Effects of COVID-19 Lockdown on Nutritional, Functional and Frailty Biomarkers of People Living in Nursing Homes. A Prospective Study.

BACKGROUND: Nursing home residences suffered a lockdown from the beginning of the COVID-19 pandemic. The present study prospectively evaluates the frailty, functional, and nutritional statuses of nursing home residents. METHODS: Three hundred and one residents from three nursing homes took part in the study. Frailty status was measured using the FRAIL scale. Functional status was evaluated using the Barthel Index. Additionally, Short Physical Performance Batter (SPPB), SARC-F, hand-grip strength, and gait speed were also evaluated. Nutritional status was determined using the mini nutritional assessment test (MNA) and several anthropometrical and biochemical markers. RESULTS: Mini Nutritional Assessment test scores decreased in 20% throughout the confinement (p < .001). Barthel index, SPPB and SARC-F scores also decreased, although to a lesser extent, reflecting a decrease in functional capacity. However, both anthropometric parameters, hand grip strength and gait speed, remained stable throughout confinement (p > .050 in all cases). Morning cortisol secretion significantly decreased by 40% from baseline to post-confinement. A significant reduction in daily cortisol variability was observed, which may suggest increased distress. Fifty-six residents died during the period of confinement (81.4% survival rate). Sex, FRAIL and Barthel Index scores were significant predictors of resident survival. CONCLUSION: After the first COVID-19 blockade, several alterations in residents' frailty markers were observed, which were small and potentially reversible. However, many of the residents were pre-frail after the lockdown. This fact highlights the need for preventive strategies to reduce the impact of future social and physical stressors on these vulnerable individuals.

EATING HABITS OF ADULTS IN SLOVAKIA DURING THE COVID-19 PANDEMIC

The COVID-19 pandemic, domestic isolation and lockdown have resulted a change in people's lifestyles habits and behaviours, including nutritional behaviour worldwide. The aim of the research was to evaluate selected nutritional and health indicators and changes in eating habits of adults in Slovakia affected by the COVID-19 pandemic. The group (n = 860;50.1% women) consisted of adults who did not have COVID-19, with a mean age of 41.3 ± 10.1 years. The comparison of eating habits from the online questionnaire was focused on the period before the pandemic vs. during the pandemic. The values of anthropometric parameters were obtained by the self-reported method. We used the software Statistica 10.0 (StatSoft Inc., USA) for statistical evaluation. Body weight increased during the pandemic in 39.2% of those surveyed. Significant (p < 0.05) weight loss was observed in men. During the pandemic, there was an increase in the consumption of milk and dairy products in 13.7% of respondents, but significantly (p < 0.001) more women (17.2% vs. 10%) limited the intake of milk and dairy products during the pandemic. The consumption of meat and meat products during the pandemic was significantly less in 22% of the group (with a predominance of women 26% vs. men 18%) (p < 0.01). A significant increase occurred in egg consumption in 14.9% of those surveyed (with a 6.4% predominance in males) (p < 0.05). Spirits were consumed by 67% of the group during the pandemic, significantly more men drank alcohol than women (74.8% vs. 59.2%) (p < 0.001). A favourable finding was the increased consumption of fresh vegetables and fruits during the pandemic period, while an increase in salt consumption was an unfavorable observation. During the pandemic the largest increase in the use of nutritional supplements was in the use of vitamin D (57.9%) and vitamin C (47.9%). However, the majority of respondents chose not to take probiotics (65%). Home isolation and lockdown resulted in a significant change in the nutritional behaviour of adults. © 2023, Consulting and Training Center - KEY. All rights reserved.

