non-COVID-19 ARDS patients. At intubation, EVLWI was noticeably elevated and significantly higher in COVID-19 patients than in the control group (17 (11-38) vs. 11 (6-26) mL/kg; p < 0.001). High pulmonary vascular permeability index values (2.9 (1.0-5.2) versus 1.9 (1.0-5.2); p = 0.003) suggested a non-cardiogenic pulmonary oedema. By contrast, the cardiac parameters SVI, GEF and GEDVI were comparable in both cohorts. High EVLWI values were associated with viral persistence, prolonged intensive care treatment and in-hospital mortality (23.2 ± 6.7% vs. 30.3 ± 6.0%, p = 0.025). Also, EVLWI showed a significant between-subjects (r = - 0.60; p = 0.001) and within-subjects correlation (r = - 0.27; p = 0.028) to Horowitz index. Compared to non COVID-19 ARDS, COVID-19 results in markedly elevated EVLWI-values in patients with ARDS. High EVLWI reflects a non-cardiogenic pulmonary oedema in COVID-19 ARDS and could serve as parameter to monitor ARDS progression on ICU.


Asunto(s)
59585/complicaciones , Agua Pulmonar Extravascular/inmunología , Edema Pulmonar/mortalidad , Síndrome de Dificultad Respiratoria del Adulto/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , 59585/diagnóstico , 59585/inmunología , 59585/mortalidad , Permeabilidad Capilar , Progresión de la Enfermedad , Agua Pulmonar Extravascular/virología , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Pulmón/irrigación sanguínea , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/estadística & datos numéricos , Pronóstico , Edema Pulmonar/diagnóstico , Edema Pulmonar/inmunología , Edema Pulmonar/virología , Respiración Artificial , Síndrome de Dificultad Respiratoria del Adulto/diagnóstico , Síndrome de Dificultad Respiratoria del Adulto/etiología , Síndrome de Dificultad Respiratoria del Adulto/terapia , Medición de Riesgo/métodos , 59565/aislamiento & purificación , Índice de Severidad de la Enfermedad , Termodilución/métodos , Termodilución/estadística & datos numéricos , Adulto Joven
17.
Sci Rep ; 11(1): 11416, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34075173

RESUMEN

The first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March-3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March-3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.


Asunto(s)
59585/prevención & control , Pandemias/prevención & control , Trastornos del Sueño del Ritmo Circadiano/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , 59477 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , 59585/epidemiología , 59585/psicología , 59585/transmisión , Ritmo Circadiano/fisiología , Control de Enfermedades Transmisibles/normas , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Fotoperiodo , Prevalencia , 59565/patogenicidad , Sueño/fisiología , Trastornos del Sueño del Ritmo Circadiano/etiología , Trastornos del Sueño del Ritmo Circadiano/fisiopatología , Trastornos del Sueño del Ritmo Circadiano/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Trastornos del Inicio y del Mantenimiento del Sueño/fisiopatología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto Joven
18.
Wiad Lek ; 74(5): 1057-1060, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34090263

RESUMEN

OBJECTIVE: The aim: The aim of the study is to assess the quality of medical care and determine the relationship between treatment outcomes of patients and acute respiratory viral infectious disease caused by SARS-CoV-2,depending on patients` age, the time from onset of symptoms to hospitalization, and the presence of comorbidity. PATIENTS AND METHODS: Materials and methods: According to the specially designed form, a retrospective analysis of primary accounting documents was carried out (f. No. 103/o) in 158 patients with COVID-19. The research was carried out in specialized inpatient infectious diseases wards of health institutions of the Sumy region during the period from April to September 2020. The study used a systemic approach, bibliosemantic, comparative and statistical analyses, logical generalization methods. RESULTS: Results: Among the study group of patients, namely 158 people, a bigger number of women (56.33±3.95%) than men (43.67±3.95%) were recorded. Patients of working age (from 18 to 64 years old) took 70.89±3.61% of all patients, and people aged 65 years and older - 29.11±3.61%. The time from the beginning of symptoms to hospitalization in each second patient (49.37±3.98%) lasted 5-7 days. In most cases, the patient's stay in the hospital equaled 13-15 bed-days - 32.28±3.72%. The index of patients with severe and critical state was 20.89±3.23% (33 patients). In 8.23±2.19% (13 people) of treated cases of hospital stay ended in death. A large index of patients with a severe course of the disease, the treatment of which ended in discharge, were in hospital for more than 13 bed days - 12.03±2.59% (19 people). All of these patients were older, had CNCDs (chronic non-communicable diseases), half of them were hospitalized on day 7 and later from the onset of symptoms. CONCLUSION: Conclusions: In older people, the disease progresses faster and complications are developing more often. Also, the severity of the SARS-CoV-2 pattern and the length of staying in the hospital are affected by the time starting the onset of symptoms till hospitalization and the presence of CNCDs. The hereinafter data allows to increase knowledge about spreading of COVID-19, to improve the quality of organizational and preventive events in the provision of medical care, and reducing mortality.


