DYNAMO Covid-19 Dynamic assessment of multi organ level dysfunction in patients recovering from Covid-19: insulin resistance and metabolic flexibility

P226 Figure 1ConclusionPatients recovering from severe Covid-19 have worse insulin sensitivity compared to controls, but similar metabolic flexibility. Physical inactivity and liver adiposity may play a role in these observations.FundingNIHR Nottingham BRC (NoRCoRP), PHOSP UKRI, Nottingham Hospitals Charity, University of Nottingham alumni donation.

Heritability of temperature and theeffects of ageing on temperatureregulation: An observational multi-cohortstudy

Introduction Ageing affects homeostasis and immunosenescence, resulting inaberrant fever and immune responses to infection in older adults.This study assesses heritability of basal temperature and exploreseffects of ageing on basal temperature and temperature inresponse to SARS-CoV-2 infection. Methods Observational study using multiple cohorts. Participants: (a) Twinvolunteers: 1089 healthy adults enrolled in Twins-UK, mean age59 (17);tympanic temperature measurements;(b) Community-based: 3972 adults using the COVID Symptom Study mobileapplication, age 43 (13);self-reported test-positive for SARS-CoV-2 infection;self-reported temperature measurements;(c)Hospitalised: cohorts of 520 and 757 adult patients withemergency admission to two teaching hospitals between01/03/2020-04/05/2020, age 62 (17) and 68 (17) respectively;RT-PCR-confirmed SARS-CoV-2 infection. Analysis (a) heritability analysed using saturated and ACE univariatemodels;linear mixed-effect model for associations between basaltemperature and age, sex and BMI. (b&c) multivariable linearregression for associations between temperature and age, sex and BMI;multivariable logistic regression for associations betweenfever(>/= 37.8°C) and age, sex and BMI. Results Basal temperature in twins demonstrated 50% heritability(95%CI[42-57%]). In healthy twin, community-based and hospitalised cohorts, increasing age is associated with lowertemperatures, and increasing BMI with higher temperatures: (a)Twins (age:p < 0.001;BMI:p = 0.002);(b) Community-based (age:p < 0.001;BMI: p < 0.001);(c) Hospitalised (1st hospital: age: p = 0.106;BMI: p = 0.033;2nd hospital: age: p < 0.001;BMI: p = 0.010).Increasing age was negatively and BMI positively associated withfever (1st hospital: Age: OR = 0.99, p = 0.033;BMI: OR = 1.00, p = 0.045;2nd hospital: Age: OR = 0.99, p = 0.010;BMI: OR 1.02, p = 0.038). Conclusions Heritability of basal temperature suggests a genetic component tothermoregulation. Associations observed between increasing ageand lower temperatures and higher BMI and higher temperaturesare important in understanding effects of ageing and obesity onbasal temperature and the fever response. In older adults, findingshave important implications for defining fever thresholds and diagnosing infections, including SARS-CoV-2.