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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322034

ABSTRACT

Background: . Patients with inborn errors of metabolism (IEM) pose specific management challenges, considering their multisystem involvement. Among them, children and adults with organic acidemias (OA) and other disorders of the amino acid metabolism have a high risk for severe metabolic events that need to be recognized and promptly treated, and therefore require frequent clinical and biochemical evaluations. The novel highly pathogenic SARS-CoV2 virus appeared in Europe in the first trimester of 2020. This pandemic has a huge impact on the health care systems all over the world, interrupting the follow-up of many chronic diseases. For metabolic patients, travel to reference units may be reduced due to mobility restrictions but more importantly, attendance to medical facilities can be a risk of infection that can be a danger in itself but also trigger a metabolic decompensation. Methods: . During the first coronavirus disease (COVID-19 ) outbreak in Spain from March to June 2020, we designed a model of remote monitoring of our patients with amino acid disorders using telephone and/or online clinical assessments and using filter paper samples to continue the biochemical control. Results: . Fourteen patients with inborn errors of amino acid metabolism other than PKU received filter papers and instructions to collect blood and urine samples home and send them to our reference laboratory. Conclusions: . Considering the COVID19 pandemic evolution, new strategies to ensure IEM patients have an evaluation continuity need to be implemented. We believe that blood and urine filter paper biochemical follow-up, together with online or telephone clinical assessments, can help minimize the need for in-hospital visits.

3.
Nutrition ; 91-92: 111467, 2021.
Article in English | MEDLINE | ID: covidwho-1442501

ABSTRACT

OBJECTIVES: Zinc and copper are important to protect cells from oxidative stress and to enhance immunity. An association between low zinc levels and the severity of acute respiratory distress syndrome has been shown for people with COVID-19. We aimed to study serum zinc and copper concentrations in people with severe COVID-19 and zinc supplementation in parenteral nutrition (PN). METHODS: Thirty-five people with COVID-19 in need of PN were studied in a retrospective design. Serum samples were collected at three time points: at the start of PN, between 3 and 7 d after, and at the end of PN. RESULTS: Participants were on PN for a mean of 14 d, with a mean (± SD) daily supplemental zinc of 14.8 ± 3.7 mg/d. Serum zinc increased during PN administration from 98.8 ± 22.8 to 114.1 ± 23.3 µg/dL (Wilks' λ = 0.751, F = 5.459, P = 0.009). Conversely, serum copper did not vary from baseline (107.9 ± 34.2 µg/dL) to the end of the study (104.5 ± 37.4 µg/dL, Wilks' λ = 0.919, F = 1.453, P = 0.248). Serum zinc within the first week after starting PN and at the end of PN inversely correlated with total hospital stay (r = -0.413, P = 0.014, and r = -0.386, P = 0.022, respectively). Participants in critical condition presented lower serum copper (z = 2.615, P = 0.007). Mortality was not associated with supplemental zinc or with serum zinc or copper concentrations at any time of the study (P > 0.1 for all analyses). CONCLUSIONS: Serum zinc concentrations during PN support were inversely associated with length of hospital stay but not with mortality. Serum copper concentrations were lower in participants in critical condition but not associated with prognosis.


Subject(s)
COVID-19 , Copper , Dietary Supplements , Humans , Parenteral Nutrition , Retrospective Studies , SARS-CoV-2 , Zinc
4.
Nutrients ; 13(9)2021 Aug 28.
Article in English | MEDLINE | ID: covidwho-1374478

ABSTRACT

We aimed to study the possible association of stress hyperglycemia in COVID-19 critically ill patients with prognosis, artificial nutrition, circulating osteocalcin, and other serum markers of inflammation and compare them with non-COVID-19 patients. Fifty-two critical patients at the intensive care unit (ICU), 26 with COVID-19 and 26 non-COVID-19, were included. Glycemic control, delivery of artificial nutrition, serum osteocalcin, total and ICU stays, and mortality were recorded. Patients with COVID-19 had higher ICU stays, were on artificial nutrition for longer (p = 0.004), and needed more frequently insulin infusion therapy (p = 0.022) to control stress hyperglycemia. The need for insulin infusion therapy was associated with higher energy (p = 0.001) and glucose delivered through artificial nutrition (p = 0.040). Those patients with stress hyperglycemia showed higher ICU stays (23 ± 17 vs. 11 ± 13 days, p = 0.007). Serum osteocalcin was a good marker for hyperglycemia, as it inversely correlated with glycemia at admission in the ICU (r = -0.476, p = 0.001) and at days 2 (r = -0.409, p = 0.007) and 3 (r = -0.351, p = 0.049). In conclusion, hyperglycemia in critically ill COVID-19 patients was associated with longer ICU stays. Low circulating osteocalcin was a good marker for stress hyperglycemia.


Subject(s)
COVID-19/blood , Hyperglycemia/blood , Osteocalcin/blood , Parenteral Nutrition/mortality , SARS-CoV-2 , Aged , Biomarkers/blood , COVID-19/complications , COVID-19/mortality , Critical Care Outcomes , Critical Illness/mortality , Female , Humans , Hyperglycemia/mortality , Hyperglycemia/virology , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Middle Aged , Prognosis
6.
Mol Genet Metab ; 131(3): 285-288, 2020 11.
Article in English | MEDLINE | ID: covidwho-797595

ABSTRACT

Quantitative estimates for the global impact of COVID-19 on the diagnosis and management of patients with inborn errors of metabolism (IEM) are lacking. We collected relevant data from 16 specialized medical centers treating IEM patients in Europe, Asia and Africa. The median decline of reported IEM related services in March 1st-May 31st 2020 compared to the same period in 2019 were as high as 60-80% with a profound impact on patient management and care for this vulnerable patient group. More representative data along with outcome data and guidelines for managing IEM disorders under such extraordinary circumstances are needed.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/statistics & numerical data , Metabolism, Inborn Errors/diagnosis , Metabolism, Inborn Errors/therapy , Africa/epidemiology , Asia/epidemiology , COVID-19/epidemiology , COVID-19/virology , Comorbidity , Delivery of Health Care/methods , Delivery of Health Care/trends , Europe/epidemiology , Humans , Infant, Newborn , Mass Screening/methods , Mass Screening/statistics & numerical data , Metabolism, Inborn Errors/epidemiology , Neonatal Screening/methods , Pandemics , Phenylketonurias/diagnosis , Phenylketonurias/epidemiology , Phenylketonurias/therapy , SARS-CoV-2/physiology
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