COMPARISON OF BODY MASS INDEX LEVEL BY TRIAGE LEVEL IN THE EMERGENCY DEPARTMENT

INTRODUCTION: Obesity is a high cause of death in both non-communicable and communicable diseases such as COVID-19. The aim of this study is to increase the awareness of emergency department (ED) managers and employees about this problem by showing obesity rates according to triage level in patients admitted to the ED. MATERIAL AND METHODS: BMI levels and complaints of 1246 patients admitted to the ED according to the 3-level triage were re-evaluated with the 5-level ESI (Emergency Severity Index) triage for this study. RESULTS: The mean BMI of 1246 patients was found to be 27.25 ± 5.88 (overweight). 26% of the ED patients were found to be obese and 37.7% of them were overweight. While the mean BMI score of the 6-11 age group was found to be class 1 obesity, the other pediatric and adult age groups were found to be overweight. The highest mean BMI according to both the 3-stage triage system and the 5-stage ESI triage system was found in triage 1 patients (28.8011 ± 7.98;28.18 ± 6.78, respectively). Obese patients mostly applied to the ED with orthopedic problems and trauma (26.5%). Also, of the patients with class 3 severe obesity, 50% presented with trauma. CONCLUSIONS: The higher the BMI, the higher the triage severity level. BMI levels should be evaluated in the field of triage together with vital signs, especially in trauma patients, and obesity should be considered in ED and hospital management. Copyright © 2023 Via Medica.

Differences in Perceived Stress and Depression among Weight (Dis)Satisfied Midwestern College Students during COVID-19

Background: Stress and depression are common mental health concerns among college students. Factors related to weight status and stigma are associated with poor mental health outcomes. We sought to describe the prevalence of weight dissatisfaction in relation to stress and depression among college students (n = 551). Methods: A cross-sectional study was conducted via a convenient sample between December 2020 and February 2021. Mean differences in the Perceived Stress Scale-10 scores and Center for Epidemiologic Studies Depression Scale scores were examined using a one-way analysis of variance. Associations between stress, depression, and weight dissatisfaction were measured by logistic regression. Results: Weight dissatisfied (75.1%) students had significantly higher mean depression scores compared to weight satisfied. The weight dissatisfied students were 1.05 times more likely to be depressed compared to those who were weight satisfied. Significant mean differences in stress and/or depression were found for weight dissatisfied students by gender, race, parental status, marital status, residence, and U.S. citizenship. Weight dissatisfaction was higher than that reported in the literature, possibly due to the influence of social isolation during the COVID-19 pandemic. Conclusions: Strategies to reduce the prevalence of weight dissatisfaction for improved mental health should be explored, particularly efforts to reduce weight stigmatization and expand access to mental health care. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Age, Sex and BMI Relations with Anti-SARS-CoV-2-Spike IgG Antibodies after BNT162b2 COVID-19 Vaccine in Health Care Workers in Northern Greece.

The aim of this work was to study age, sex, and BMI (Body Mass Index)-related differences in the development of anti-SARS-CoV-2-Spike IgG antibodies, after vaccination with the BNT162b2 COVID-19 vaccine, in health care workers of a General Hospital in a city in Northern Greece. Blood sampling was drawn two to four weeks following the second dose of the vaccine, and six months after the first blood sample collection. Measurement of serum IgG antibodies against the spike domain of SARS-CoV-2 was performed using the SARS-CoV-2 IgG II Quant assay. All participants had sufficient serum IgG titers in the first measurement. Women developed higher IgG titers than men. The IgG titers were inversely related to age in both sexes; there was also a small, insignificant tendency to be inversely related to BMI. Six months after the first measurement, the IgG titers decreased dramatically to values less than 5% of the initial. This decrease was observed in both men and women and was inversely related to age. Multivariate regression analysis showed that age and sex explained with statistical significance 9% of the variance in SARS-CoV-2 IgG titers in our study population; the role of BMI was limited and insignificant.

The effect of eating restaurant prepared food on BMI: evidence from China during the COVID-19 pandemic

Leveraging the unexpected variation in the frequency of eating restaurant prepared food due to the COVID-19 pandemic, we seek to identify and estimate the causal relationship between the frequency of eating restaurant prepared food and people's BMI. We use first-differencing and instrumental variable approaches to correct for potential endogeneity bias due to both the time-invariant and time-varying unobserved factors. Our results show eating more restaurant prepared food has a positive and statistically significant effect on BMI, and in addition to other channels that have been identified in the literature, mood-boosting is another channel through which eating restaurant prepared food leads to weight gain. Heterogeneous effect analysis further shows that eating restaurant prepared food is more likely to have an impact on those people who lead a more stressful lifestyle before the pandemic.

