Preparing Pandemic Vaccine Capacity

Among the challenges of a pandemic is the need to scale up to billions of doses, at a larger scale than typically needed for vaccines, from raw materials all the way through to the materials for the containers for fill/finish. Having adequate raw materials, building and staffing the facilities, and tech transfer are all keys to success. [...]we can plug into existing infrastructure, including services (gas, water, waste, etc.) as well as analytics and quality labs." Emergent BioSolutions says that its flexible CDMO capacity deployment model can respond quickly to demand fluctuations. The company's facilities in France, Switzerland, and the US are working on the project;at CordenPharma Colorado, unique high-pressure chromatography systems usually used for manufacturing peptides have been reallocated for purifying lipids.

Cracking the Code of Complex Drug Modalities via Multidimensional Liquid Chromatography Coupled to Mass Spectrometry

Reducing the molecule complexity is achieved by reducing the molecule size after enzymatic digestion to produce smaller fragments more amenable to LC separation and tandem mass spectrometry (MS/MS) sequencing. Non-denaturing CEX chromatography, size-exclusion chromatogra- phy (SEC), hydrophobic interaction chromatography (HIC), and protein A modes can be easily coupled to reversed-phase LC (RPLC) because of the high aqueous conditions, enabling the versatile 4D-LC-MS systems with the use of alternative modes to 1D CEX, such as SEC or Protein A (6,7). [...]the nanopar-ticle size and free drug concentration are determined at the particle Level, whereas the encapsulated drug and lipids forming the layer are commonly characterized at the molecuar level after denaturing the lipid nanoparticle (LNP) via a surfactant. [...]MDLC-MS setups present a formidable opportunity to unify the characterization of drug delivery systems at the molecular and particle evels, which would enable their high throughput analysis.

Elevated platelet large cell-ratio levels as a demonstrative biomarker associated with severe COVID-19

Objective: To represent the effects of the severity of COVID-19 infection on platelet large cell ratio (PLC-R). Materials and Methods: A hundred eleven patients diagnosed with COVID-19 were included in this study. Positive results for SARS-CoV-2 based on a typical RT-PCR test performed on nasopharyngeal swabs were included in the study Groups. Patients with COVID-19 were divided into three Groups according to their chest CT features. Group 1 (45 patients) was defined as mild, Group 2 (34 patients) as moderate and Group 3 (32 patients) as severe. Complete blood count parameters including platelet volume indices (PVI) values, CRP, D-dimer and lipid profiles were analyzed in all study participants. The correlation between COVID-19 patient Groups and PLC-R values were demonstrated using SPSS and ANFC methods. Results: The significant impact of our study is that PLC-R was significantly higher in the severe COVID-19 patients than the moderate and mild patients. Spearman's rho correlation analysis showed that PLC-R and WBC levels increased, and Htc and Hb levels decreased with the severity of the disease. ROC analysis showed that PLC-R > 38.3% had 59.4% sensitivity and 68.4% specificity in predicting severe COVID-19 disease (AUC 0.672, %95 CI 0.560, 0.784;p=0.005, cut off=38.3). CRP, ferritin and D-dimer values of the patients in Group 3 were significantly higher than the patients in Group 1, and the iron values of the patients in Group 3 were significantly lower than the patients in Group 1. Conclusion: PLC-R values are useful for anticipating acute thrombotic events. Based on the results of our study, PLC-R values can be used as appropriate biomarkers to describe the severity of COVID-19 infection.

Chewing the fat: How lipidomics is changing our understanding of human health and disease in 2022

Lipids are biological molecules that play vital roles in all living organisms. They perform many cellular functions, such as 1) forming cellular and subcellular membranes, 2) storing and using energy, and 3) serving as chemical messengers during intra- and inter-cellular signal transduction. The large-scale study of the pathways and networks of cellular lipids in biological systems is called "lipidomics” and is one of the fastest-growing omics technologies of the last two decades. With state-of-the-art mass spectrometry instrumentation and sophisticated data handling, clinical studies show how human lipid composition changes in health and disease, thereby making it a valuable medium to collect for clinical applications, such as disease diagnostics, therapeutic decision-making, and drug development. This review gives a comprehensive overview of current workflows used in clinical research, from sample collection and preparation to data and clinical interpretations. This is followed by an appraisal of applications in 2022 and a perspective on the exciting future of clinical lipidomics.

