Protective role of physical activity patterns prior to COVID-19 confinement with the severity/duration of respiratory pathologies consistent with COVID-19 symptoms in Spanish populations.

The main purpose of the present study was to determine the association of physical activity (PA) patterns prior to COVID-19 confinement with severe respiratory distress consistent with COVID-19 symptoms. Participants were recruited by sending a survey through various social network channels via the snowball method. A voluntary sample of 420 individuals consisting of 199 men and 221 women from the Spanish national territory participated in this study. Some factors, such as being overweight and obese were related to the presence of a greater number of symptoms associated with COVID-19. Interestingly, it was observed that not performing moderate or vigorous PA increased the risk of COVID-19 symptoms. Consequently, when the effect of the practise of PA was evaluated in terms of the number of practises per week and in minutes per practise per week, a protective effect was observed, where moderate PA >150 min per week reported an inverse association with hospitalization for respiratory symptoms (RR: 95%CI: 0.24, 0.05-1.04, P = 0.05). Likewise, overweight (RR: 16.3, 95%CI: 1.93-137.9, P = 0.01), obesity (RR: 19.1, 95%CI: 1.63-222.5, P = 0.019) and non-performance of moderate PA (RR: 4.12, 95%CI; 0.95-17.76, P = 0.05) reported positive associations with hospitalization for respiratory symptoms. Thus, the practise of moderate PA (>150 min per week) is a protective factor against hospitalization for respiratory symptoms consistent with COVID-19 symptoms.

Outcome predictors in COVID-19: An analysis of emergent systemic inflammation indices in Mexican population.

Introduction: The systemic viral disease caused by the SARS-CoV-2 called coronavirus disease 2019 (COVID-19) continues to be a public health problem worldwide. Objective: This study is aimed to evaluate the association and predictive value of indices of systemic inflammation with severity and non-survival of COVID-19 in Mexican patients. Materials and Methods: A retrospective study was carried out on 807 subjects with a confirmed diagnosis of COVID-19. Clinical characteristics, acute respiratory distress syndrome (ARDS), severity according to PaO2/FiO2 ratio, invasive mechanical ventilation (IMV), and non-survival outcome were considered to assess the predictive value and the association of 11 systemic inflammatory indices derived from hematological parameters analyzed at the hospital admission of patients. The receiver operating characteristics curve was applied to determine the thresholds for 11 biomarkers, and their prognostic values were assessed via the Kaplan-Meier method. Results: 26% of the studied subjects showed COVID-19 severe (PaO2/FiO2 ratio ≤ 100), 82.4% required IMV, and 39.2% were non-survival. The indices NHL, NLR, RDW, dNLR, and SIRI displayed predictive values for severe COVID-19 and non-survival. NHL, SIRI, and NLR showed predictive value for IMV. The cut-off values for RDW (OR = 1.85, p < 0.001), NHL (OR = 1.67, p = 0.004) and NLR (OR = 1.56, p = 0.012) were mainly associated with severe COVID-19. NHL (OR = 3.07, p < 0.001), AISI (OR = 2.64, p < 0.001) and SIRI (OR = 2.51, p < 0.001) were associated with IMV support, while for non-survival the main indices associated were NHL (OR = 2.65, p < 0.001), NLR (OR = 2.26, p < 0.001), dNLR (OR = 1.92, p < 0.001), SIRI (OR = 1.67, p = 0.002) and SII (OR = 1.50, p = 0.010). The patients with an RDW, PLR, NLR, dNLR, MLR, SII, and NHL above the cut-off had a survival probability of COVID-19 50% lower, with an estimated mean survival time of 40 days. Conclusion: The emergent systemic inflammation indices NHL, NLR, RDW, SII, and SIRI have a predictive power of severe COVID-19, IMV support, and low survival probability during hospitalization by COVID-19 in Mexican patients.

The Social Distance Impacts from COVID-19 Pandemic on the Development of Two Orders of a Concurrent Training Programme for Morbidly Obese Patients.