The effect of environmental factors on precocious puberty in children: a case-control study.

BACKGROUND: Recently the prevalence of precocious puberty development is increasing among Chinese children. Proper understanding of the risk factors for precocious puberty in children is pivotal as could help to improve children's health. This study aims to evaluate the effect of environmental factors on precocious puberty in children. METHODS: We matched the cases and controls by age at the ratio of 1:1 (201 cases and 201 controls) for girls and 1:4 (24 cases and 96 controls) for boys. We used conditional logistic regression to explore the effect of environmental factors on precocious puberty, and a random forest model to identify the most important risk factor. RESULTS: In the multivariate regression, cesarean section (OR = 1.99, 95% CI: 1.05, 3.76), child body mass index [BMI] (OR = 1.25, 95% CI: 1.10, 1.43), maternal BMI (OR = 1.13, 95%CI: 1.01, 1.26), and exposure to secondhand smoke several times a month but less than once a week (OR = 4.09, 95%CI: 1.79,9.35), and almost every day (OR = 6.48, 95% CI: 2.14, 19.56) were risk factors for precocious puberty in girls. While maternal height (OR = 0.82, 95% CI: 0.75, 0.88), paternal height (OR = 0.91, 95% CI: 0.85, 0.98), bedtime at night (OR = 0.30, 95% CI: 0.17, 0.51), and night sleep (OR = 0.43, 95% CI: 0.21, 0.86) were protective factors. In boys, only exposure to secondhand smoke several times a month but less than once a week (OR = 7.94, 95% CI: 1.25, 50.33) was a risk factor for precocious puberty. In the random forest model, Child BMI was the most important risk factor for precocious puberty in girls. CONCLUSIONS: Our findings suggest that environmental factors were associated with precocious puberty in children, particularly in girls.

Obesity and Viral Infections.

The 2019 novel coronavirus disease (COVID-19) triggered a rapidly expanding global pandemic. The presence of obesity in patients with COVID-19 has been established as a risk factor for disease severity, hospital admission, and mortality. Thus, it is imperative those living with obesity be vaccinated against COVID-19. Although there is a timeframe COVID-19 vaccines are efficacious in those living with obesity, more studies need to be conducted to ensure that those long-lasting protection is maintained, as obesity has implications on the immune system.

Adherence to Mediterranean diet and dietary changes according to the fear of COVID-19 during the pandemic: a cross-sectional study.

The coronavirus disease 2019 (COVID-19) has led to the implementation of restrictions to reduce transmission worldwide. The restrictions and measures have affected the psychological health and eating habits. The objective of the present study was to evaluate dietary habits, lifestyle changes, adherence to the Mediterranean diet (MD) and fear of COVID-19 in Turkey during the pandemic. A cross-sectional online survey of socio-demographic characteristics, anthropometric measurements, nutrition, physical activity and lifestyle habits was used for data collection. The fear of COVID-19 levels of the participants was determined by the fear of COVID-19 scale (FCV-19S). The Mediterranean Diet Adherence Screener (MEDAS) was used to evaluate participants' adherence to the MD. The differences between the FCV-19S and MEDAS according to gender were compared. Eight hundred and twenty subjects (76⋅6 % women and 28⋅4 % men) were evaluated within the study. The mean of MEDAS (ranged between 0 and 12) was 6⋅4 ± 2⋅1, and almost half of the participants moderately adhered to the MD. The mean of FCV-19S (ranged between 7 and 33) was 16⋅8 ± 5⋅7, while women's FCV-19S and MEDAS were significantly higher than men's (P < 0⋅001). The consumption of sweetened cereals, grains, pasta, homemade bread and pastries of the respondents with high FCV-19S were higher than in those with low FCV-19S. High FCV-19S was also characterized by decreased take-away food and fast food consumption in approximately 40 % of the respondents (P < 0⋅01). Similarly, women's fast food and take-away food consumption decreased more than men's (P < 0⋅05). In conclusion, the respondents' food consumption and eating habits varied according to the fear of COVID-19.