High-Density Lipoprotein function is modulated by the SARS-CoV-2 spike protein in a lipid-type dependent manner.

There is a close relationship between the SARS-CoV-2 virus and lipoproteins, in particular high-density lipoprotein (HDL). The severity of the coronavirus disease 2019 (COVID-19) is inversely correlated with HDL plasma levels. It is known that the SARS-CoV-2 spike (S) protein binds the HDL particle, probably depleting it of lipids and altering HDL function. Based on neutron reflectometry (NR) and the ability of HDL to efflux cholesterol from macrophages, we confirm these observations and further identify the preference of the S protein for specific lipids and the consequent effects on HDL function on lipid exchange ability. Moreover, the effect of the S protein on HDL function differs depending on the individuals lipid serum profile. Contrasting trends were observed for individuals presenting low triglycerides/high cholesterol serum levels (LTHC) compared to high triglycerides/high cholesterol (HTHC) or low triglycerides/low cholesterol serum levels (LTLC). Collectively, these results suggest that the S protein interacts with the HDL particle and, depending on the lipid profile of the infected individual, it impairs its function during COVID-19 infection, causing an imbalance in lipid metabolism.

Association of Low Levels of Soluble Low-Density Lipoprotein Receptor-Related Protein-1 and COVID-19 Outcomes During the First Wave of Pandemic.

Low-density lipoprotein receptor-related protein-1 (LRP1) is an endocytosis receptor that clears inflammatory proteins from circulation. LRP1 has anti-inflammatory effects that bind pro-inflammatory cytokines or ligands. LRP1 has a soluble form (sLRP1) which can be measured in serum. We report sLRP1 levels in hospitalized patients with COVID-19. The first objective of this study is to compare the sLRP1 levels between COVID-19 patients and healthy controls. The second objective is to examine the association between sLRP1 and the clinical outcome of COVID-19. All patients (20-80 years of age) were evaluated in a hospital using a positive PCR test for SARS­CoV­2 between April 1, 2020, and June 1, 2020. Controls (n=59) were selected from healthy subjects. sLRP1 levels were measured in patients from the emergency department (ED), inpatient service (IS), and the intensive care unit (ICU). The study included 180 cases. COVID-19 patients showed significantly lower sLRP1 levels compared to controls (1.43 (1.86) versus 2.27 (1.68) µg/mL, respectively, p<0.001). sLRP1 levels were 1.26 (1.81), 1.37 (1.65), and 1.74 (1.98) µg/mL in patients from ED, IS, and ICU, respectively (p=0.022). Patients who were admitted from ED displayed lower sLRP1 levels compared to those who were discharged (median sLRP1 levels were 0.86 versus 1.7 µg/mL, p=0.045). COVID-19 patients display significantly lower sLRP1 levels compared to the healthy controls. sLRP1 levels do not show any association with the clinical outcome of COVID-19. This study demonstrates that LRP1 displays a bidirectional course in COVID-19. A low sLRP1 level is a potential risk factor for susceptibility and hospital admission due to COVID-19. Further studies with larger sample sizes and longer follow-ups are needed to understand the long-term effects of novel biomarkers such as sLRP1 on the outcome of COVID-19.

Antiviral activity of nano-monocaprin against Phi6 as a surrogate for SARS-CoV-2.

The COVID-19 pandemic involving SARS-CoV-2 has raised interest in using antimicrobial lipid formulations to inhibit viral entry into their host cells or to inactivate them. Lipids are a part of the innate defense mechanism against pathogens. Here, we evaluated the use of nano-monocaprin (NMC) in inhibiting enveloped (phi6) and unenveloped (MS2) bacteriophages. NMC was prepared using the sonochemistry technique. Size and morphology analysis revealed the formation of ~ 8.4 ± 0.2-nm NMC as measured by dynamic light scattering. We compared the antiviral activity of NMC with molecular monocaprin (MMC) at 0.5 mM and 2 mM concentrations against phi6, which we used as a surrogate for SARS-CoV-2. The synthesized NMC exhibited 50% higher antiviral activity against phi6 than MMC at pH 7 using plaque assay. NMC inactivated phi6 stronger at pH 4 than at pH 7. To determine if NMC is toxic to mammalian cells, we used MTS assay to assess its IC50 for HPDE and HeLa cell lines, which were ~ 203 and 221 µM, respectively. NMC may be used for prophylactic application either as a drop or spray since many viruses enter the human body through the mucosal lining of the nose, eyes, and lungs.

