Obesity as an independent risk factor for COVID-19 severity and mortality.

BACKGROUND: Since December 2019, the world has struggled with the COVID-19 pandemic. Even after the introduction of various vaccines, this disease still takes a considerable toll. In order to improve the optimal allocation of resources and communication of prognosis, healthcare providers and patients need an accurate understanding of factors (such as obesity) that are associated with a higher risk of adverse outcomes from the COVID-19 infection. OBJECTIVES: To evaluate obesity as an independent prognostic factor for COVID-19 severity and mortality among adult patients in whom infection with the COVID-19 virus is confirmed. SEARCH METHODS: MEDLINE, Embase, two COVID-19 reference collections, and four Chinese biomedical databases were searched up to April 2021. SELECTION CRITERIA: We included case-control, case-series, prospective and retrospective cohort studies, and secondary analyses of randomised controlled trials if they evaluated associations between obesity and COVID-19 adverse outcomes including mortality, mechanical ventilation, intensive care unit (ICU) admission, hospitalisation, severe COVID, and COVID pneumonia. Given our interest in ascertaining the independent association between obesity and these outcomes, we selected studies that adjusted for at least one factor other than obesity. Studies were evaluated for inclusion by two independent reviewers working in duplicate.  DATA COLLECTION AND ANALYSIS: Using standardised data extraction forms, we extracted relevant information from the included studies. When appropriate, we pooled the estimates of association across studies with the use of random-effects meta-analyses. The Quality in Prognostic Studies (QUIPS) tool provided the platform for assessing the risk of bias across each included study. In our main comparison, we conducted meta-analyses for each obesity class separately. We also meta-analysed unclassified obesity and obesity as a continuous variable (5 kg/m2 increase in BMI (body mass index)). We used the GRADE framework to rate our certainty in the importance of the association observed between obesity and each outcome. As obesity is closely associated with other comorbidities, we decided to prespecify the minimum adjustment set of variables including age, sex, diabetes, hypertension, and cardiovascular disease for subgroup analysis.  MAIN RESULTS: We identified 171 studies, 149 of which were included in meta-analyses.  As compared to 'normal' BMI (18.5 to 24.9 kg/m2) or patients without obesity, those with obesity classes I (BMI 30 to 35 kg/m2), and II (BMI 35 to 40 kg/m2) were not at increased odds for mortality (Class I: odds ratio [OR] 1.04, 95% confidence interval [CI] 0.94 to 1.16, high certainty (15 studies, 335,209 participants); Class II: OR 1.16, 95% CI 0.99 to 1.36, high certainty (11 studies, 317,925 participants)). However, those with class III obesity (BMI 40 kg/m2 and above) may be at increased odds for mortality (Class III: OR 1.67, 95% CI 1.39 to 2.00, low certainty, (19 studies, 354,967 participants)) compared to normal BMI or patients without obesity. For mechanical ventilation, we observed increasing odds with higher classes of obesity in comparison to normal BMI or patients without obesity (class I: OR 1.38, 95% CI 1.20 to 1.59, 10 studies, 187,895 participants, moderate certainty; class II: OR 1.67, 95% CI 1.42 to 1.96, 6 studies, 171,149 participants, high certainty; class III: OR 2.17, 95% CI 1.59 to 2.97, 12 studies, 174,520 participants, high certainty). However, we did not observe a dose-response relationship across increasing obesity classifications for ICU admission and hospitalisation. AUTHORS' CONCLUSIONS: Our findings suggest that obesity is an important independent prognostic factor in the setting of COVID-19. Consideration of obesity may inform the optimal management and allocation of limited resources in the care of COVID-19 patients.

The Privacy Paradox-Investigating People's Attitude Towards Privacy in a Time of COVID-19

The advent of digital technologies used as a mechanism to deal with the Covid-19 global pandemic, has raised serious concerns around privacy and security issues. Despite these concerns and the potential risk of data misuse, including third party use, countries around the world have pushed the use and proliferation of contact-tracing applications. However, the success of these contact-tracing applications relies on their adoption and use. A well known phenomenon referred to as privacy paradox is defined as the discrepancy between the expressed privacy concern and the actual behaviour of users when it comes to protect their privacy. In this context, this paper presents a study investigating the privacy paradox in the context of a global pandemic. A national survey has been conducted and the data is analysed to examine people's privacy risk perception. The results show inconsistencies between people's privacy concerns and their actual behaviour that is reflected in their attitude shift of sharing their mobile data during a global pandemic. The study also compiles a list of recommendations for policymakers. © 2022 IEEE.

Low-carbohydrate versus balanced-carbohydrate diets for reducing weight and cardiovascular risk.