Obesity is a Major Health Problem Threatening the Iraqis- review article

Obesity can be defined as an excessive or abnormal fat accumulation which may impair health. It is recognized as a top public health issue and it is ranked as the 5th foremost cause of death worldwide. The current review set out to summarize the studies which provide basic information about the obesity prevalence in Iraq (adults, children and adolescents);moreover, it set out to address the impact of obesity on multiple health conditions. It is now demonstrated that obesity (dependent upon the duration, distribution, and degree of the excess adipocytes/weight) may progressively exacerbate and/or cause a wide range of comorbidities. This review discusses the contributions of obesity toward the pathogenesis of type II diabetes, insulin resistance, metabolic syndrome, and COVID-19 in addition to other diseases.

Open and sustainable business model innovation: An intention-based perspective from the Spanish cultural firms

SMEs, including cultural and creative firms, are encountering increasingly difficult obstacles in today's competitive landscape. In particular, during the COVID-19 pandemic, these SMEs had to confront significant challenges that endangered their survival, requiring a shift in their business model. Many successful firms responded to this crisis by adopting business model innovation (BMI) as a strategic solution. The pandemic also emphasised the importance of sustainable practices and the necessity to enhance readiness for and responsiveness to future challenges. This study proposes examining Sustainable Business Model Innovation in the light of the Theory of Planned Behavior. While some studies have explored BMI through the TPB framework, we expand the interpretative schema by introducing an additional predictor: the influence of open innovation ecosystem partnerships. From an open innovation perspective, the new construct proposes how peer professional organisations and technological clusters play a significant role in managers' intentions to implement SBM. A purposive sample of 122 Spanish cultural and creative firm managers and business owners was surveyed and analysed using PLS-SEM. The data collected supports the model and supports the prominent role of open innovation environments as a mediation effect of the intention to implement a sustainable and innovative business model. The study adds new insights into the theoretical framework to better understand the implementation of sustainable business models' innovation actions, with specific support for the role of open innovation ecosystems such as professional organisations and technological clusters. Practitioners and open innovation ecosystem promoters can gain new clues for initiatives to promote the diffusion of innovations among creative and cultural SMEs.

The Global, Regional, and National Uterine Cancer Burden Attributable to High BMI from 1990 to 2019: A Systematic Analysis of the Global Burden of Disease Study 2019.

Uterine cancer (UC) is the most common gynecologic malignancy, and high body mass index (BMI) is a poor prognostic factor for UC. However, the associated burden has not been fully assessed, which is crucial for women's health management and the prevention and control of UC. Therefore, we utilized the Global Burden of Disease Study (GBD) 2019 to describe the global, regional, and national UC burden due to high BMI from 1990 to 2019. The data show that globally, women's high BMI exposure is increasing annually, with most regions having higher rates of high BMI exposure than the global average. In 2019, 36,486 [95% uncertainty interval (UI): 25,131 to 49,165] UC deaths were attributed to high BMI globally, accounting for 39.81% (95% UI: 27.64 to 52.67) of all UC deaths. The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALY) rate (ASDR) for high BMI-associated UC remained stable globally from 1990 to 2019, with significant differences across regions. Higher ASDR and ASMR were found in higher socio-demographic index (SDI) regions, and lower SDI regions had the fastest estimated annual percentage changes (EAPCs) for both rates. Among all age groups, the fatal outcome of UC with high BMI occurs most frequently in women over 80 years old.

New onset diabetes mellitus in post-COVID-19 patients.

Background: Diabetes, is known to have a bilateral relationship with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Precise mechanism of diabetes onset in COVID-19 patients remains unclear. Aim: To analyse the incidence of new onset diabetes (NODM) among COVID-19 patients, as well as the effect of body mass index (BMI), family history, and steroid use on the incidence of the disease. Methods: Adult, not known diabetic patients, tested positive with Rapid Antigen Test or RT-PCR admitted to a tertiary care hospital and research institute were included in the present prospective observational study. The patients who developed NODM and NOPD (New Onset Pre-diabetes) during the three months follow-up and the risk factors associated were assessed. Patients with HbA1c >6.4% were diagnosed with NODM. An HbA1c of 5.7% to 6.4% was used to characterize NOPD. Results: Out of 273 previously not known diabetic COVID-19 infected individuals, a total of 100 were studied for three months after consent. Mean age of the patients 48.31 ± 19.07 years with male predominance (67%). Among these, 58% were non-diabetics and 42% were pre-diabetics. 6 (10.3%) of the 58 non-diabetics developed NOPD, and 8 (13.8%) developed NODM. 6 (14.2%) of the 42 pre-diabetics became non-diabetic, and 16.6% (7) developed NODM. Family history of DM (P < 0.001), severity at admission (P < 0.006), diabetic ketoacidosis (P < 0.0275), and persistent symptoms were associated significantly with NODM. Those with NODM had significantly greater BMI, O2 duration, steroid duration, FBS, and PPBS (P < 0.001 for all). Nearly 67% of the patients who developed NOPD had shortness of breath as the common symptom at time of admission (P = 0.0165). Conclusion: The incidence of NODM was strongly influenced by positive family history of DM, higher BMI, steroid dosage, and its duration. Hence, patients with COVID-19 need to be under surveillance for blood glucose screening.