Features and outcomes of adolescent deliveries during COVID-19 pandemic - a bicentric study

Introduction: adolescent pregnancies represent a global public health problem associated with multiple consequences on the well-being of young mothers, their babies and general population. The biggest prevalence of adolescent pregnancies in Europe can be found in southeastern countries. Objective(s): to analyze the features and outcomes of adolescent deliveries during the COVID-19 pandemic. Material(s) and Method(s): retrospective, descriptive study of adolescent mothers delivered in the period 01.01.2020-31.12.2021 in two university medical centers: the Emergency Clinical County Hospital of Arad (Romania), and Clinic of Gynecology and Obstetrics of University Clinical Center of Vojvodina (Serbia). Demographic and anthropometric parameters of adolescent mothers, number and way of delivery, birth weight and Apgar score of neonate, COVID-19 status and data about pathologies and complications associated with pregnancy and delivery were collected from medical records and analyzed statistically using IBM SPSS. Result(s): there were total of 458 adolescent mothers, aged between 12 and 17 (average 16.07+/-1.07 year). From urban environment there were 182 (60.3%) cases and from rural 276 (39.7%) cases. Number of previous pregnancies and births ranged from 0-3, with majority of mothers being primiparas (76.2%). Cesarean section was performed in 40.8%, vaginal birth in 59.2%. The most common indications for cesarean section were maternal-pelvic disproportion, transverse lie or deflected cephalic presentation, twin pregnancies, severe fetal distress, preeclampsia, scarred uterus with risk of rupture and premature placental abruption. The average fetal weight at birth was 3010.22g ranging from 860 to 4500 g. The average Apgar score was 8.73. There were 9.66% of premature labors. There were 9 (2%) positive COVID-19 cases at birth and additional 4 (0.9%) cases who had COVID-19 during pregnancy. We observed a very high percentage (73.86%) of pregnancies without adequate prenatal care. Conclusion(s): Adolescent mothers are prone to develop complications compared to general population. The COVID-19 pandemic might have additional negative influence on the addressability of underage mothers to medical care, this phenomenon being the basis of most complications during pregnancy. Effective interventions, better sexual education and social programs are needed to reduce the number of adolescent mothers and to help them get a much better social reinsertion and an increase in the general quality of life.Copyright © 2023

Effects of In-Utero SARS-CoV-2 exposure on Prospective Anthropometric and Body Composition Measurements in a subgroup of the COVID-19 Mother Baby Outcomes (COMBO) Cohort

Objectives The effects of in-utero SARS-CoV-2 exposure on the long-term health of exposed infant are unknown. Many in-utero events, including maternal illness, affect the developing fetus. Early impacts often manifest as body size differences, which can herald cardiometabolic risk later in life. Our objective is to determine the effects of in-utero SARS-CoV-2 exposure on fetal body growth and composition. Methods This study is nested in the COVID-19 Mother Baby Outcomes (COMBO) Initiative, a multidisciplinary collaborative intended to follow health outcomes in SARS-CoV-2 exposed mothers and their newborns. Anthropometric measures (weight, length, head circumference) and body composition measures by Quantitative Magnetic Resonance (QMR;fat mass, lean mass and total water) were obtained at two time points: 0-2 weeks of life and 16-32 weeks of life. Continuous variables were compared using Wilcoxon Rank Sum and categorical variables using chi2 test. Stepwise regression identified the most parsimonious model by AIC when estimating lean and fat mass, with exposure status, infant age, infant sex, mode of delivery, gestational age, maternal ethnicity and all anthropometric parameters in the full model, using the statistical program R (Version 4.0.3);p-value<0.05. Results The infant cohort to date (20 exposed [EXP], 19 unexposed [UNEXP]) includes 64% male, 62% born by vaginal delivery, and a median gestational age of 39.0 weeks (Table 1). Maternal Hispanic ethnicity differed between groups (78% EXP vs. 33% UNEXP, p=0.007). Distribution of crude anthropometric and body composition measures are shown in Table 2. Following stepwise model selection, the final lean mass model retained maternal exposure status as a predictor and gestational age and weight were significant predictors in the final linear regression model. In the final fat mass model, exposure status was not retained after stepwise model selection and length and weight were significant predictors (Table 3). Conclusions In a prospective observational cohort study of infants born during the COVID-19 pandemic, Hispanic maternal ethnicity was overrepresented in the exposed group, adding to our growing understanding of the COVID-19 pandemic exacerbating health disparities. In parsimonious linear regression models obtained using stepwise model selection, length and weight were predictors of fat mass, and gestational age and weight were predictors of lean mass. Recruitment and prospective measurements are ongoing.

