Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
Ther Adv Endocrinol Metab ; 12: 20420188211054686, 2021.
Article in English | MEDLINE | ID: covidwho-1496096

ABSTRACT

Over time, various guidelines have emphasised the importance of physical activity and exercise training in the management of type 2 diabetes, chronic diseases, including cardiovascular disease and musculoskeletal disorders. The aim of this review is to evaluate the effectiveness of physical activity in people with type 2 diabetes and COVID-19. Most research to date indicates that people with type 2 diabetes who engage in both aerobic and resistance exercise see the greatest improvements in insulin sensitivity. Physical activity is now also known to be effective at reducing hospitalisation rates of respiratory viral diseases, such as COVID-19, due to the beneficial impacts of exercise on the immune system. Preliminary result indicates that home-based exercise may be an essential component in future physical activity recommendations given the current COVID-19 pandemic and the need for social distancing. This home-based physical exercise can be easily regulated and monitored using step counters and activity trackers, enabling individuals to manage health issues that benefit from physical exercise.

2.
Diabetes Care ; 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1496877

ABSTRACT

BACKGROUND: This review was commissioned by the World Health Organization and presents a summary of the latest research evidence on the impact of coronavirus disease 2019 (COVID-19) on people with diabetes (PWD). PURPOSE: To review the evidence regarding the extent to which PWD are at increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and/or of suffering its complications, including associated mortality. DATA SOURCES: We searched the Cochrane COVID-19 Study Register, Embase, MEDLINE, and LitCOVID on 3 December 2020. STUDY SELECTION: Systematic reviews synthesizing data on PWD exposed to SARS-CoV-2 infection, reporting data on confirmed SARS-CoV-2 infection, admission to hospital and/or to intensive care unit (ICU) with COVID-19, and death with COVID-19 were used. DATA EXTRACTION: One reviewer appraised and extracted data; data were checked by a second. DATA SYNTHESIS: Data from 112 systematic reviews were narratively synthesized and displayed using effect direction plots. Reviews provided consistent evidence that diabetes is a risk factor for severe disease and death from COVID-19. Fewer data were available on ICU admission, but where available, these data also signaled increased risk. Within PWD, higher blood glucose levels both prior to and during COVID-19 illness were associated with worse COVID-19 outcomes. Type 1 diabetes was associated with worse outcomes than type 2 diabetes. There were no appropriate data for discerning whether diabetes was a risk factor for acquiring SARS-CoV-2 infection. LIMITATIONS: Due to the nature of the review questions, the majority of data contributing to included reviews come from retrospective observational studies. Reviews varied in the extent to which they assessed risk of bias. CONCLUSIONS: There are no data on whether diabetes predisposes to infection with SARS-CoV-2. Data consistently show that diabetes increases risk of severe COVID-19. As both diabetes and worse COVID-19 outcomes are associated with socioeconomic disadvantage, their intersection warrants particular attention.

3.
BMC Infect Dis ; 21(1): 908, 2021 Sep 04.
Article in English | MEDLINE | ID: covidwho-1455937

ABSTRACT

BACKGROUND: Pre-existing comorbidities have been linked to SARS-CoV-2 infection but evidence is sparse on the importance and pattern of multimorbidity (2 or more conditions) and severity of infection indicated by hospitalisation or mortality. We aimed to use a multimorbidity index developed specifically for COVID-19 to investigate the association between multimorbidity and risk of severe SARS-CoV-2 infection. METHODS: We used data from the UK Biobank linked to laboratory confirmed test results for SARS-CoV-2 infection and mortality data from Public Health England between March 16 and July 26, 2020. By reviewing the current literature on COVID-19 we derived a multimorbidity index including: (1) angina; (2) asthma; (3) atrial fibrillation; (4) cancer; (5) chronic kidney disease; (6) chronic obstructive pulmonary disease; (7) diabetes mellitus; (8) heart failure; (9) hypertension; (10) myocardial infarction; (11) peripheral vascular disease; (12) stroke. Adjusted logistic regression models were used to assess the association between multimorbidity and risk of severe SARS-CoV-2 infection (hospitalisation/death). Potential effect modifiers of the association were assessed: age, sex, ethnicity, deprivation, smoking status, body mass index, air pollution, 25-hydroxyvitamin D, cardiorespiratory fitness, high sensitivity C-reactive protein. RESULTS: Among 360,283 participants, the median age was 68 [range 48-85] years, most were White (94.5%), and 1706 had severe SARS-CoV-2 infection. The prevalence of multimorbidity was more than double in those with severe SARS-CoV-2 infection (25%) compared to those without (11%), and clusters of several multimorbidities were more common in those with severe SARS-CoV-2 infection. The most common clusters with severe SARS-CoV-2 infection were stroke with hypertension (79% of those with stroke had hypertension); diabetes and hypertension (72%); and chronic kidney disease and hypertension (68%). Multimorbidity was independently associated with a greater risk of severe SARS-CoV-2 infection (adjusted odds ratio 1.91 [95% confidence interval 1.70, 2.15] compared to no multimorbidity). The risk remained consistent across potential effect modifiers, except for greater risk among older age. The highest risk of severe infection was strongly evidenced in those with CKD and diabetes (4.93 [95% CI 3.36, 7.22]). CONCLUSION: The multimorbidity index may help identify individuals at higher risk for severe COVID-19 outcomes and provide guidance for tailoring effective treatment.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Aged, 80 and over , Hospitalization , Humans , Middle Aged , Multimorbidity , Risk Factors
4.
Prim Care Diabetes ; 15(4): 653-681, 2021 08.
Article in English | MEDLINE | ID: covidwho-1253459

