GLP1 analogues among patients with overweight or obesity during lockdown

Background and objectives One of the potential negative effects of a lockdown are changes in dietary and lifestyle patterns, which can lead to weight gain. Our objective was to assess the changes on dietary habits and eating patterns in a lockdown situation and their impact on weight. We aimed to determine whether the treatment with GLP1 analogues (aGLP1) could impact on these parameters. Material and methods 100 overweight/obese patients were consecutively recruited for a review at the end of the lockdown. A structured interview was designed to see changes in dietary habits, routines and exercise. Results 52% patients gained weight during lockdown. The percentage of subjects with an active history of depression or anxiety was higher among the group of patients who gained weight. The percentage of patients who worsened their hyperphagia was higher in those who gained weight (71.2% vs 10.6%;P < .0001);similar results were observed with binge eating (92% vs 10.6%;P < .0001) and cravings, both sweet and salty (69.2% vs 21.3% and 69.2% vs 14.9%;P < .0001 and P < .0001 respectively). Of the 48 patients who did not gain weight, 30 were under aGLP1 treatment (61.7%). The worsening of abnormal eating patterns was lower among patients treated with aGLP-1. Conclusions A lockdown is a vulnerable period to gain weight, especially in those patients with a psychopathological history. aGLP1 manage to control emotional eating, making them a valuable therapeutic option. Resumen Antecedentes y objetivos Uno de los potenciales efectos negativos de un confinamiento son los cambios en los patrones dietéticos y de estilo de vida, que pueden conllevar a una ganancia de peso. El objetivo fue ver los cambios sobre los hábitos higiénico-dietéticos y de patrones de ingesta en una situación de confinamiento y el impacto sobre el peso. Asimismo, ver si el estar bajo tratamiento con análogos de GLP1 (aGLP1) modificó estos parámetros. Material y métodos Se reclutaron de forma consecutiva 100 pacientes con sobrepeso/obesidad que acudieron a revisión al finalizar el confinamiento. Se diseñó una entrevista estructurada para ver los cambios en los hábitos dietéticos, rutinas y ejercicio. Resultados El 52% pacientes ganaron peso durante el confinamiento. El porcentaje de sujetos con historia activa de depresión o ansiedad fue superior entre el grupo de pacientes que ganó peso. El porcentaje de pacientes que empeoraron su hiperfagia ansiosa fue superior en aquellos que ganaron peso (71,2% vs 10,6%;P < ,0001);lo mismo ocurrió con los atracones (92% vs 10,6%;P < ,0001) y los cravings, dulces y salados (69,2% vs 21,3% y 69,2% vs 14,9%;P < ,0001 y P < ,0001 respectivamente). De los 48 pacientes que no ganaron peso, 30 estaban bajo tratamiento con aGLP1 (61,7%). El empeoramiento de los patrones anómalos de ingesta fue inferior entre los pacientes bajo tratamiento con aGLP-1. Conclusiones Un confinamiento es un período vulnerable para ganar peso, especialmente en aquellos pacientes con antecedentes psicopatológicos. Los aGLP1 consiguen controlar la ingesta emocional convirtiéndolos en una opción terapéutica valiosa.

The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection.

BACKGROUND AND AIMS: The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19. METHODS: This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl. RESULTS: 11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5). CONCLUSIONS: The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.

Influence of nutritional status on clinical outcomes among hospitalized patients with COVID-19.

BACKGROUND AND AIMS: Several factors that worsen the prognosis of the new coronavirus SARS-CoV-2 have been identified, such as obesity or diabetes. However, despite that nutrition may change in a lockdown situation, little is known about the influence of malnutrition among subjects hospitalized due to COVID-19. Our study aimed to assess whether the presence of malnutrition among patients admitted due to COVID-19 had any impact on clinical outcomes compared with patients with the same condition but well nourished. METHODS: 75 patients admitted to hospital due to COVID-19 were analyzed cross-sectionally. Subjective Global Assessment (SGA) was completed by phone interview. Clinical parameters included were extracted from the electronic medical record. RESULTS: According to the SGA, 27 admitted due to a COVID-19 infection had malnutrition. Patients not well nourished were older than patients with a SGA grade A (65 ± 14.1 vs 49 ± 15.1 years; p < 0.0001). Length of hospital stay among poorly nourished patients was significantly higher (18.4 ± 15.6 vs 8.5 ± 7.7 days; p = 0.001). Mortality rates and admission to ICU were greater among subjects with any degree of malnutrition compared with well-nourished patients (7.4% vs 0%; p = 0.05 and 44.4% vs 6.3%; p < 0.0001). CRP (120.9 ± 106.2 vs 60.8 ± 62.9 mg/l; p = 0.03), D-dimer (1516.9 ± 1466.9 vs 461.1 ± 353.7 ng/mL; p < 0.0001) and ferritin (847.8 ± 741.1 vs 617.8 ± 598.7mcg/l; p = 0.03) were higher in the group with malnutrition. Haemoglobin (11.6 ± 2.1 vs 13.6 ± 1.5 g/dl; p < 0.0001) and albumin 3.2 ± 0.7 vs 4.1 ± 0.5 g/dl; p < 0.0001) were lower in patients with any degree of malnutrition. CONCLUSIONS: The presence of a poor nutritional status is related to a longer stay in hospital, a greater admission in the ICU and a higher mortality.