NOVEL CORONAVIRUS INFECTION IN THE FIRST TRIMESTER OF PREGNANCY: PERINATAL AND MATERNAL OUTCOMES

Objective: To investigate the characteristic features of the course of pregnancy, labor, and perinatal outcomes in women who had a new coronavirus disease 2019 (COVID-19) in the first trimester of pregnancy. Material(s) and Method(s): The first stage of the study consisted of a retrospective analysis of the COVID-19 registry of pregnant and postpartum women from the Ural Federal District (UFD) for 2020-2021. A total of2347patients had COVID-19 in the first trimester of pregnancy in the UFD in 2020-2021. The second stage of the study was a single center cross-sectional comparative study in two independent groups. The study group included 131 patients who had COVID-19 in the first trimester of pregnancy;the comparison group comprised 216 patients who gave birth before COVID-19 pandemic (2019). The analysis included the course of pregnancy, labor and delivery, neonatal health status, and histological examination of 10placentas of women in the study group. Result(s): Pregnancy was terminated in 19.4% of patients who developed severe COVID-19 in the first trimester. Spontaneous miscarriages were registered in 9.2% of the women with mild and moderate COVID-19. In two cases in patients who had COVID-19 before 6 weeks, fetal malformations were detected that were incompatible with life, which are extremely rare in the population. COVID-19 in the first trimester of pregnancy increased the risk of gestational hypertension (OR=3.3;95% CI 1.6-6.6;p<0.001) and threatened preterm birth (OR=3.4;95% CI 1.4-8.0;p=0.004). The mean gestational age at delivery was significantly lower [38.4 (2.0), p<0.001] than in patients who gave birth before the COVID-19 pandemic. The newborns showed a significant decrease in anthropometric parameters and Apgar scores at 1 [7 (6:8), p=0.035] and 5 [8 (7:8), p<0.001] minutes compared to the newborns of the comparison group. At the same time, there were signs of both maternal and fetal blood flow abnormalities in the placenta. Conclusion(s): Women who had COVID-19 in the first trimester of pregnancy may be at increased risk of adverse perinatal and maternal outcomes. Copyright © A group of authors, 2022.

Existential Intelligence Influences Adversity Quotient among Youth in Becoming Life Smart Learner

The whole world has been knocked down by the Pandemic COVID-19 crisis which had impacted people's health globally, including death among people mostly with comorbidity. Some even lost their loved ones. Huge number of people lost jobs due to economic depression that incurred due to restricted movement control orders imposed globally. Whole pandemic events culminated into affecting physical, mental, social, emotional and spiritual well-being. On the flip side, these have been indicated as essential mechanisms to cope up with the current adaptation during this crisis. Role of Existential Intelligence's (Ex I) in influencing Adversity Quotient (AQ) while handling crisis is still immature. The connection between Ex I and AQ is able to provide a bigger picture to stakeholders namely customers, employees, investors, suppliers and vendors, communities, and government in improving the current situation, especially during the post-crisis recovery period. In the present paper, an attempt is made to unravel Ex I adaptation and its contribution towards high AQ in various scenarios. There is no precise test developed pertaining to Ex I as a full-fledged intelligence. However, certain characteristics of Ex I are interconnected to spiritual or religious aspects. Certain degrees of relation are identified between Intelligence Quotient (IQ), Emotional Quotient (EQ), Spiritual Quotient (SQ), and Adversity Quotient (AQ) as foundation for intrapersonal competencies. Therefore, existentialism creates self-realization while handling crisis such as Pandemic COVID-19, appreciating every life moment which is deep rooted in the spiritual and religious teachings. Further in-depth research is needed to better appreciate or understand the contribution of Ex I on AQ for overall well-being of the society in the challenging global environment. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Assessment of therapeutic targets in patients with type 2 diabetes mellitus and cardiovascular disease