BACKGROUND: Although there is relevant information regarding the consequences of the coronavirus SARS-CoV-2 (COVID-19), little is known about the impact of the imposed social confinement (at home) on the development of exercise training programmes in populations with morbid obesity. AIM: To describe the effects of the imposed COVID-19 confinement on the cardiometabolic health benefits acquired through a concurrent training programme that started before the pandemic in populations with morbid obesity. METHODS: This was an experimental randomized clinical study, in which sedentary morbidly obese women were assigned 1:1 to a high-intensity interval training (HIIT) plus resistance training (RT) group (HIIT + RT; n = 11; BMI 42.1 ± 6.6) or to the same exercise dose, but in different order group of RT plus HIIT group (RT + HIIT; n = 7; BMI 47.5 ± 8.4). Both groups undertook two sessions/week. When COVID-19 confinement at home started, a post-test was applied in January 2020 (Post1) and after 20 months (Post2). The main outcomes were waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), high-density lipids (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG). RESULTS: In the HIIT + RT group, the WC showed significant increases from Post1 to Post2 (Δ + 3.1 cm, p = 0.035); in the RT + HIIT group, it decreased from Post1 to Post2 (Δ - 4.8 cm, p = 0.028). In the HIIT + RT group, SBP showed significant increases from Post1 to Post2 (Δ + 6.2 mmHg, p = 0.041); the RT + HIIT group decreased SBP from Pre0 to Post1 (Δ - 7.2 mmHg, p = 0.026) and increased DBP from Pre0 to Post1 (Δ + 8.1 mmHg, p = 0.015). Tg in the HIIT + RT group decreased from Pre0 to Post1 (Δ - 40.1 mg/dL, p = 0.023) but increased from Post1 to Post2 (Δ + 86.3 mg/dL, p < 0.0001). CONCLUSIONS: The COVID-19 social confinement worsened metabolic syndrome (MetS) outcomes that had improved from 20 weeks' RT + HIIT during the training period, such as WC, SBP, and Tg from HIIT + RT, when, worryingly, SBP increased to another more serious clinical classification in both groups.

TNFRSF1B and TNF Variants Are Associated With Differences in Levels of Soluble Tumor Necrosis Factor Receptors in Patients With Severe COVID-19.

BACKGROUND: The impact of genetic variants in the expression of tumor necrosis factor-α (TNF-α) and its receptors in coronavirus disease 2019 (COVID-19) severity has not been previously explored. We evaluated the association of TNF (rs1800629 and rs361525), TNFRSF1A (rs767455 and rs1800693), and TNFRSF1B (rs1061622 and rs3397) variants with COVID-19 severity, assessed as invasive mechanical ventilation (IMV) requirement, and the plasma levels of soluble TNF-α, TNFR1, and TNFR2 in patients with severe COVID-19. METHODS: The genetic study included 1353 patients. Taqman assays were used to assess the genetic variants. ELISA was used to determine soluble TNF-α, TNFR1, and TNFR2 in plasma samples from 334 patients. RESULTS: Patients carrying TT (TNFRSF1B rs3397) exhibited lower PaO2/FiO2 levels than those with CT + CC genotypes. Differences in plasma levels of TNFR1 and TNFR2 were observed according to the genotype of TNFRSF1B rs1061622, TNF rs1800629, and rs361525. According to the studied genetic variants, there were no differences in the soluble TNF-α levels. Higher soluble TNFR1 and TNFR2 levels were detected in patients with COVID-19 requiring IMV. CONCLUSIONS: Genetic variants in TNF and TNFRSFB1 influence the plasma levels of soluble TNFR1 and TNFR2, implicated in COVID-19 severity.

IFNAR2 relevance in the clinical outcome of individuals with severe COVID-19.

Interferons (IFNs) are a group of cytokines with antiviral, antiproliferative, antiangiogenic, and immunomodulatory activities. Type I IFNs amplify and propagate the antiviral response by interacting with their receptors, IFNAR1 and IFNAR2. In COVID-19, the IFNAR2 (interferon alpha and beta receptor subunit 2) gene has been associated with the severity of the disease, but the soluble receptor (sIFNAR2) levels have not been investigated. We aimed to evaluate the association of IFNAR2 variants (rs2236757, rs1051393, rs3153, rs2834158, and rs2229207) with COVID-19 mortality and to assess if there was a relation between the genetic variants and/or the clinical outcome, with the levels of sIFNAR2 in plasma samples from hospitalized individuals with severe COVID-19. We included 1,202 subjects with severe COVID-19. The genetic variants were determined by employing Taqman® assays. The levels of sIFNAR2 were determined with ELISA in plasma samples from a subgroup of 351 individuals. The rs2236757, rs3153, rs1051393, and rs2834158 variants were associated with mortality risk among patients with severe COVID-19. Higher levels of sIFNAR2 were observed in survivors of COVID-19 compared to the group of non-survivors, which was not related to the studied IFNAR2 genetic variants. IFNAR2, both gene, and soluble protein, are relevant in the clinical outcome of patients hospitalized with severe COVID-19.