BACKGROUND: Debates on effective and safe diets for managing obesity in adults are ongoing. Low-carbohydrate weight-reducing diets (also known as 'low-carb diets') continue to be widely promoted, marketed and commercialised as being more effective for weight loss, and healthier, than 'balanced'-carbohydrate weight-reducing diets. OBJECTIVES: To compare the effects of low-carbohydrate weight-reducing diets to weight-reducing diets with balanced ranges of carbohydrates, in relation to changes in weight and cardiovascular risk, in overweight and obese adults without and with type 2 diabetes mellitus (T2DM). SEARCH METHODS: We searched MEDLINE (PubMed), Embase (Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection (Clarivate Analytics), ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) up to 25 June 2021, and screened reference lists of included trials and relevant systematic reviews. Language or publication restrictions were not applied. SELECTION CRITERIA: We included randomised controlled trials (RCTs) in adults (18 years+) who were overweight or living with obesity, without or with T2DM, and without or with cardiovascular conditions or risk factors. Trials had to compare low-carbohydrate weight-reducing diets to balanced-carbohydrate (45% to 65% of total energy (TE)) weight-reducing diets, have a weight-reducing phase of 2 weeks or longer and be explicitly implemented for the primary purpose of reducing weight, with or without advice to restrict energy intake.  DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts and full-text articles to determine eligibility; and independently extracted data, assessed risk of bias using RoB 2 and assessed the certainty of the evidence using GRADE. We stratified analyses by participants without and with T2DM, and by diets with weight-reducing phases only and those with weight-reducing phases followed by weight-maintenance phases. Primary outcomes were change in body weight (kg) and the number of participants per group with weight loss of at least 5%, assessed at short- (three months to < 12 months) and long-term (≥ 12 months) follow-up. MAIN RESULTS: We included 61 parallel-arm RCTs that randomised 6925 participants to either low-carbohydrate or balanced-carbohydrate weight-reducing diets. All trials were conducted in high-income countries except for one in China. Most participants (n = 5118 randomised) did not have T2DM. Mean baseline weight across trials was 95 kg (range 66 to 132 kg). Participants with T2DM were older (mean 57 years, range 50 to 65) than those without T2DM (mean 45 years, range 22 to 62). Most trials included men and women (42/61; 3/19 men only; 16/19 women only), and people without baseline cardiovascular conditions, risk factors or events (36/61). Mean baseline diastolic blood pressure (DBP) and low-density lipoprotein (LDL) cholesterol across trials were within normal ranges. The longest weight-reducing phase of diets was two years in participants without and with T2DM. Evidence from studies with weight-reducing phases followed by weight-maintenance phases was limited. Most trials investigated low-carbohydrate diets (> 50 g to 150 g per day or < 45% of TE; n = 42), followed by very low (≤ 50 g per day or < 10% of TE; n = 14), and then incremental increases from very low to low (n = 5). The most common diets compared were low-carbohydrate, balanced-fat (20 to 35% of TE) and high-protein (> 20% of TE) treatment diets versus control diets balanced for the three macronutrients (24/61). In most trials (45/61) the energy prescription or approach used to restrict energy intake was similar in both groups. We assessed the overall risk of bias of outcomes across trials as predominantly high, mostly from bias due to missing outcome data. Using GRADE, we assessed the certainty of evidence as moderate to very low across outcomes.  Participants without and with T2DM lost weight when following weight-reducing phases of both diets at the short (range: 12.2 to 0.33 kg) and long term (range: 13.1 to 1.7 kg).  In overweight and obese participants without T2DM: low-carbohydrate weight-reducing diets compared to balanced-carbohydrate weight-reducing diets (weight-reducing phases only) probably result in little to no difference in change in body weight over three to 8.5 months (mean difference (MD) -1.07 kg, (95% confidence interval (CI) -1.55 to -0.59, I2 = 51%, 3286 participants, 37 RCTs, moderate-certainty evidence) and over one to two years (MD -0.93 kg, 95% CI -1.81 to -0.04, I2 = 40%, 1805 participants, 14 RCTs, moderate-certainty evidence); as well as change in DBP and LDL cholesterol over one to two years. The evidence is very uncertain about whether there is a difference in the number of participants per group with weight loss of at least 5% at one year (risk ratio (RR) 1.11, 95% CI 0.94 to 1.31, I2 = 17%, 137 participants, 2 RCTs, very low-certainty evidence).  In overweight and obese participants with T2DM: low-carbohydrate weight-reducing diets compared to balanced-carbohydrate weight-reducing diets (weight-reducing phases only) probably result in little to no difference in change in body weight over three to six months (MD -1.26 kg, 95% CI -2.44 to -0.09, I2 = 47%, 1114 participants, 14 RCTs, moderate-certainty evidence) and over one to two years (MD -0.33 kg, 95% CI -2.13 to 1.46, I2 = 10%, 813 participants, 7 RCTs, moderate-certainty evidence); as well in change in DBP, HbA1c and LDL cholesterol over 1 to 2 years. The evidence is very uncertain about whether there is a difference in the number of participants per group with weight loss of at least 5% at one to two years (RR 0.90, 95% CI 0.68 to 1.20, I2 = 0%, 106 participants, 2 RCTs, very low-certainty evidence).  Evidence on participant-reported adverse effects was limited, and we could not draw any conclusions about these.  AUTHORS' CONCLUSIONS: There is probably little to no difference in weight reduction and changes in cardiovascular risk factors up to two years' follow-up, when overweight and obese participants without and with T2DM are randomised to either low-carbohydrate or balanced-carbohydrate weight-reducing diets.