Comparing the BMI and Some Physical Parameters Before and One Year After the COVID-19 Pandemic among High School Students in Rafsanjan City, Iran

Background: Obesity has many side effects and deadly risks. During the COVID-19 pandemic, school closures have been affecting the lifestyle of students worldwide. This study aims to assess changes in the BMI and some physical parameters among students before and one year after the COVID-19 pandemic in Rafsanjan City, Iran. Materials and Methods: In this descriptive study, the sample included 793 high school students (422 males and 371 females) within the age range of 11 to 19. The sampling method was multistage clustering. Accordingly, we compared pre-pandemic data on the BMI and the circumference of the waist, hip, neck, and wrist with the data collected one year after the COVID-19 pandemic. Results: Our findings demonstrated that the BMI and the circumference of the waist, hip, and wrist were significantly higher in males one year after the outbreak of the disease. However, except for the neck circumference, a comparison of other variables before and after the COVID-19 pandemic in females showed no significant difference. Moreover, the results showed that the average BMI of all participants, regardless of their gender, increased significantly from 20.55 to 22.00 kg/m2. Conclusion: The data obtained from this survey would serve as an important evidence necessitating future planning for controlling overweight and obesity in order to reduce the probability of chronic diseases incidence in future. . Additionally, it is recommended that more comprehensive studies and extracurricular physical activity programs be designed to counteract the negative effects of sedentary behavior. © The Author(s) 2022;All rights reserved.

Social Challenges as a Consequence of the COVID-19 Pandemic among South Florida Preschool Children with Disability and Obesity.

The COVID-19 pandemic has negatively impacted the childcare industry over the past two years. This study examined how pandemic-related challenges impacted preschool-aged children by disability and obesity status. Participants were 216 children (80% Hispanic, 14% non-Hispanic Black) aged 2 to 5 years in 10 South Florida childcare centers. In November/December 2021, parents completed a COVID-19 Risk and Resiliency Questionnaire, and body mass index percentile (BMI) was collected. Multivariable logistic regression models examined the association of COVID-19 pandemic-related social challenges (transportation, employment) and child BMI and disability status. As compared to normal-weight children, those families with a child who was obese were more likely to report pandemic-related transportation (OR: 2.51, 95% CI: 1.03-6.28) challenges and food insecurity (OR: 2.56, 95% CI: 1.05-6.43). Parents of children with disabilities were less likely to report that food did not last (OR: 0.19, 95% CI: 0.07-0.48) and that they could not afford balanced meals (OR: 0.33, 95% CI: 0.13-0.85). Spanish-speaking caregivers were more likely to have a child who was obese (OR: 3.04, 95% CI: 1.19-8.52). The results suggest that COVID-19 impacts obese preschool children from Hispanic backgrounds, while disability was a protective factor.

Covid-19 and Obstructive Sleep Apnea: The Theatricals and Quality-of-Life Impact.

COVID-19 caused by SARS-CoV2 has reached pandemic proportions. The fear of Covid-19 has deterred many to abandon efforts for seeking timely medical help. In this setting, Obstructive sleep apnea (OSA)-like covid/non-covid cohorts have presented. Atypical pathologies can present like OSA and take the clinician unawares. With this series of misfits suffering silently, it would be unwise to underestimate its impact on quality-of-life (QOL). To determine the effect on quality-of-life by pathologies mimicking OSA and assess Covid-19 as a cause for delayed presentation. This was a prospective cross-sectional study. 127(N). Recent onset of symptoms of OSA. Study duration March 2020 to September 2021. Pittsburgh Sleep Quality Index (PSQI) screening done. Study criteria defined. Sleep parameters calculated. Primary surgical intervention given. Non-responders were put on CPAP therapy. QOL assessment done with sf-36 and SAQLI. Fear of Covid-19 scale (FCV-19S) quantified to study cause for temporal delay. Correlations computed. Level of Evidence-Level 3. 97 candidates completed study. Demographic and anthropometric details noted. Mean range was 43.85 ± 11.39 years. Male predominance. Overall AHI-19.73 ± 8.72. Moderate impact on QOL by sf-36/SAQLI. 78n Primary surgical candidates fared well. Polysomnography (PSG) and Continuous positive airway pressure (CPAP) titration/trial characteristics for 19n available. Statistically significant improvement in QOL after treatment completion. Correlations were meaningful. Body Mass Index (BMI) as a single factor was not influential on OSA-mimickers. Fear of Covid-19 significantly impacted emergency medical aid acquisition. OSA mimicking atypical airway pathologies may need emergent treatment not only from a surgical point-of-view but also from the QOL of the patient. On the contrary, these also unmask sub-clinical OSA, especially in patients with low/normal BMI. This category of recent onset OSA, if fortunately picked up at the earliest possible presentation, may hopefully not go through the significant QOL impact suffered by chronic OSA candidates.