Oxidative damage by 3-nitrotyrosine in young adults with obesity: its implication in chronic and contagious diseases.

INTRODUCTION: Cellular damage by oxidation is present in numerous chronic diseases, such as obesity, type II diabetes, cardiovascular disease, and nonalcoholic fatty liver, among others. The oxidized compound 3-nitrotyrosine is a marker of oxidative stress and protein oxidation damage. The objective of this work is to establish by means of 3-nitrotyrosine whether this marker in young people with obesity is higher than in the same population without obesity. METHOD: Anthropometry and blood chemistry analyses were performed on 24 young Mexican participants (18-30 years old), forming two groups based on their waist circumference: With Obesity (≥ 80 cm women;> 90 cm men) and Without-Obesity (<80 cm women; <90 cm men). Additionally, 3-nitrotyrosine blood values were quantified by ELISA. RESULTS: Except for HDL-cholesterol, the mean values of lipids increase in women and men With Obesity (p<0.05), and 3-nitrotyrosine concentration (nM/µg total protein) was higher by 60% in the group With Obesity compared to the group Without Obesity, both for women (66.21 ± 23.85 vs. 40.69 ± 16.25, p<0.05) and men (51.72 ± 20.56 vs. 30.52 ± 5.21, p<0.05). CONCLUSIONS: Oxidative damage measured by compound 3-nitrotyrosine is higher in the groups With Obesity than in the groups Without Obesity, which if not controlled can lead to a chronic oxidative condition and thereby to a degree of cellular aging with diverse health effects.

Cholesterol and Melatonin Exert Opposite Effects on the Interaction of Model DMPC Membranes with the SARS-CoV-2 S-Protein: A SANS Study

An effect of receptor-binding domain (RBD) of SARS-CoV-2 S-protein on structural parameters of model lipid membranes presented by dimyristoylphosphatidylcholine (DMPC) systems with cholesterol and melatonin impurities is studied by small angle neutron scattering (SANS). It is shown that an increase in melatonin concentration in the lipid membrane leads to a decrease in the thickness of the lipid bilayer, while an increase in the concentration of cholesterol leads to an increase in its thickness. It is suggested that increasing the concentration of melatonin in a membrane prevents the interaction of coronaviral S-protein with a lipid membrane of a cell. In the presence of cholesterol in the system, the interaction of a lipid membrane with an active part of S-protein occurs depending on a phase state of the lipid: in the case of a gel phase, there is no changes in structural parameters, but at higher temperatures in the case of a liquid crystal phase, an addition of RBD SARS-CoV-2 to the system causes a reduce in the membrane thickness. © 2023 Wiley-VCH GmbH.

Prevalence of metabolic syndrome criteria among adults post COVID pandemic situation and steps towards prevention