Background and Aims : Cardiovascular disease (CVD) affects approximately one third of type 2 diabetes mellitus (T2DM) patients. We aimed to evaluate treatment targets of T2DM patients with CVD. Method(s): This retrospective study included 469 T2DM patients attending a Diabetes Center before COVID-19 (08.2016-12.2019). Data regarding diabetes history, complications and comorbidities, anthropometric parameters, metabolic profile were collected from medical records. Result(s): The patients' mean age was 62.27+/-9.98 and 48.8% were men. The mean diabetes duration was 6.81+/-7.04 years and the metabolic parameters were: BMI 31.78+/-5.32 kg/m2, HbA1c 7.5+/-1.47%, glycaemia 159.96+/-49.31 mg/dl, LDL-cholesterol 99.60+/-42.68 mg/dl, triglycerides 200.33+/-143.37 mg/dl. 203 patients had atherosclerotic CVD (angina, cardiac ischemic disease, peripheral arterial disease). A comparative analysis revealed higher values in CVD patients for age, diabetes duration, abdominal circumference, glycaemia, urinary albumin to creatinine ratio (ACR), p <0.05. Diabetes duration and ACR seemed to be predictive factors for CVD (AUC=0.579, p <0.01, CI=0.52 - 0.63, respectively AUC=0.607, p <0.01, CI=0.52 - 0.68). Regarding treatment targets of CVD patients, 45.5% had systolic blood pressure <130 mmHg, 14.8% had LDL-cholesterol <55 mg/dl, and 26.6% had HbA1c <7%. Conclusion(s): In clinical practice, some T2DM patients fail to achieve cardio-metabolic control even if managed according to the latest ESC recommendations. Copyright © 2022

Effects of an online yoga program on anthropometric parameters among overweight female students during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) outbreak is a public health concern. However, stay-at-home regulations to prevent disease spread increased sedentary behavior with unintended adverse outcomes. Overweight is a major global health issue, and standard treatments have a poor track record of long-term effectiveness. The purpose of this study was to evaluate how online yoga affected participants who were overweight in terms of anthropometric measurements. The study, which was designed as a experimental study, enrolled sixty overweight adolescents. The participants were divided into two groups: a control group (n = 30) and an intervention group (n = 30) who performed an online yoga home exercise program comprising basic yoga practice with 15 poses and minimal rest periods on Monday Wednesday and Friday, from 5.00 to 5.45 pm for 12 weeks. The intensity of the exercise was 65-75 percent of maximum heart rate (MHR). Anthropometric parameters, including body weight (BW), body mass index (BMI), body circumference measurements (BCM), and resting heart rate (RHR) were assessed. All parameters were measured at weeks 0, 8, and 12. Within group and between group comparisons were performed. The results revealed improved BW, BMI, BCM, and RHR in the intervention group; the median BW and BMI of the intervention group was significantly decreased at week 12, and the BCM of the intervention group showed a significant decrease in the chest, waist, hip, and thigh. This declining trend started from week 8. This 12-week online yoga program decreased BW, BMI, BCM, and RHR, which indicates that practicing yoga at home is effective on anthropometric parameters and may be an alternative therapy for health promotion and controlling body weight during the COVID-19 pandemic. However, an appropriate and continuous exercise program must be followed.

