[Influence of diet in COVID-19 infection and severity risk: a systematic review]. / Influencia de la dieta en el riesgo de infección y de gravedad de la COVID-19: una revisión sistemática.

Introduction: Introduction: the risk and/or prognosis of COVID-19, caused by the SARS-CoV-2 virus, have been related to chronic diseases such as obesity, diabetes mellitus, and cardiovascular diseases, with poor-quality diet being a predisposing factor for these diseases. Objective: to synthesize the scientific evidence on the effect of diet on the risk of SARS-CoV-2 infection and severe COVID-19. Methods: a systematic review was carried out following the PRISMA guidelines. The bibliographic search was made in the databases Web of Science, Scopus and Medline (through the PubMed search engine). Risk of bias analysis was performed using the Newcastle-Ottawa and Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies scales. Results: 14 studies were included. Good adherence to the Mediterranean diet was associated with a decreased risk of SARS-CoV-2 infection (OR = 0.44; 95 % CI, 0.22-0.88, for high versus low adherence, and significant ORs of 0.88 and 0.95 in studies that analyzed adherence quantitatively) but not with the severity of COVID-19. A plant-based diet also had a protective association against both COVID-19 infection and severity. Specifically, a high consumption of vegetables, legumes and cereals, and a low intake of dairy products and red meat showed a protective effect against infection and/or COVID-19 severity, depending on the study. Vitamin and probiotic supplements also lowered the risk of infection. Conclusion: the available evidence suggests that a healthy diet, based on a Mediterranean or plant-based diet, with moderate consumption of dairy and red meat, exerts a protective effect against COVID-19.

Introducción: Introducción: el riesgo y/o el pronóstico de la COVID-19, causado por el virus SARS-CoV-2, se han relacionado con enfermedades crónicas como obesidad, diabetes mellitus y enfermedades cardiovasculares, siendo la dieta de mala calidad un factor predisponente para estas enfermedades. Objetivo: sintetizar la evidencia científica sobre el efecto de la dieta en el riesgo de infección por SARS-CoV-2 y de COVID-19 grave. Métodos: revisión sistemática realizada siguiendo las guías PRISMA. La búsqueda bibliográfica se hizo en las bases de datos Web of Science, Scopus y Medline (a través del buscador PubMed). El análisis del riesgo de sesgo se realizó mediante las escalas Newcastle-Ottawa y Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Resultados: se incluyeron 14 estudios. Una buena adherencia a la dieta mediterránea se asoció con una disminución del riesgo de infección por SARS-CoV-2 (razón de momios RM = 0,44; IC 95 %: 0,22-0,88, para adherencia alta versus baja, y RM significativas de 0,88 y 0,95 en los estudios que analizaron la adherencia de forma cuantitativa) pero no con la gravedad de la COVID-19. Una dieta basada en plantas presentó una asociación protectora frente a la infección y la enfermedad grave. Concretamente, un alto consumo de verdura, legumbres y cereales, y una baja ingesta de lácteos y carnes rojas mostraron un efecto protector frente a la infección y/o la COVID-19 grave, según el estudio. Los suplementos vitamínicos y probióticos también disminuyeron el riesgo de infección. Conclusión: la evidencia disponible sugiere que una dieta saludable, basada en un patrón de dieta mediterránea o en alimentos vegetales, con consumo de lácteos y carnes rojas moderado, ejerce un efecto protector frente a la COVID-19.

Psychological Impact of COVID-19 in the Setting of Dentistry: A Review Article.

The worldwide pandemic has exposed healthcare professionals to a high risk of infection, exacerbating the situation of uncertainty caused by COVID-19. The objective of this review was to evaluate the psychological impact of the COVID-19 pandemic on dental professionals and their patients. A literature review was conducted using Medline-Pubmed, Web of Science, and Scopus databases, excluding systematic reviews, narratives, meta-analyses, case reports, book chapters, short communications, and congress papers. A modified version of the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies. The search retrieved 3879 articles, and 123 of these were selected for the review (7 longitudinal and 116 cross-sectional studies). Elevated anxiety levels were observed in dental professionals, especially in younger and female professionals. Except for orthodontic treatments, patients reported a high level of fear that reduced their demand for dentist treatment to emergency cases alone. The results suggest that the COVID-19 pandemic has had psychological and emotional consequences for dental professionals and their patients. Further research is necessary to evaluate the persistence of this problem over time.

Impact of COVID-19 on Spanish mortality rates in 2020 by age and sex.

BACKGROUND: Previous studies have used different biometric indicators to measure the effect of Covid-19 on population mortality such as the number of deaths or the decrease of life expectancy showing a dependence of mortality on age and sex. According to them, the impact of the pandemic was greater on women than in men and that the older the population, the greater the number of deaths caused by Covid-19. METHODS: We apply graduation techniques and non-parametric methods to estimate mortality rates allowing us to obtain an age-by-age picture of changes in mortality rates from 2018-2019 to 2020. RESULTS: Graduation techniques have detected a significant U-shaped reduction in infant mortality rates although with an anomalous peak in girls aged 10-12. Likewise, we have observed a notable increase in mortality rates of the female population between 28 and 40 years of age. The increase of mortality rates after the age of 70 years was similar for both men and women with a slight decline after the age of 80. CONCLUSIONS: The use of graduation techniques and the focus on age-by-age changes in mortality rates showed a complex behaviour in some tranches of the mortality curve that might otherwise have gone unnoticed.

Tocilizumab in COVID-19: Factors Associated With Mortality Before and After Treatment.

Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized patients with COVID-19 receiving TCZ. In addition, the mean differences between discharged and deceased patients in laboratory parameters measured before and 3, 6 and 9 days after TCZ administration were estimated with weighted generalized estimation equations. The variables associated with time to death were immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17, 8.51), diabetes mellitus (HR 2.63; 95% CI 1.23-5.64), age (HR 1.05; 95% CI 1.02-1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI 1.00-1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis and compared to discharged patients, deceased patients had more lactate dehydrogenase (p = 0.013), troponin I (p = 0.013), C-reactive protein (p = 0.013), neutrophils (p = 0.024), and fewer platelets (p = 0.013) and lymphocytes (p = 0.013) as well as a lower average PaO2/FiO2 ratio. In conclusion, in COVID-19 diagnosed patients receiving TCZ, early treatment decreased the risk of death, while age, some comorbidities and baseline lower platelet counts increased that risk. After TCZ administration, lower platelet levels were again associated with mortality, together with other laboratory parameters.