Impacts of commute mode on body mass index: A longitudinal analysis before and during the COVID-19 pandemic.

Introduction: COVID-19 has impacted millions of commuters by decreasing their mobility and transport patterns. While these changes in travel have been studied, less is known about how commute changes may have impacted individuals' body mass index (BMI). The present longitudinal study explores the relationship between commute mode and BMI of employed individuals in Montréal, Canada. Methods: This study uses panel data drawn from two waves of the Montréal Mobility Survey (MMS) conducted before and during the COVID-19 pandemic (n = 458). BMI was modeled separately for women and men as a function of commuting mode, WalkScore©, sociodemographic, and behavioral covariates using a multilevel regression modeling approach. Results: For women, BMI significantly increased during the COVID-19 pandemic, but telecommuting frequency, and more specifically telecommuting as a replacement of driving, led to a statistically significant decrease in BMI. For men, higher levels of residential local accessibility decreased BMI, while telecommuting did not have a statistically significant effect on BMI. Conclusions: This study's findings confirm previously observed gendered differences in the relations between the built environment, transport behaviors, and BMI, while offering new insights regarding the impacts of the changes in commute patterns linked to the COVID-19 pandemic. Since some of the COVID-19 impacts on commute are expected to be lasting, findings from this research can be of use by health and transport practitioners as they work towards generating policies that improve population health.

Image Scanning Microscopy to Investigate Polycomb Protein Colocalization onto Chromatin

Super-resolution microscopy has been recently applied to understand the 3D topology of chromatin at an intermediated genomic scale (kilobases to a few megabases), as this corresponds to a sub-diffraction spatial scale crucial for the regulation of gene transcription. In this context, polycomb proteins are very renowned gene repressors that organize into the multiprotein complexes Polycomb Repressor Complex 1 (PRC1) and 2 (PRC2). PRC1 and PRC2 operate onto the chromatin according to a complex mechanism, which was recently recapitulated into a working model. Here, we present a functional colocalization study at 100–140 nm spatial resolution targeting PRC1 and PRC2 as well as the histone mark H3K27me3 by Image Scanning Microscopy (ISM). ISM offers a more flexible alternative to diffraction-unlimited SRMs such as STORM and STED, and it is perfectly suited to investigate the mesoscale of PRC assembly. Our data suggest a partially simultaneous effort of PRC1 and PRC2 in locally shaping the chromatin topology.

Microbiome in the Framework of Predictive, Preventive and Personalised Medicine

The human body is inhabited by trillions of diverse microorganisms collectively called "microbiome" or "microbiota". Microbiota consists of bacteria, viruses, fungi, protozoa, and archaea. Microbiome demonstrates multi-faceted effects on human physical and mental health. Per evidence there is a multi-functional interplay between the whole-body microbiome composition on the epithelial surfaces including skin, nasal and oral cavities, airway, gastro-intestinal and urogenital tracts on one hand and on the other hand, the individual health status. Microbiota composition as well as an option to modulate it - together create a highly attractive operation area for the translational bio/medical research with multi-professional expertise and healthcare-relevant output in the framework of predictive, preventive and personalised medicine (PPPM/3 PM). Advanced PPPM strategies implemented in the microbiome area are expected to significantly improve individual outcomes and overall cost-efficacy of healthcare. According to the accumulated research data, corresponding diagnostic and treatment approaches are applicable to primary care (health risk assessment in individuals with sub-optimal health conditions and prevention of a disease development), secondary care (personalised treatment of clinically manifested disorders preventing a disease progression) and tertiary care (making palliation to an optimal management of non-curable diseases). In the current book, we do highlight the implementation potential of the microbiome-relevant research in the framework of predictive diagnostics, targeted prevention and treatments tailored to the individualised patient profile.Copyright © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The effect of weekly virtual health sessions based on the health belief model on the BMI of overweight African American children

