Association between lifestyle factors and weight in Japan university students during COVID-19 mild lockdown: a quantitative study (preprint)

We investigated the lifestyle factors influencing weight gain in university students during restrictions (mild lockdown) imposed owing to the novel coronavirus disease pandemic in Japan. In this cross-sectional study, a questionnaire survey of Nagasaki University students undergoing health examinations was conducted in 2021. Students reporting >=3 kg weight gain were included in the weight gain group; the remaining students were in the non-weight gain group. Fishers exact test and binary logistic regression were performed to detect the associations between weight gain and each lifestyle factor. We included 3,059 respondents (response rate: 45.7%), and 9.5% respondents reported >=;3 kg weight gain. The following factors were associated with weight gain (odds ratio, 95% confidence interval, p value from Fishers exact test): dining out for >=4 times/week (2.16 [1.40, 3.32], p = 8.7 x 10-4), gaming time of >=4 h/day (2.26 [1.45, 3.47], p = 2.4 x 10-4). Binary logistic regression among the four highest odds ratios showed that after adjusting for other factors frequently dining out and prolonged gaming time were significantly associated with weight gain. Prolonged gaming and frequently dining out were associated with weight gain in students during the mild lockdown.

Evaluation of triage checklist for mild COVID-19 outpatients in predicting subsequent emergency department visits and hospitalization during isolation period (preprint)

ABSTRACT Background and objective Limited evidence exists regarding the outcomes of patients with coronavirus disease 2019 (COVID-19) who are not hospitalized. This study aimed to assess the outcomes for mild COVID-19 patients in terms of emergency department (ED) visits and hospital admission given initial outpatient triage evaluation and to identify the triage factors affecting these outcomes. Methods This retrospective cohort study investigated adult COVID-19 Japanese patients who were triaged at Nagasaki University Hospital between April 1, 2021, and May 31, 2021. A triage checklist with 30 factors was used to identify patients requiring hospitalization. Patients recommended for isolation were followed up for later ED visit or hospital admission. Results Overall, 338 COVID-19 patients (mean age, 44.7; 45% women) visited the clinic at an average of 5.4 days after symptom onset. Thirty-six patients (10.6%) were hospitalized from triage, and the rest were recommended for isolation. Seventy-two non-hospitalized patients (23.8%) visited ED during their isolation period, and 30 (9.9%) were hospitalized after ED evaluation. The mean duration to ED visit and hospitalization after symptom onset were 8.8 and 9.7 days, respectively. Checklist factors associated with hospitalization during the isolation period were age > 50 years, obesity with BMI > 25, underlying hypertension, tachycardia with HR > 100/min or blood pressure >135 mmHg at triage, and >□3-day delay in hospital visit after symptom onset. Conclusion Clinicians should be wary of COVID-19 patients with above risk factors and prompt them to seek follow-up assessment by a medical professional. SUMMARY AT A GLANCE Overall, 338 patients with mild COVID-19 were retrospectively followed up. Factors such as age >□50 years, BMI□> □25, underlying hypertension, high blood pressure and tachycardia at triage, and delayed visit after symptom onset were associated with emergency department visit and hospitalization during the isolation period.

Rethinking antiviral effects for COVID-19 in clinical studies: early initiation is key to successful treatment (preprint)

Development of an effective antiviral drug for COVID-19 is a global health priority. Although several candidate drugs have been identified through in vitro and in vivo models, consistent and compelling evidence for effective drugs from clinical studies is limited. The lack of evidence could be in part due to heterogeneity of virus dynamics among patients and late initiation of treatment. We first quantified the heterogeneity of viral dynamics which could be a confounder in compassionate use programs. Second, we demonstrated that an antiviral drug is unlikely to be effective if initiated after a short period following symptom onset. For accurate evaluation of the efficacy of an antiviral drug for COVID-19, antiviral treatment should be initiated before or soon after symptom onset in randomized clinical trials.