Efecto del confinamiento por COVID-19 sobre el estilo de vida en población universitaria de Argentina: Evaluación de la actividad física, alimentación y sueño (Effect of Confinement by COVID-19 on the Lifestyle of the University Population of Argentina: E

Objective: to determine lifestyle changes, such as physical activity, nutrition, and sleep in an Argentinean university population, caused by confinement during the COVID-19 pandemic. Methods: Cross-sectional study via web survey. 1021 the Argentinean university population (women, n = 645 and men, n = 376) aged between 18–70 years old was participate. Survey was utilized to measure participant physical activity behavior, nutrition, and sleep April to May 2020. Results: the main findings revealed that 4.3% of the sample showed obesity;the highest proportion of the sample stayed more than 6 hours in a sedentary status;21.74% reported bad sleep quality;a reduction in good feeding pattern;and an increase in subjects who do not perform physical activity. According to socio-demographic and anthropometric factors, being a student (OR 2.19, CI95% 1.18 - 4, p= .012), overweight (OR 1.71, CI95% 1.19 – 2.44, p= .003), obesity (OR 4.45, CI95% 2.27 – 8.7, p< .001), and have been confined more than 45 days was associated with bad feeding. Likewise, low physical activity levels were associated with obesity (OR 3.2 CI95% 1.66 – 6.18, p= .001), being female (OR 1.61, CI95% 1.14 –2.28, p= .006) and get married (OR 1.72, CI95% 1.14 – 2.61, p= .009). Moreover, being a student was associated with poor sleep quality (OR 43.6, CI95%5.4 – 350, p< .001). Conclusion: This study suggests that confinement decreased healthy living habits such as good nutrition and physical activity and affected the quality of sleep in young subjects. Alternate :Objetivo: determinar los cambios en el estilo de vida, como la actividad física, la nutrición y el sueño en una población universitaria argentina, causados por el confinamiento durante la pandemia de COVID-19. Métodos: Estudio transversal mediante encuesta por Internet. Participaron 1021 personas de la población universitaria argentina (mujeres, n = 645 y hombres, n = 376) de entre 18 y 70 años de edad. La encuesta fue utilizada para medir el comportamiento de la actividad física, la nutrición y el sueño de los participantes de abril a mayo de 2020.Resultados: los principales hallazgos mostraron que el 4,3% de la muestra presentaba obesidad;la mayor proporción de la muestra permaneció más de 6 horas en estado sedentario;el 21,74% informó sobre la mala calidad del sueño;una reducción de los hábitos correctos de alimentación;y un aumento de los participantes que no realizan actividad física. De acuerdo con factores socio-demográficos y antropométricos, ser estudiante (OR 2.19, CI95% 1.18 - 4, p= .012), el sobrepeso (OR 1.71, CI95% 1.19 - 2.44, p= .003), la obesidad (OR 4.45, CI95% 2.27 - 8.7, p< .001), y haber estado confinado más de 45 días se asoció con una mala alimentación. Asimismo, los bajos niveles de actividad física se asociaron con la obesidad (OR 3,2;IC95% 1,66 - 6,18, p= .001), ser mujer (OR 1,61;IC95% 1,14 -2,28, p= .006) y estar casado (OR 1,72;IC95% 1,14 - 2,61, p= .009). Además, ser estudiante se asoció con una mala calidad de sueño (OR 43,6, CI95% 5,4 - 350, p< .001). Conclusión: Este estudio sugiere que el confinamiento disminuyó los hábitos de vida saludables como la buena nutrición, la actividad física, y afectó la calidad del sueño en sujetos jóvenes.Alternate :Objetivo: determinar mudanças no estilo de vida, como atividade física, nutrição e sono em uma população universitária argentina, causadas pelo confinamento durante a pandemia de COVID-19. Métodos: Estudo transversal via web survey. Participou 1.021 a população universitária argentina (mulheres, n = 645 e homens, n = 376) com idade entre 18 e 70 anos. A pesquisa foi utilizada para medir o comportamento de atividade física, nutrição e sono dos participantes de abril a maio de 2020. Resultados: os principais achados revelaram que 4,3% da amostra apresentava obesidade;a maior proporção da amostra permaneceu mais de 6 horas em sedentarismo;21,74% relataram má qualidade do sono;uma redução no bom padrão de alimentação;e aumento de sujeitos que não realizam atividade física. De acordo com fatores sociodemográficos e antropométricos, ser estudante (OR 2,19, IC95% 1,18 - 4, p = 0,012), sobrepeso (OR 1,71, IC95% 1,19 - 2,44, p = 0,003), obesidade (OR 4,45, IC95% 2,27 - 8,7, p <0,001) e ter sido confinado por mais de 45 dias foi associado a má alimentação. Da mesma forma, baixos níveis de atividade física foram associados à obesidade (OR 3,2 IC95% 1,66 - 6,18, p = 0,001), ser do sexo feminino (OR 1,61, IC95% 1,14 -2,28, p = 0,006) e casar (OR 1,72, IC95 % 1,14 - 2,61, p = 0,009). Além disso, ser estudante foi associado à má qualidade do sono (OR 43,6, IC95% 5,4 - 350, p <0,001). Conclusão: Este estudo sugere que o confinamento diminuiu hábitos de vida saudáveis, como boa alimentação e atividade física, e afetou a qualidade do sono em jovens.