Metabolic Syndrome (MetS) is one among the Non-Communicable Diseases (NCDs) which might occur due to genetic, environmental, physiological and behavioural factors. MetS is increasing alarmingly in the population. Addressing the modifiable factors to reduce the risk is of prime importance. The current study is intended to observe the prevalence of Metabolic Syndrome criteria with respect to its relation to lifestyle factors among subjects post pandemic situation and the MetS incidence to understand how the disease can be prevented and the means to improve the public health. Random sampling method was used to enrol 20-50 year old (male and female) urban adults of Bengaluru into the study. Type-I-diabetics, lactating and pregnant women, post-cardiac surgery/ pre-post-transplant/ covid-19 recovered patients were excluded. Height, weight, Waist-Circumference (WC) and hip-circumference were measured. BMI and Waist-Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBS), Triglycerides (TG), HDL, Blood Pressure (BP) values were analysed and recorded. Diet recall was captured and calories consumed per day was estimated. The habits of exercise routine, smoking, tobacco chewing and alcohol were observed. IDF (International Diabetes Federation, 2006) criteria was used to categorise MetS. The data was analysed using relevant statistical tools. A total of 1211 adults (females 486 and males 725) were assessed. High WC indicating central obesity was observed in 55%. High FBS was observed in 29%. Hyper-triglyceridemia was more in males (36%) than females (19%). Low HDL was observed in 65% females against 43% males. High BP was observed among 10% in males and 8% in females. Lack of exercise was observed among 81% of the adults. Due to pandemic situation 10.7% stopped doing exercise. Moderate activity in 5.6% and vigorous activity in 2.8% was recorded;68% of the subjects were consuming >2000 calories/day on an average;18.6% were alcoholic. MetS was observed in 10.6% and MetS-2 criteria in 33.4% and MetS-1criteria in 24.5% before pandemic situation and post pandemic there was an increase. MetS was observed in 12.2% and MetS-2criteria in 49.7% and MetS-1criteria in 27.9% post pandemic. The lack of exercise and high-calorie consumption had a significant correlation with altered lipid values and central obesity. High WC had significant relation to High BMI. WHR had very significant correlation with high FBS and TG. Women had significantly high WC compared to men. The alcohol habit had a significant correlation with hypertriglyceridemia in males. Increased calorie consumption had a moderate correlation with raised FBS and WHR. MetS was significantly observed in those who had lack of exercise, high calorie consumption and alcohol habit. Findings suggest that MetS is in rise in 31-50 year age group. Central obesity, dyslipidemia and high FBS were predominant in 31-40 year group. High BP was observed in 45-50 years age group. Identifying and educating the young adults to correct their life style is the need of the hour to reduce increase of MetS in community.

Reduced Cholesterol Levels during Acute Human Babesiosis.

BACKGROUND: Babesiosis, an intra-erythrocytic protozoan disease, is an emerging zoonotic parasitic disease worldwide. Cholesterol levels are correlated with severe infections, such as sepsis and COVID-19, and anecdotal reports suggest that high-density lipoprotein (HDL) cholesterol declines during acute babesiosis. Our aim was to describe the cholesterol levels in patients with acute babesiosis diagnosed in an endemic area in New York, hypothesizing that HDL levels correlate with the severity of infection. METHODS: We reviewed the medical records of adult patients with babesiosis diagnosed by identification of Babesia parasites on a thin blood smear and confirmed by polymerase chain reaction from 2013 to 2018, who also had available a lipid profile drawn at the time of clinical presentation. Additional lipid profile levels were considered as "baseline" if they were drawn within 2 months before or after the infection as part of routine care. RESULTS: A total of 39 patients with babesiosis had a lipid profile drawn on presentation. The patients were divided into two groups for comparison based on the treating physician's clinical decision: 33 patients who were admitted to the hospital and 8 patients who were evaluated as outpatients. A history of hypertension was more common in admitted patients (37% vs. 17%, p = 0.02). The median levels of low-density lipoprotein (LDL) and HDL were significantly reduced in admitted patients compared to non-admitted patients (46 vs. 76 mg/dL, p = 0.04; and 9 vs. 28.5 mg/dL, p = 0.03, respectively). In addition, LDL and HDL levels returned to baseline values following resolution of acute babesiosis. CONCLUSION: LDL and HDL levels are significantly reduced during acute babesiosis, suggesting that cholesterol depletion may predict disease severity. Pathogen and host factors may contribute to a reduction in serum cholesterol levels during acute babesiosis.

Multicomponent Lipid Nanoparticles for RNA Transfection.