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic crisis in health care systems worldwide. These may have significant implications for the management of cardiometabolic diseases. We conducted a systematic review of published evidence to assess the indirect impact of the COVID-19 pandemic on hospitalisations for cardiovascular diseases and their management. METHODS: Studies that evaluated volume of hospitalisations for cardiometabolic conditions and their management with comparisons between the COVID-19 and pre-COVID periods were identified from MEDLINE, Embase and the reference list of relevant studies from January 2020 to 25 February 2021. RESULTS: We identified 103 observational studies, with most studies assessing hospitalisations for acute cardiovascular conditions such as acute coronary syndrome, ischemic strokes and heart failure. About 89% of studies reported a decline in hospitalisations during the pandemic compared to pre-pandemic times, with reductions ranging from 20.2 to 73%. Severe presentation, less utilization of cardiovascular procedures, and longer patient- and healthcare-related delays were common during the pandemic. Most studies reported shorter length of hospital stay during the pandemic than before the pandemic (1-8 vs 2-12 days) or no difference in length of stay. Most studies reported no change in in-hospital mortality among hospitalised patients. CONCLUSION: Clinical care of patients for acute cardiovascular conditions, their management and outcomes have been adversely impacted by the COVID-19 pandemic. Patients should be educated via population-wide approaches on the need for timely medical contact and health systems should put strategies in place to provide timely care to patients at high risk. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2021: CRD42021236102.


Subject(s)
COVID-19 , Cardiovascular Diseases/therapy , Health Services Accessibility/trends , Hospitalization/trends , Metabolic Diseases/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/mortality , Hospital Mortality/trends , Humans , Metabolic Diseases/diagnosis , Metabolic Diseases/mortality , Observational Studies as Topic , Prognosis , Severity of Illness Index , Time Factors
5.
Int J Obes (Lond) ; 45(5): 1155-1159, 2021 05.
Article in English | MEDLINE | ID: covidwho-1104458

ABSTRACT

Obesity is an emerging risk factor for coronavirus disease-2019 (COVID-19). Simple measures of physical fitness, such as self-reported walking pace, may also be important risk markers. This analysis includes 412,596 UK Biobank participants with linked COVID-19 data (median age at linkage = 68 years, obese = 24%, median number of comorbidities = 1). As of August 24th 2020, there were 1001 cases of severe (in-hospital) disease and 336 COVID-19 deaths. Compared to normal weight individuals, the adjusted odds ratio (OR) of severe COVID-19 in overweight and obese individuals was 1.26 (1.07, 1.48) and 1.49 (1.25, 1.79), respectively. For COVID-19 mortality, the ORs were 1.19 (0.88, 161) and 1.82 (1.33, 2.49), respectively. Compared to those with a brisk walking pace, the OR of severe COVID-19 for steady/average and slow walkers was 1.13 (0.98, 1.31) and 1.88 (1.53, 2.31), respectively. For COVID-19 mortality, the ORs were 1.44 (1.10, 1.90) and 1.83 (1.26, 2.65), respectively. Slow walkers had the highest risk regardless of obesity status. For example, compared to normal weight brisk walkers, the OR of severe disease and COVID-19 mortality in normal weight slow walkers was 2.42 (1.53, 3.84) and 3.75 (1.61, 8.70), respectively. Self-reported slow walkers appear to be a high-risk group for severe COVID-19 outcomes independent of obesity.