COVID-19 Survivor Patients Carrying the Rs35705950 Risk Allele in MUC5B Have Higher Plasma Levels of Mucin 5B.

BACKGROUND: Genetic susceptibility to infectious diseases is partly due to the variation in the human genome, and COVID-19 is not the exception. This study aimed to identify whether risk alleles of known genes linked with emphysema (SERPINA1) and pulmonary fibrosis (MUC5B) are associated with severe COVID-19, and whether plasma mucin 5B differs according to patients' outcomes. MATERIALS AND METHODS: We included 1258 Mexican subjects diagnosed with COVID-19. We genotyped rs2892474 and rs17580 of the SERPINA1 gene and rs35705950 of MUC5B. Based on the rs35705950 genotypes, mucin 5B plasma protein levels were quantified. RESULTS: Homozygous for the risk alleles of the three polymorphisms were found in less than 5% of the study population, but no statistically significant difference in the genotype or allele association analysis. At the protein level, non-survivors carrying one or two copies of the risk allele rs35705950 in MUC5B (GT + TT) had lower levels of mucin 5B compared to the survivors (0.0 vs. 0.17 ng/mL, p = 0.0013). CONCLUSION: The polymorphisms rs28929474 and rs17580 of SERPINA1 and rs35705950 of MUC5B are not associated with the risk of severe COVID-19 in the Mexican population. COVID-19 survivor patients bearing one or two copies of the rs35705950 risk allele have higher plasma levels of mucin 5B.

Anthropometric Parameters, Physical Activity, Physical Fitness, and Executive Functions among Primary School Children.

Physical activity during childhood and adolescence favors brain development and cognitive functioning, particularly the executive functions. This study aimed to assess potential associations between anthropometric parameters, physical activity, physical fitness, and executive functions among elementary school children returning to school after the COVID-19 lockdown in Chile. School-age male and female participants (n = 90; age, 10-12 years) participated in the study. To determine the association between variables, a multivariable linear regression analysis was performed. Higher fat-related anthropometric indexes were associated with lower working memory, cognitive flexibility, planning, and attention (r = -0.55 to -0.22; p = 0.031 to <0.001). In contrast, higher physical activity levels, better sprint performance, higher lower-body muscular power, and greater upper-body muscular strength were associated with better working memory, cognitive flexibility, inhibition, planning, and/or attention (r = 0.19 to -0.54; p = 0.04 to <0.001). Current results consistently suggest the need for adequate levels of physical activity, physical fitness, and anthropometric parameters among the school-age population to promote healthy and adequate executive functions.

Novel Ratio Soluble Fms-like Tyrosine Kinase-1/Angiotensin-II (sFlt-1/ANG-II) in Pregnant Women Is Associated with Critical Illness in COVID-19.