Despite the wide variety of available cationic lipid platforms for the delivery of nucleic acids into cells, the optimization of their composition has not lost its relevance. The purpose of this work was to develop multi-component cationic lipid nanoparticles (LNPs) with or without a hydrophobic core from natural lipids in order to evaluate the efficiency of LNPs with the widely used cationic lipoid DOTAP (1,2-dioleoyloxy-3-[trimethylammonium]-propane) and the previously unstudied oleoylcholine (Ol-Ch), as well as the ability of LNPs containing GM3 gangliosides to transfect cells with mRNA and siRNA. LNPs containing cationic lipids, phospholipids and cholesterol, and surfactants were prepared according to a three-stage procedure. The average size of the resulting LNPs was 176 nm (PDI 0.18). LNPs with DOTAP mesylate were more effective than those with Ol-Ch. Core LNPs demonstrated low transfection activity compared with bilayer LNPs. The type of phospholipid in LNPs was significant for the transfection of MDA-MB-231 and SW 620 cancer cells but not HEK 293T cells. LNPs with GM3 gangliosides were the most efficient for the delivery of mRNA to MDA-MB-231 cells and siRNA to SW620 cells. Thus, we developed a new lipid platform for the efficient delivery of RNA of various sizes to mammalian cells.

Beneficial Flavonoid in Foods and Anti-obesity Effect

Obesity is a global health problem. In the past decades, the prevalence rate of obesity has risen sharply in epidemiology. Obesity has become an increasingly severe epidemic burden linked with different kinds of diseases, consisting of cardiovascular disease, diabetes, metabolic associated fatty liver disease, and even in COVID-19. Beneficial flavonoids in foods, as functional ingredients, combat obesity and maintain energy balance through multiple mechanisms. This review provides a brief overview of biological targets, possible mechanisms and the current therapeutic interventions including suppressing appetite, increasing energy consumption, regulating gut microbiota, inhibiting adipogenesis, anti-inflammation. In vitro and in vivo experiments as well as available clinical evidence related to the anti-obesity effects of pure flavonoid and flavonoid-rich extracts are also summarized and depicted. Furthermore, the metabolism and bioavailability of flavonoids are also concluded and discussed. Beneficial flavonoids have become promising candidates for treating and avoiding obesity, but poor bioavailability and short elimination half-life affects the absorption and efficacy. This paper reviews the different types of flavonoids and their potential effect of preventing obesity, which provide the basis for further research.

Lipid based nanocarriers: Production techniques, concepts, and commercialization aspect

Over the past decade, compared to all other macromolecules lipid-based nanocarriers have proven to be an excellent carrier and delivery system for various pharmaceutical drugs of poor bioavailability. In addition to that, they exhibit exceptional qualities such as minimal toxicity, economical scale-up production, great biocompatibility, and high drug loading efficiency. In this study, we have discussed the various types of lipid nanoparticles, such as liposomes, nanostructured lipid carriers, solid lipid nanoparticles, and lipid polymer hybrid nanoparticles. We have also conferred in detail, the composition, shape and size, methods of preparation, advantages, and certain limitations associated with these lipid-based nanocarriers. Additionally, we have exclusively accounted for several examples of lipid-based nanomedicines that have either been approved and commercialized or are under the different phases of clinical trials. The current review overall focuses on the up-to-date research that has recently been published in view of developing lipid-based nanocarriers for various biological applications, including gene therapy, breast cancer therapy, and vaccine development.Copyright © 2022

COVID-related alteration in the balance between pro-and anti/inflammatory bioactive lipids and cytokines

COVID-19 caused by SARS-CoV-2 is an inflammatory condition involving mainly lungs, vascular endothelium, liver, heart, and brain with significant disturbances in the innate and adaptive immune responses. SARS-CoV-2 virus enters the cells by binding to ACE2 receptor that is present in many tissues. Despite the availability of effective vaccine(s) against SARS-CoV-2 and its variants current pandemic continues to cause significant morbidity and mortality The emergence of several mutant variants of SARS-CoV-2 is a major concern especially about the efficacy of current vaccines against these variants and other variants that are likely to emerge in the future. In this context, the observation that essential fatty acids (EFAs) such as linoleic acid (LA) and their metabolites can inactivate SARS-CoV-2, regulate inflammatory events and immune responses, and suppress inappropriate excess production of proinflammatory interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a), and bradykinin and thus, restore homeostasis is noteworthy. Of all the EFAs, LA and arachidonic acid (AA) are the most effective to inactivate SARS-CoV-2 and other similar viruses and prevent unwarranted inflammation, enhance wound healing by augmenting the production of anti-inflammatory bioactive lipids and cytokines. Since an imbalance between pro- and anti-inflammatory cytokine(s) and other molecules involved in inflammation and wound healing have a significant role in other serious diseases such as sepsis, ARDS (acute respiratory distress syndrome), ischemia-reperfusion injury and severe pneumonia(s), it remains to be seen whether administration of LA and AA and other fatty acids can prevent and suppress these life-threatening diseases in addition to COVID-19.