AORTIC STIFFNESS AND INDEXES OF DISEASE SEVERITY IN SUBJECTS WITH PREVIOUS COVID-19 PNEUMONIA: A FOLLOWUP STUDY

Objective: Up to date the possibility of a vascular damage due to COVID-19 pneumonia is a not clarified. We searched for relationships between the carotidfemoral pulse wave velocity (cfPWV) and clinical and biochemical markers of severity of the infectious disease, after hospital discharge, in a group of patients who had been admitted in care units. Design and method: In 69 subjects (age 58 ± 13 years, 36 males), previously admitted in hospital because of COVID-19 pneumonia, we evaluated at the time of hospital admission anthropometric parameters, blood pressure, history of arterial hypertension or other diseases, drugs, smoking and alcohol habit, physical activity level, and indexes of infectious disease severity, such as the SIMEU score, need for invasive oxygen delivery, PaO2, PaCo2, inflammatory markers such as white blood cells count, levels of proadrenomedulline (proADM), reactive C protein, procalcitonin, IL- 6, glomerular filtration rate (GFR), troponin, mioglobin, B natriuretic peptide. After an average 2 months follow-up the cf- PWV was measured. Results: At univariate analysis the cfPWV was significantly and positively related to age (r = 0.454, P < 0.001), body mass index (r = 0.436, P = 0.016), waist circumference (r = 0.345, P = 0.004), levels of plasma glucose (r = 0.430, P = 0.001), proADM (r = 0.456, P = 0.006), IL-6 (r = 0.280, P = 0.037), mioglobin (r = 0.443, P = 0.001) and inversely related to GFR (r = -0.289, P = 0.023). The cfPWV was higher in diabetics subjects than in non-diabetics (P = 0.011), and in patients who had needed invasive oxygen support (P = 0.044). There was no difference in cfPWV in patients with or without history of arterial hypertension or with different blood pressure levels at admission. At multivariate analysis the cfPWV was independently associated with invasive oxygen support (B = 0.168, P = 0.012), body mass index (B = 0.180, P = 0.001), waist circumference (B = 0.162, P = 0.002), GFR (B = 0.078, P = 0.008), and proADM levels (B = 0.161, P = 0.003). Conclusions: In patients who recovered from COVID-19 pneumonia the aortic stiffness is associated with severity of disease and levels of proADM, but not with history of hypertension. Patients with more higher proADM levels in acute phase of the infectious disease could need a longer follow-up evaluation of the CFPWV after the recovering from disease to search for long time vascular damage.

Impact of SARS-CoV-2 Lockdown on Anthropometric Parameters in Children 11/12 Years Old.

BACKGROUND: During the great lockdown in Spain due to SARS-CoV-2, in between the months of March and June 2020, dietary and physical activity habits were modified in children. The aim of the study was to determine the impact of the lockdown on anthropometric parameters in children aged 11/12 years. METHODS: Fifty Spanish children aged 11/12 years (M = 11.40; SD = 0.50) participated: 33 (66%) boys and 17 (34%) girls. For data collection, we used an anthropometry kit; the Alpha-Fitness Battery, a validated instrument to assess dietary intake, habits and practices; and an ad hoc survey to collect sociodemographic and other data under investigation. RESULTS: There were significant differences in the anthropometric parameters measured and in the results obtained for Body Mass Index (BMI) and body fat percentage pre- and post-lockdown in both boys and girls (p < 0.05). No significant differences were found in waist-circumference measurements (p > 0.05). CONCLUSIONS: There is evidence of a significant impact of the SARS-CoV-2 lockdown on anthropometric parameters in boys and girls aged 11/12 years.

An anthropometric evaluation of the scapula, with emphasis on the coracoid process and glenoid fossa in a South African population.