BACKGROUND: In healthy pregnancies, components of the Renin-Angiotensin system (RAS) are present in the placental villi and contribute to invasion, migration, and angiogenesis. At the same time, soluble fms-like tyrosine kinase 1 (sFlt-1) production is induced after binding of ANG-II to its receptor (AT-1R) in response to hypoxia. As RAS plays an essential role in the pathogenesis of COVID-19, we hypothesized that angiogenic marker (sFlt-1) and RAS components (ANG-II and ACE-2) may be related to adverse outcomes in pregnant women with COVID-19; Methods: Prospective cohort study. Primary outcome was severe pneumonia. Secondary outcomes were ICU admission, intubation, sepsis, and death. Spearman's Rho test was used to analyze the correlation between sFlt-1 and ANG-II levels. The sFlt-1/ANG-II ratio was determined and the association with each adverse outcome was explored by logistic regression analysis and the prediction was assessed using receiver-operating-curve (ROC); Results: Among 80 pregnant women with COVID-19, the sFlt-1/ANG-II ratio was associated with an increased probability of severe pneumonia (odds ratio [OR]: 1.31; p = 0.003), ICU admission (OR: 1.05; p = 0.007); intubation (OR: 1.09; p = 0.008); sepsis (OR: 1.04; p = 0.008); and death (OR: 1.04; p = 0.018); Conclusion: sFlt-1/ANG-II ratio is a good predictor of adverse events such as pneumonia, ICU admission, intubation, sepsis, and death in pregnant women with COVID-19.

Lifestyle and Sociodemographic Parameters Associated with Mental and Physical Health during COVID-19 Confinement in Three Ibero-American Countries. A Cross-Sectional Pilot Study.

BACKGROUND: The aim of the present study was to determine the association between the health-related quality of life (HRQoL) with sociodemographic parameters and lifestyle during COVID-19 confinement in Mexico, Chile, and Spain. METHODS: A cross-sectional pilot study, with 742 observations of online surveys in 422, 190, and 130 individuals from Mexico, Chile, and Spain, respectively. Sociodemographic data, presence of comorbidities, food habits, and physical activity (PA) patterns were evaluated. The HRQoL was evaluated according to the SF-36 Health Survey. The multilinear regression analysis was developed to determine the association of variables with HRQoL and its physical and mental health dimensions. RESULTS: The female sex in the three countries reported negative association with HRQoL (Mexico: ß -4.45, p = 0.004; Chile: ß -8.48, p < 0.001; Spain: ß -6.22, p = 0.009). Similarly, bad eating habits were associated negatively with HRQoL (Mexico: ß -6.64, p < 0.001; Chile: ß -6.66, p = 0.005; Spain: ß -5.8, p = 0.032). In Mexico, PA limitations presented a negative association with HRQoL (ß -4.71, p = 0.011). In Chile, a sedentary lifestyle (h/day) was linked negatively with HRQoL (ß -0.64, p = 0.005). In Spain, the highest associations with HRQoL were the presence of comorbidity (ß -11.03, p < 0.001) and smoking (ß -6.72, p = 0.02). Moreover, the PA limitation in Mexico (ß -5.67, p = 0.023) and Chile (ß -9.26, p = 0.035) was linked negatively with mental health. CONCLUSIONS: The bad eating habits, PA limitations, female sex, comorbidity presence, and smoking were parameters linked negatively with HRQoL.

Positive and Negative Changes in Food Habits, Physical Activity Patterns, and Weight Status during COVID-19 Confinement: Associated Factors in the Chilean Population.

The association between the changes in lifestyle during coronavirus disease 2019 (COVID-19) confinement and body weight have not been studied deeply. Therefore, the aim of the present study was to determine lifestyle changes, such as eating habits and physical activity (PA) patterns, caused by confinement during the COVID-19 pandemic and to analyze its association with changes in body weight. Seven hundred participants (women, n = 528 and men, n = 172) aged between 18-62 years old of the Chilean national territory participated in the study. Food habits, PA, body weight, and sociodemographic variables were measured through a survey in May and June 2020. The body weight increase presented positive association with the consumption of fried foods ≥ 3 times per week (OR; 3.36, p < 0.001), low water consumption (OR; 1.58, p = 0.03), and sedentary time ≥6 h/day (OR; 1.85, p = 0.01). Conversely, fish consumed (OR; 0.67, p = 0.03), active breaks (OR; 0.72, p = 0.04), and PA ≥ 4 times per week (OR; 0.51, p = 0.001) presented an inverse association with body weight increase. Daily alcohol consumption (OR; 4.77, p = 0.003) was associated with PA decrease. Food habits, PA, and active breaks may be protective factors for weight increase during COVID-19 confinement.