A study of relationship between lipid profile and severity of SARS-CoV-2

COVID-19 is a severe acute respiratory disease caused by coronavirus 2. While many biochemical alterations have been studied in patients with COVID-19, only a few studies were available to explore the relationship between serum lipid profile values and the severity of SARS COVID-19 infection. A cross-sectional study was conducted at Chettinad Hospital and Research Institute on 128 patients infected with SARS COVID-19 from March 2020 to September 2020. It was an age and sex-matched study. Patients were categorized into mild and severe based on the signs and symptoms. A fasting serum lipid profile and IL-6 levels were measured and Pearson's correlation analysis was done. There was a highly significant decrease in the median and IQR levels of TC, HDL, and LDL in severe cases as compared to mild cases [TC - mild: (256,64), severe (125,44), HDL - mild (46,11), severe (25,13), and LDL - mild (170,48), severe (76,36)]. TGL showed a significant decrease [mild: (170,67), severe:(110,69)]. IL-6 showed a significant increase in severe cases when compared to mild cases [mild:(20,37), severe:(62,105)]. Pearson's correlation analysis showed a significant inverse relationship between the levels of TC, HDL, and IL-6. However, TGL and LDL showed inverse but no significant relationship with IL-6. As the severity of COVID-19 increases, lipid profile levels start decreasing. Hypolipidemia is a pathognomic finding in severe SARS COVID-19 infection.

Slovak adult population during the SARS-CoV-2 virus pandemic

To mark World Obesity Day on 4th March 2021 an online survey was conducted between 4th and 8th March 2021 as part of the project "Be fit during the pandemic!". The aim was to analyze changes in eating habits, physical activity and health indicators in adults during the Covid-19 pandemic caused by the coronavirus SARS-CoV-2 from March 2020 until March 2021. The survey involved 1,035 respondents from Slovakia (50.5% women and 49.5% men) with a mean age of 44.93 +or- 61.19 years (aged 20 to 73 years). Of those asked 70.9% lived in an urban area while 29.1% in the countryside. We assessed the lifestyle changes of the respondents using an anonymous questionnaire during the pandemic, based on whether they had Covid-19 and separated them by gender. We evaluated changes in health parameters (changes in glycaemia, total cholesterol, HDL, LDL, triacylglycerol's, blood pressure, body mass index-BMI, and waist-to-hip ratio-WHR indices). We used the statistical software Statistica 10.0 (StatSoft Inc., USA) for statistical evaluation with differences considered significant at p < 0.05.15% of the adults asked recovered from Covid-19. In the respondents' diet, we confirmed a significant difference (p < 0.01) in the consumption of meat and meat products, which were mainly consumed by men (37.97%, 9.49% more than women). During the pandemic, more women (p < 0.01) (44.30%) used vitamin D nutritional supplements than men (by 17.08%). When evaluating physical activity, more men (p < 0.01) used the stairs (33.76%, 10.76% more than women). In summary, to a greater or lesser extent, physical activity was predominantly performed by men (82.67% of men, 23.63% more than women, p < 0.05). Based on the online survey analyses, it is vital to raise people's awareness about positive lifestyle changes and their beneficial impact on health during a pandemic.

Correlation of low HDL and high triglycerides with outcome in patients with COVID 19 infection

