Clinical and cardiovascular characteristics from subjects with in COVID-19 and viral outbreaks.

Introduction: Lower respiratory tract infections remain the deadliest communicable disease worldwide. The relationship between cardiovascular diseases and viral infections is well known; for example, during the AH1N1 influenza pandemic, many patients developed acute cardiovascular disease. In the SARS-CoV2 pandemic, cardiovascular health has again become a challenge, with early reports showing cardiac damage in these patients. Objective: The study aims to describe the clinical characteristics of COVID-19 patients with an emphasis on cardiovascular compromises, compared with past outbreaks of influenza AH1N1, to identify prognostic factors of severity. Methods: A cross-sectional study of 72 subjects with a confirmed diagnosis of COVID-19 was conducted. Subjects were evaluated in two groups: 38 hospitalized patients and 34 patients in the Intensive Care Unit (ICU). Data from different outbreaks of influenza AH1N1 were then compared with this group. Results: The 34 subjects in the ICU had higher levels of high sensible troponin, D dimer, creatinine, and leukocytes compared with the 38 hospitalized subjects. The lymphocytes count was diminished in 85.29% of ICU subjects. When compared with AH1N1 patients, it was found that SARS-CoV2 patients were 10 years older on average. The proportion of overweight and obese SARS-CoV2 patients was double that in the influenza outbreaks. In addition, it was observed that a high number of SARS-CoV2 subjects presented with diabetes mellitus. Conclusion: There were various clinical and severity differences between each of these outbreaks. However, viral respiratory infection diseases such as SARS-CoV2 are a significant risk factor for acute ischemic, functional, and structural cardiovascular complications. The only way to combat this risk is a prevention approach, specifically through vaccines, but also through measures that force drastic changes in health policies to reduce perhaps the worst of pandemics, obesity, and its metabolic consequences.

Body composition and risk factors associated with sarcopenia in post-COVID patients after moderate or severe COVID-19 infections.

BACKGROUND: Post-COVID-19 syndrome is characterized by diverse symptoms and abnormalities that persist beyond 12 weeks from the onset of acute COVID-19. Severity disease has been associated with more musculoskeletal alterations such as muscle weakness, dyspnea, and distance walking. The aim was to evaluate the impact of invasive mechanical ventilation (IMV) on body composition and investigate risk factors associated with sarcopenia in post-COVID-19 patients three months after moderate or severe COVID-19 infections. METHODS: Cross-sectional study. 530 patients with PCR-confirmed diagnoses of moderate to severe COVID-19, > 18 years old, oxygen saturation ≤ 93%, PaO2/FiO2 ratio < 300, who required hospitalization and were discharged were included. We excluded those who died before the follow-up visit, declined to participate, or could not be contacted. RESULTS: The mean age was 53.79 ± 12.90 years. IMV subjects had lower phase angle and handgrip strength and higher impedance index, frequency of low muscle mass, and low muscle strength than those without IMV. The risk factors of sarcopenia were > 60 years of age, diabetes, obesity, IMV, and prolonged hospital stay. The multivariate model showed that age > 60 years (OR: 4.91, 95% CI: 2.26-10.63), obesity (OR: 3.73, 95% CI: 1.21-11.54), and interaction between prolonged length of hospital stay and IMV (OR: 2.92; 95% CI: 1.21-7.02) were related to a higher risk of sarcopenia. CONCLUSION: Obesity and the interaction between prolonged length of hospital stay and IMV are associated with a higher risk of sarcopenia at 3 months after severe or moderate COVID-19 infection.

Effect in self-care behavior and difficulties in coping with diabetes during the COVID-19 pandemic

In this study, difficulties in coping with diabetes were evaluated during the coronavirus disease 2019 (COVID-19) lock-down. Similarly, the change in diabetes self-care activities was evaluated in patients with a recent assessment before COVID-19 lockdown in Mexico City. In 212 patients with type 2 diabetes (T2D) and regular primary care, a designed questionnaire was used to evaluate the presence/absence of difficulties in self-care related to diet, physical activity/exercise, glucose monitoring, treatment adherence, getting pharmacological treatment, and confinement adherence. The Summary of Diabetes Self-Care Activities tool was used to compare the frequency of self-care behaviors in the past 7 days. Self-reported difficulties in coping with T2D were documented and included difficulties in self-care behaviors related to diet (41.6%), physical activity/exercise (40.5%), glucose monitoring (23.7%), getting pharmacological treatment (22.9%), pharmacological treatment adherence (19%), and home-confinement adherence (11.7%). In the group of patients with a recent previous-lockdown evaluation, global self-care behavior decreased from 5.15±0.9 to 4.49 ± 1.02 days/week, p 0.001. Diabetes self-care was a predictor for the presence of difficulties in coping with diabetes. Patients with T2D reported difficulties in coping with T2D and decreased diabetes self-care activities during the COVID-19 lockdown in Mexico City. Health-care policies must be designed and implemented to attenuate diabetes disease burden caused by this ongoing and future health-contingencies. En el presente estudio se evaluaron las dificultades para hacer frente a la diabetes por los pacientes durante el confinamiento por COVID-19. Así mismo, se evaluó el cambio en las actividades de autocuidado de diabetes en pacientes con evaluación reciente antes del confinamiento por COVID-19 en la Ciudad de México. En 212 pacientes con diabetes tipo 2 (DT2), se utilizó un cuestionario diseñado para evaluar la presencia/ausencia de dificultades para el autocuidado. La herramienta Summary of Diabetes Self-Care Activities (SDCA) se utilizó para comparar las actividades de autocuidado, reportado en días a la semana. Las dificultades reportadas por los pacientes incluyeron las relacionadas con: alimentación (41.6%), actividad física/ejercicio (40.5%), monitoreo de glucosa (23.7%), acceso al tratamiento farmacológico (22.9%), adherencia al tratamiento farmacológico (19%) y adherencia al confinamiento (11.7%). En el grupo de pacientes con una evaluación reciente previa al confinamiento, la actividad global de autocuidado disminuyó de 5,15±0,9 a 4,49±1,02 días/semana, valorp 0,001. El autocuidado en diabetes fue predictor de la presencia de dificultades para hacer frente a la diabetes. Los pacientes informaron dificultades para afrontar la diabetes y disminuyeron las actividades de auto-cuidado durante el confinamiento por COVID-19. Políticas de atención médica deben diseñarse e implementarse para atenuar la carga de la enfermedad causado por esta y futuras contingencias en salud.