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Background: Kidney dysfunction is a prevalent disease that leads to many complications over time, such as hypertension, heart disease, and death. ACEI/ARBs are known to be renoprotective. However, few studies describe the association between ACEI/ARB use and kidney dysfunction in patients with SARS-CoV-2 infection. Purpose(s): To explore the association between patients with SARS-CoV- 2 and kidney dysfunction in patients taking an ACEI/ARB. We hypothesize a negative association between patients with SARS-CoV-2 taking an ACEI/ARB and kidney dysfunction. Method(s): A retrospective query between March 2020 and April 2021 was performed in patients 18 years and older who tested positive for SARSCoV- 2 using a polymerase chain reaction test. Patients were divided into two groups: Kidney dysfunction and no kidney dysfunction. Kidney dysfunction was defined as any diagnosis of chronic kidney disease or acute kidney injury. Primary outcomes were all-cause mortality and hospitalization rate. Secondary outcomes included myocardial infarction (MI), hypotension, intubation, vasopressor use, ventricular tachycardia, and ventricular fibrillation. We used multivariate logistic regression to adjust for baseline characteristics. Result(s): We identified 996 patients with kidney dysfunction and 22,106 without kidney dysfunction who tested positive for SARS-CoV-2. The incidence was 258 (25.9%) for ACEI/ARB use in patients with kidney dysfunction. Adjusted odds ratio (OR) for patients with kidney dysfunction was 5.705 (95% Confidence Interval [CI]: 4.554-7.146;p<0.001) for hospitalization, 0.895 (95% CI: 0.707-1.135;p<0.361) for patients taking ACEI/ARB, and 0.529 (95% CI: 0.333-0.838;<0.007) for mortality in patients with kidney dysfunction who took ACEI/ARB. All secondary outcomes had significantly greater adjusted OR (p<0.001), except for MI (p<0.339), ventricular tachycardia (p<0.697), and ventricular fibrillation (p<0.060). Conclusion(s): To date, the benefits of ACEI/ARB in SARS-CoV-2 patients have been controversial. While ACEI/ARB is known to have renoprotective properties, we did not find a significant association between ACEI/ARB and kidney dysfunction in patients with SARS-CoV-2. However, we found the use of ACEI/ARB in patients with kidney dysfunction to be associated with lower mortality. Therefore, clinicians should continue using this medication for its mortality benefits in patients with kidney dysfunction and its cardioprotective effects.
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Background: The COVID-19 pandemic may have worsened food insecurity and altered the eating behaviour of young adults. Therefore, this cross-sectional study aims to investigate the correlation between moderate-to-severe food insecurity and the risk of eating disorders among young urbanists in Malaysia after the pandemic-led lockdown. Methods: The food security status and the risk of eating disorders were assessed using the validated Food Insecurity Experience Scale (FIES) and Eating Attitude Test (EAT-26), respectively. Results: Among the 208 young urbanists, approximately one-third (30.8%) were moderate-to-severe food insecure and about one-fifth (18.8%) were at risk of eating disorders after the nationwide lockdown. With the adjustment of gender, the binary logistic regression analysis revealed that moderate-to-severe food insecure individuals were 2.279 times (P = 0.030, 95% CI = 1.084-4.791) more likely to engage in disordered eating in the aftermath of the COVID-19 pandemic. The findings of partial correlation further indicated that moderate-to-severe food insecurity was positively correlated (rpartial = 0.156, P = 0.024) with bulimia and food preoccupation after the outbreak. Conclusions: Governments and non-governmental organizations must work closely to develop effective policies to address food insecurity and disordered eating behaviour among young urbanists - after the pandemic.
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Background: To date, the Malaysian government has implemented three nationwide lockdowns (Movement Control Order, MCO) to mitigate the spread of COVID-19 transmission. It is predicted that children’s eating behaviour could be different due to the sudden change in daily routine and school closure during the pandemic. Therefore, this study aims to compare the children’s eating behaviour during the implementation of MCO 1.0 and MCO 2.0. Methods: Children’s eating behaviour during the lockdowns was assessed with a 35-item validated Children’s Eating Behaviour Questionnaire (CEBQ). Results: Children in Malaysia attained significantly higher mean scores (p<0.05) in food responsiveness, enjoyment of food, and desire to drink subscales in MCO 2.0 than that of MCO 1.0. Conversely, significantly lower mean scores (p<0.05) were observed in satiety responsiveness and slowness in eating subscales during the MCO 2.0 compared to MCO 1.0. Conclusion: Children residing in Malaysia had higher food responsiveness, food enjoyment, desire to drink, and eating speed during the MCO 2.0 than MCO 1.0. The findings of this study may be useful for the policymakers in formulating healthy eating intervention strategies in the post-COVID-19 era. © 2022, Faculty of Medicine, University of Malaya. All rights reserved.