Background: The world is still experiencing corona virus disease-19 (COVID-19) pandemic. So far, we experienced a total of more than 23 crore cases and 47 lakh deaths from COVID 19 disease. Severe acute respiratory syndrome - corona virus - 2 (SARS-CoV-2) was believed to affect lipid metabolism, with many authors reporting an increase in triglycerides and a decrease in high density lipoprotein (HDL) levels. This study gave the clinical features of COVID-19 patients with various HDL-C levels and an interrelation between HDL-C levels and the risk for adverse outcome in the form of deaths. Methods: We conducted a cross sectional study on 100 COVID-19 adult patients diagnosed by reverse transcription - polymerase chain reaction (RT-PCR) test admitted to the medicine department, from January 2020 to December 2020, who were also tested for lipid parameters. The detailed history and lab parameters of the patients were collected and the severe outcome of the same was measured in terms of deaths. Results: The mean age of study participants was 57.92 +or- 12.41 years. Majority of the participants were from the age group of 41 to 60 years with 50 patients (50%). There were 73 males (73%) and 27 females (27%) in our study. We observed that a total of 36 patients had co-morbidities (36%), such as diabetes seen in 22 cases (22%), hypertension in 18 cases (18%), ischaemic heart disease (IHD) in 8 cases (8%). A significant association was seen between the presence of co-morbidities and deaths in our study (P = 0.043). A significant association was seen between the patients who required intensive care and deaths (P < 0.001). We found a significant difference between the triglycerides and HDL parameters of lipid profiles in patients who died as compared to those who survived. (P < 0.05) The mean triglyceride level in patients who died was 223.14 +or- 56.59, significantly higher than those who survived 134.43 +or- 96.16. (P = 0.003) Conclusions: The lipid profile evaluation in our study was found to be effective in detecting the correlation of severity and outcome in COVID-19 patients. We conclude that the severity of COVID-19 cases is associated with low HDL and high triglyceride levels.

Intensity Differences of Resistance Training for Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis.

Resistance training is used as adjunctive therapy for type 2 diabetes (T2DM), and the aim of this study was to investigate the differences in the treatment effects of different intensities of resistance training in terms of glycemia, lipids, blood pressure, adaptations, and body measurements. A comprehensive search was conducted in the PubMed, EMBASE (Excerpta Medica dataBASE), EBSCO (Elton B. Stephens Company) host, Cochrane Library, WOS (Web of Science), and Scopus databases with a cut-off date of April 2022, and reference lists of relevant reviews were also consulted. The literature screening and data extraction were performed independently by two researchers. RoB2 (Risk of bias 2) tools were used for the literature quality assessment, the exercise intensity was categorized as medium-low intensity and high intensity, and the meta subgroup analysis was performed using R Version. A fixed or random effects model was selected for within-group analysis based on the heterogeneity test, and a random effects model was used for the analysis of differences between subgroups. A total of 36 randomized controlled trials were included, with a total of 1491 participants. It was found that resistance training significantly improved HbA1c (glycated hemoglobin), fasting blood glucose, TG (triglycerides), TC (total cholesterol), and LDL (low-density lipoprotein cholesterol) levels in patients with T2DM and caused a significant reduction in systolic blood pressure, percent of fat mass, and HOMA-IR (homeostatic model assessment for insulin resistance) indexes. The effects of high and medium-low intensity resistance training on T2DM patients were different in terms of HOMA-IR, maximal oxygen consumption, weight, waist-to-hip ratio, and body mass indexes. Only medium-low intensity resistance training resulted in a decrease in HOMA-IR. In addition to weight (MD = 4.25, 95% CI: [0.27, 8.22], I2 = 0%, p = 0.04; MD = -0.33, 95% CI: [-2.05, 1.39], I2 = 0%, p = 0.76; between groups p = 0.03) and HOMA-IR (MD = 0.11, 95% CI: [-0.40, -0.63], I2 = 0%, p = 0.85; MD = -1.09, 95% CI: [-1.83, -0.36], I2 = 87%, p = < 0.01; between groups p = 0.0085), other indicators did not reach statistical significance in the level of difference within the two subgroups of high intensity and medium-low intensity. The treatment effects (merger effect values) of high intensity resistance training were superior to those of medium-low intensity resistance training in terms of HbA1c, TG, TC, LDL levels and diastolic blood pressure, resting heart rate, waist circumference, fat mass, and percentage of fat mass. Therefore, high intensity resistance training can be considered to be a better option to assist in the treatment of T2DM and reduce the risk of diabetic complications compared to medium-low intensity resistance training. Only one study reported an adverse event (skeletal muscle injury) associated with resistance training. Although results reflecting the difference in treatment effect between intensity levels reached no statistical significance, the practical importance of the study cannot be ignored.