Subject(s)
COVID-19 , Obesity/epidemiology , Walking Speed/physiology , Aged , Body Mass Index , COVID-19/epidemiology , COVID-19/mortality , COVID-19/physiopathology , Comorbidity , Databases, Factual , Female , Humans , Male , Middle Aged , Risk Factors , SARS-CoV-2 , United Kingdom
6.
Endocrinol Diabetes Metab ; : e00176, 2020 Aug 14.
Article in English | MEDLINE | ID: covidwho-716216

ABSTRACT

Background: Obesity accompanied by excess ectopic fat storage has been postulated as a risk factor for severe disease in people with SARS-CoV-2 through the stimulation of inflammation, functional immunologic deficit and a pro-thrombotic disseminated intravascular coagulation with associated high rates of venous thromboembolism. Methods: Observational studies in COVID-19 patients reporting data on raised body mass index at admission and associated clinical outcomes were identified from MEDLINE, Embase, Web of Science and the Cochrane Library up to 16 May 2020. Mean differences and relative risks (RR) with 95% confidence intervals (CIs) were aggregated using random effects models. Results: Eight retrospective cohort studies and one cohort prospective cohort study with data on of 4,920 patients with COVID-19 were eligible. Comparing BMI ≥ 25 vs <25 kg/m2, the RRs (95% CIs) of severe illness and mortality were 2.35 (1.43-3.86) and 3.52 (1.32-9.42), respectively. In a pooled analysis of three studies, the RR (95% CI) of severe illness comparing BMI > 35 vs <25 kg/m2 was 7.04 (2.72-18.20). High levels of statistical heterogeneity were partly explained by age; BMI ≥ 25 kg/m2 was associated with an increased risk of severe illness in older age groups (≥60 years), whereas the association was weaker in younger age groups (<60 years). Conclusions: Excess adiposity is a risk factor for severe disease and mortality in people with SARS-CoV-2 infection. This was particularly pronounced in people 60 and older. The increased risk of worse outcomes from SARS-CoV-2 infection in people with excess adiposity should be taken into account when considering individual and population risks and when deciding on which groups to target for public health messaging on prevention and detection measures. Systematic review registration: PROSPERO 2020: CRD42020179783.

7.
Diabetes Metab Syndr ; 14(5): 965-967, 2020.
Article in English | MEDLINE | ID: covidwho-611900

ABSTRACT

Routine care for chronic disease is an ongoing major challenge. We aimed to evaluate the global impact of COVID-19 on routine care for chronic diseases. An online survey was posted 31 March to 23 April 2020 targeted at healthcare professionals. 202 from 47 countries responded. Most reported change in routine care to virtual communication. Diabetes, chronic obstructive pulmonary disease, and hypertension were the most impacted conditions due to reduction in access to care. 80% reported the mental health of their patients worsened during COVID-19. It is important routine care continues in spite of the pandemic, to avoid a rise in non-COVID-19-related morbidity and mortality.


Subject(s)
Betacoronavirus/isolation & purification , Chronic Disease/therapy , Coronavirus Infections/epidemiology , Health Personnel/psychology , Pneumonia, Viral/epidemiology , Practice Patterns, Physicians'/statistics & numerical data , COVID-19 , Coronavirus Infections/virology , Humans , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires
8.
Diabetes Obes Metab ; 22(10): 1942-1945, 2020 10.
Article in English | MEDLINE | ID: covidwho-102319

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) has been declared a pandemic by the World Health Organization and sent all countries scrambling to review emergency healthcare provisions. There is global evidence of each nation struggling to effectively manage the number of people being diagnosed with the virus. These are testing times which have not been experienced in recent generations and there are a number of insecurities regarding the management of people with COVID-19 and cardiometabolic diseases. This review highlights the current concerns related to COVID-19 and provides advice in terms of the therapeutic uncertainty and potential adverse harms associated with therapy when managing people, particularly those with cardiometabolic diseases, who have contracted or are at increased risk of contracting COVID-19.


Subject(s)
COVID-19/complications , COVID-19/therapy , Cardiovascular Diseases/therapy , Metabolic Diseases/therapy , Uncertainty , Aged , COVID-19/epidemiology , Cardiovascular Diseases/complications , Cardiovascular Diseases/epidemiology , Chloroquine/therapeutic use , Clinical Trials as Topic/methods , Clinical Trials as Topic/standards , Delivery of Health Care/methods , Delivery of Health Care/standards , Female , Glucocorticoids/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , Hypoglycemic Agents/therapeutic use , Male , Metabolic Diseases/complications , Metabolic Diseases/epidemiology , Middle Aged , Pandemics , SARS-CoV-2/physiology
SELECTION OF CITATIONS
SEARCH DETAIL
...