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Background: SARS-CoV-2 infection affects the cardiovascular system and can result in vascular dysregulation and dysfunction. However, the hospitalization rates due to pre-existing cardiovascular disease and concomitant SARS-CoV-2 infection are not fully known. Purpose: To further elucidate the association between hospitalization and SARS-CoV-2 patients with pre-existing cardiovascular disease. We hypothesize that pre-existing cardiovascular disease is positively associated with hospitalization in patients who test positive for SARS-CoV-2. Methods: This is a retrospective study of patients 18 years and older who tested positive for SARS-CoV-2 between March 2020 and April 2021. Patients with cardiovascular co-morbidities, specifically hypertension, coronary artery disease (CAD), heart failure, were analyzed. The primary outcome was hospitalization. Secondary outcomes were all-cause mortality, myocardial infarction (MI), vasopressor use, hypotension, intubation, and acute kidney injury. Multivariate logistic regression analysis adjusted for demographics and comorbidities. Results: We identified 23,076 patients who tested positive for SARS-CoV-2;the hospitalization rate was 11.8% (2,721 patients). The incidence was 722 (26.5%) for CAD, 2068 (76%) for hypertension, 534 (91.3%) for heart failure, 188 (6.9%) for ESRD, 1484 (58.6%) for diabetes in patients who were hospitalized. The adjusted odds ratio (OR) of hospitalization was of 1.54 (95% Confidence Interval [CI]: 1.112–2.125;p<0.009) in patients with CAD, 5.730 (95% CI: 4.685–7.009;p<0.001) in patients with hypertension, 3.639 (95% CI: 2.308–5.737;p<0.001) in patients with heart failure. Use of angiotensin-converting enzyme inhibitor (ACEI) (p<0.001) was associated with reduced hospitalization, while the use of hydralazine (p<0.001), beta-blockers (p<0.001), and calcium channel blockers (p<0.001) were associated with increased hospitalization. Conclusion: SARS-CoV-2 positive patients with CAD, hypertension or heart failure were associated with increased hospitalization. Admitted patients were more likely to be taking calcium channel blockers, beta-blockers, and hydralazine. In contrast, these patients were also less likely to be taking ACEI. Funding Acknowledgement: Type of funding sources: None.
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Purpose The Malaysian movement control order is a series of national lockdowns implemented by the Malaysian federal government to contain the spread of Coronavirus disease-2019 (COVID-19). The government has made it mandatory for all non-essential sectors to work remotely to mitigate the spread of COVID-19. The eating behavior of working adults may have altered following the changes in working norms. This study aimed to assess the eating behavior of remote working adults during the COVID-19 pandemic. Design/methodology/approach A total of 159 remote working adults were recruited through a convenience sampling approach. Bodyweight and body height were self-reported by the respondents. Body mass index was calculated according to the cut-off of World Health Organization standards. The eating behavior was evaluated using the eating behavior questionnaire. Findings Results revealed more than half of the remote working respondents did not practice meal skipping. Irrespective of the gender, more than 70% of the respondents consumed either breakfast, lunch or dinner every day. Most of the respondents consumed vegetables, bread/rice/noodles and meat/chicken at least two times per day. Regression analysis revealed meal skipping was associated with younger people, overweight status and median monthly household income. Originality/value Many sectors adopted remote working systems during the COVID-19 pandemic. It is postulated that working remotely will be a new normal even after this pandemic. Until now, to the best of the authors' knowledge, little or no data are available on assessing the eating behavior of remote working adults during the COVID-19 pandemic. This study could provide an insight into the eating behavior of adults during remote working.
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Purpose This study aims to investigate the relationships among screen time-based sedentary behaviour, eating self-regulatory skills and weight status among private university students during the Movement Control Order (MCO). Design/methodology/approach A total of 186 private university students was enrolled in this cross-sectional study using a combination of snowball and purposive sampling approaches. Anthropometric measurements, including body height, body weight before and during the MCO enforcement were self-reported by the respondents. Screen-time based sedentary behaviour sedentary behaviour was evaluated using HELENA sedentary behaviour questionnaire, whereas the Self-Regulation of Eating Behaviour Questionnaire (SREBQ) was used to determine the eating self-regulatory skills in MCO. Findings Respondents spent most of the time on the internet for non-study purposes (148 +/- 77.7 min). It is also noted that 64.5% of the respondents had medium eating self-regulatory skill during the MCO, with an average score of 3.0 +/- 0.5. Findings from path analysis confirmed that poor eating self-regulation significantly contributed to the weight gain during home confinement (ss = -0.24, p = 0.01). In conclusion, eating self-regulation, but not total screen time, emerged as the determinant for weight gain during the COVID-19 lockdown. Originality/value According to the authors' knowledge, this study was among the few that investigated sedentary behaviour, eating self-regulatory skills and weight status of university students during the COVID-19 pandemic.