The exact dimensions of the scapula, including the coracoid process and glenoid fossa, are fundamental in the patho-mechanics of the glenohumeral joint (GHJ); as these structures act as initiators of shoulder movement. The aim of the study was to evaluate the anthropometric parameters of the GHJ, with emphasis on the coracoid process and glenoid fossa. The morphometric (Linear Tools 2012, 0-150mm, LIN 86500963) and morphological parameters of a total of one hundred and sixty-four (n = 164) dry bone scapulae [Right (R): 80; Left (L): 84, Male (M): 68; Female (F): 96] were recorded. Results: (i) Shape of glenoid fossa: Type 1: (R) 16.5%, (L) 11.0%; Male (M) 20.1%, Female (F) 7.3%; Type 2: (R) 14.0%, (L) 15.2%; (M) 18.3%, (F) 11.0%; Type 3: (R) 18.3%, (L) 25.0%; (M) 27.4%, (F) 15.9%. (ii) Notch type: Type 1: (R) 1.7%, (L) 7.3%; (M) 6.7%, (F) 2.4%; Type 2: (R) 47.0%, (L) 43.9%; (M) 59.2%, (F) 31.7%. (iii) Vertical diameter of glenoid fossa (VD) (mm): (R) 35.2 ± 3.1, (L) 34.9 ± 3.0; (M) 35.3 ± 3.2, (F) 34.6 ± 2.8. (iv) Horizontal diameter 1 (HD1) of glenoid fossa (mm): (R) 18.4 ± 3.3, (L) 17.5 ± 2.9; (M) 18.2 ± 3.3, (F) 17.4 ± 2.6. (v) Horizontal diameter 2 (HD2) of glenoid fossa (mm): (R) 24.5 ± 2.9, (L) 23.6 ± 2.6; (M) 24.2 ± 2.7, (F) 23.7 ± 2.8. (vi) Length of coracoid process (CL) (mm): (R) 41.7 ± 4.7, (L) 41.5 ± 4.9; (M) 42.1 ± 4.7, (F) 40.7 ± 4.8. (vii) Width of coracoid process (CW) (mm): (R) 13.3 ± 1.9, (L) 14.2 ± 11.9; (M) 13.1 ± 1.9, (F) 15.1 ± 14.5. (viii) Coracoglenoid distance (CGD) (mm): (R) 27.4 ± 8.3, (L) 28.2 ± 3.5; (M) 28.2 ± 7.4, (F) 27.0 ± 3.4. In the present study, Type 3 (oval) was observed to be the predominant glenoid fossa shape with a higher incidence in male individuals and on the right side. Although only notch Types 1 (without a notch) and 2 (with one notch) were observed in this study, Type 2 (one notch) was the most prevalent, presenting with a significant p-value (p = 0.019), suggesting that notch Type 1 (without a notch) and 2 (with one notch) are common findings in the right and left side of individuals. The findings observed in this study may provide knowledge regarding the role of the coracoid parameters in etiology of subcoracoid impingement while knowledge on the glenoid fossa parameters and variations are essential for evaluation in shoulder arthroplasty for glenoid fractures and anterior dislocations, and for glenoid prosthesis designs for the South African population.

Positive influence of gut microbiota on the effects of Korean red ginseng in metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: Ginseng, a traditional herbal medicine, has been used for thousands of years to treat various diseases including metabolic syndrome (MS). However, the underlying mechanism(s) of such beneficial actions of ginseng against MS is poorly understood. Emerging evidence indicates a close association of the host gut microbiota with MS. The present study was conducted to examine, whether the beneficial effects of Korean red ginseng (KRG) against MS could be influenced by gut microbial population and whether gut microbial profile could be considered a valuable biomarker for targeted treatment strategy for MS in compliance with the predictive, preventive, and personalized medicine (PPPM / 3PM). METHODS: This clinical study was a randomized, double-blind, placebo-controlled trial evaluating the effects of KRG treatment for 8 weeks on patients with MS. The anthropometric parameters, vital signs, metabolic biomarkers, and gut microbial composition through 16S rRNA gene sequencing were assessed at the baseline and endpoint. The impact of KRG was also evaluated after categorizing the subjects into responders and non-responders, as well as enterotypes 1 and 2 based on their gut microbial profile at the baseline. RESULTS: Fifty out of 60 subjects who meet the MS criteria completed the trial without showing adverse reactions. The KRG treatment caused a significant decrease in systolic blood pressure (SBP). Microbial analysis revealed a decrease in Firmicutes, Proteobacteria, and an increase in Bacteroidetes in response to KRG. In patient stratification analysis, the responders showing marked improvement in the serum levels of lipid metabolic biomarkers TC and LDL due to the KRG treatment exhibited higher population of both the family Lachnospiraceae and order Clostridiales compared to the non-responders. The homeostasis model assessment-insulin resistance (HOMA-IR) and insulin level were decreased in enterotype 1 (Bacteroides-abundant group) and increased in enterotype 2 (prevotella-abundant group) following the KRG treatment. CONCLUSION: In this study, the effects of KRG on the glucose metabolism in MS patients were influenced by the relative abundances of gut microbial population and differed according to the individual enterotype. Therefore, the analysis of enterotype categories is considered to be helpful in predicting the effectiveness of KRG on glucose homeostasis of MS patients individually. This will further help to decide on the appropriate treatment strategy for MS, in compliance with the perspective of PPPM.