Childhood obesity is a global health challenge that has seen a notable increase over time. Childhood obesity is when a child has excess weight compared to the child's age and height. Childhood obesity has resulted in significant physical and economic challenges, including. physical and mental diseases in children. The coronavirus pandemic led to the virtual implementation of this study. This study aims at addressing obesity among children between 5 and 18 years old using virtual weekly classes targeting healthy nutrition and walking, with the Health Belief Model as a theoretical framework. In this quantitative study involving 30 participants from a convenience sample, the examiner analyzes the relationship between walking and a healthy diet on the children's BMI. The paired sample t-test compares the participants' BMI and behavior before and after the intervention. Correlation analysis determines the participants' weight loss by demographic characteristics. The findings from the study showed there was a reduction in BMI after the intervention. Thus, this study contributes to social change by providing evidence for preventing and managing childhood obesity by incorporating a healthy diet and walking into children's daily routines. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

COVID-19 Induces Body Composition and Metabolic Alterations.

Background Individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are highly susceptible to disease-related metabolic dysregulation given the hyperinflammatory immune response of coronavirus disease 2019 (COVID-19). These changes are remarkably involved in multiple steps in adipogenesis and lipolysis. This study aimed to elaborate on the significant relations of COVID-19 infection with body fat distribution, changes in serum insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) levels before and after the infection. Methods In this follow-up study, from July 2021 to September 2021, persons referred to a university-affiliated Nutrition Counselling Clinic were randomly selected for the study samples. Validated food frequency (FFQ) and physical activity questionnaires were completed. Body composition was assessed in this investigation. On the second visit, those who reported mild to moderate COVID-19 infection (without hospitalization) were selected as the case group and the asymptomatic individuals as the control group. All measurements were re-measured in the second visit. Results In a total of 441 patients, the mean age was 38.82±4.63 years. There were 224 (50.79%) male subjects, and 217 (49.20%) were females. There was a statistically significant difference in the longitudinal change in total fat percentage between subjects with and without COVID-19. Also, the difference in HOMA-IR before and after COVID-19 in case groups (both males and females) was statistically significant (P-value < 0.001). Moreover, serum insulin levels were significantly increased in all cases (P-value < 0.001), while remaining stable in control groups. When compared to their initial visit, COVID-19 patients' total fat percentage rose significantly (almost 2%) following a hypocaloric diet. Participants who were not infected with COVID-19 had a lower total fat percentage than those who were. Serum insulin and HOMA-IR levels increased significantly after infection compared to the primary measurements. Conclusion Individuals with COVID-19 infection may require tailored medical nutrition therapy to improve short and long-term COVID-19 outcomes such as muscle loss and fat accommodation.

Long-COVID fatigue is not predicted by pre-pandemic plasma IL-6 levels in mild COVID-19.

OBJECTIVE AND DESIGN: Fatigue is a prominent symptom in the general population and may follow viral infection, including SARS-CoV2 infection which causes COVID-19. Chronic fatigue lasting more than three months is the major symptom of the post-COVID syndrome (known colloquially as long-COVID). The mechanisms underlying long-COVID fatigue are unknown. We hypothesized that the development of long-COVID chronic fatigue is driven by the pro-inflammatory immune status of an individual prior to COVID-19. SUBJECTS AND METHODS: We analyzed pre-pandemic plasma levels of IL-6, which plays a key role in persistent fatigue, in N = 1274 community dwelling adults from TwinsUK. Subsequent COVID-19-positive and -negative participants were categorized based on SARS-CoV-2 antigen and antibody testing. Chronic fatigue was assessed using the Chalder Fatigue Scale. RESULTS: COVID-19-positive participants exhibited mild disease. Chronic fatigue was a prevalent symptom among this population and significantly higher in positive vs. negative participants (17% vs 11%, respectively; p = 0.001). The qualitative nature of chronic fatigue as determined by individual questionnaire responses was similar in positive and negative participants. Pre-pandemic plasma IL-6 levels were positively associated with chronic fatigue in negative, but not positive individuals. Raised BMI was associated with chronic fatigue in positive participants. CONCLUSIONS: Pre-existing increased IL-6 levels may contribute to chronic fatigue symptoms, but there was no increased risk in individuals with mild COVID-19 compared with uninfected individuals. Elevated BMI also increased the risk of chronic fatigue in mild COVID-19, consistent with previous reports.