Asunto(s)
59585 , Pacientes Internos , Adolescente , Adulto , Anciano , Femenino , Departamentos de Hospitales , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , 59565 , Adulto Joven
19.
Wiad Lek ; 74(5): 1114-1119, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34090274

RESUMEN

OBJECTIVE: The aim: Identify the types of eating behaviour in overweight and obesity depending on gender and age. PATIENTS AND METHODS: Materials and methods: A survey of 210 people (men -105, women -105) was conducted. The age of women ranged from 19 to 60 years, the average age was 41.5 ± 11.2 years. The age of men ranged from 22 to 60 years, the average age was 42.3 ± 12.3 years. The examined patients were divided into two clinical groups: group I - 70 people (women - 35, men - 35) with overweight. BMI of persons of the I group from 25.8 kg / m2 to 29,3 kg / m2 (BMTmid. = 27,5 ± 1,31 kg / m2); Group II - 72 people with 1st degree obesity (women -36, men - 36). Evaluation of eating disorders was carried out using the DEBQ questionnaire (Nederland) adapted to the purpose of the study. RESULTS: Results: In patients of groups I and II healthy type of eating behaviour was recorded less often than in control groups, 5.38 times (D = 13.561, p = 0.002 <0.05) and 10.45 times (D = 21.043, p = 0.022 <0.05), respectively. In group I, the restrictive type of EB among women occurred 1.7 times more often than in men (D = 0.852, p = 0.001). In group II, the restrictive type of EB among women was observed 1.3 times more often than in men (D = 0.382, p = 0.005). CONCLUSION: Conclusions: Restrictive eating behaviour disorders are one of the leading factors in the development of overweight and obesity. Correction of eating disorders in obese people must be carried out taking into account the gender and age characteristics of the patient, to obtain positive results for a shorter course of treatment.


Asunto(s)
Conducta Alimentaria , Obesidad , Adulto , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Sobrepeso/epidemiología , Encuestas y Cuestionarios , Adulto Joven
20.
Wiad Lek ; 74(5): 1274-1276, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34090304

RESUMEN

OBJECTIVE: The aim: To pay attention of clinicians to possible lesions of the central nervous system (encephalitis) in patients with COVID-19. PATIENTS AND METHODS: Case presentation: A 44-year-old woman was admitted to our clinic because of 2-month-history of mild fever, bilateral lower lobe pneumonia, respiratory failure, generalized weakness, and some neurologic symptoms. SARS-CoV-2 RNA was detected in nasopharyngeal swab. Chest CT demonstrated bilateral pulmonary poly segmental consolidations in the mid and lower zones. Focal hyper intensive abnormalities in various parts of the left hemisphere were found at MR brain imaging in T2WI, and T2 FLAIR mode. Cerebrospinal fluid (CSF) examination showed a white cell count of 31/uL (normal <5/uL), protein 0.73 g/L (0.15-0.45), and glucose 1.4 mmole/L (2.2-3.9). Standard CSF neuroviral PCR panel and PCR for SARS-CoV-2 were negative. She was treated with ganciclovir, and dexamethasone. Due to suspected tuberculosis meningitis (cytosis, decreased level of protein and glucose), she also received ex juvantibus a course of anti-TB therapy (isoniazid, kanamycin, and levofloxacin) and made a steady improvement. CONCLUSION: Conclusion: This case shows that SARS-CoV-2 in association with other pathogens may cause various lesions of the CNS accompanied by severe neurological manifestations in adults.


Asunto(s)
59585 , Encefalitis , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , ARN Viral , 59565
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