Feminist Loneliness Studies: an introduction

Writing about loneliness has been a struggle in the midst of the pandemic. Characterized by loneliness, isolation, anxiety, and fear, the COVID-19 pandemic is an exceptionally challenging time. At various points while navigating this loneliness project amid a particularly lonely time, we lamented the seeming futility of it all. A main goal of developing a Feminist Loneliness Studies in this introduction is to understand the ways that systems of oppression – white supremacy, settler colonialism, anti-queer bias, misogyny, neoliberal capitalism, and so on – create our lonely world. To date, there remains no comprehensive feminist analysis of the structural conditions that both produce and intensify experiences of loneliness. We aim to remedy this gap. That is, we seek to address what a Feminist Loneliness Studies can contribute to understanding the complexities of this complicated emotion. For example, what is the unique loneliness of the feminist killjoy who calls out, or calls in, existing forms of queerphobia, racism, and sexism? What does it mean to be a politicized person and how does that result in both alienation and isolation? What might the relationship be between white supremacy and loneliness? How is loneliness both individual and systemic, and what is the relationship between the two? What distinctive forms of loneliness are created by ableism, sanism, neoliberalism, capitalism, globalization, and the gig economy? Ought loneliness be avoided at all costs? What are the ethics of loneliness? In our introduction to this special issue, we unpack and theorize the potential perils and generative possibilities offered up by this profound emotion. Establishing a Feminist Loneliness Studies provides us with the space we need to begin addressing and comprehending loneliness.

PRIVA / A Closer Look at People's Data Privacy Attitudes in Times of COVID-19

The current Covid-19 global pandemic led to a proliferation of contact-tracing applications meant to help control and suppress the spread of the virus. However, the success of these contact-tracing apps relies on obtaining access to sensitive data stored on citizen's mobile devices. The approaches taken are different around the world. While the countries with a strong democratic and civil liberty ethos are encouraging voluntary adoption of contact-tracing apps by their citizens, other countries opted for forced mass surveillance methods that limit individual freedoms. As a result, the attempt to fight the global pandemic is actually testing people's attitudes towards privacy and government surveillance. In this context, this research introduces a pilot study examining people's privacy concerns in a time of Covid-19. The results show that people are willing to share their personal data in the interest of controlling the spread of the virus and save lives. © 2021 IEEE.

Privacy in a Time of COVID-19: How Concerned Are You?

We introduce a study examining people's privacy concerns during COVID-19 and reflect on people's willingness to share their personal data in the interest of controlling the spread of the virus and saving lives.

Irish Attitudes Toward COVID Tracker App & Privacy: Sentiment Analysis on Twitter and Survey Data

Contact tracing apps used in tracing and mitigating the spread of COVID-19 have sparked discussions and controversies worldwide. The major concerns in relation to these apps are around privacy. Ireland was in general praised for the design of its COVID tracker app, and the transparency through which privacy issues were addressed. However, the "voice"of the Irish public was not really heard or analysed. This study aimed to analyse the Irish public sentiment towards privacy and COVID tracker app. For this purpose we have conducted sentiment analysis on Twitter data collected from public Twitter accounts from Republic of Ireland. We collected COVID-19 related tweets generated in Ireland over a period of time from January 1, 2020 up to December 31, 2020 in order to perform sentiment analysis on this data set. Moreover, the study performed sentiment analysis on the feedback received from a national survey on privacy conducted in Republic of Ireland. The findings of the study reveal a significant criticism towards the app that relate to privacy concerns, but other aspects of the app as well. The findings also reveal some positive attitude towards the fight against COVID-19, but these are not necessarily related to the technological solutions employed for this purpose. The findings of the study contributed to the formulation of useful recommendations communicated to the relevant Irish actors. © 2021 Owner/Author.