ABSTRACT
Background: In this study, we aimed to investigate the pathological alterations of LDL-cholesterol, HDL-cholesterol, total cholesterol and triglycerides in COVID-19 patients during the acute phase of infection, and after recovery. Method(s): A retrospective study was performed to examine serum levels of LDL-cholesterol, HDL-cholesterol, total cholesterol and triglycerides on 55 COVID-19 patients who were hospitalized in our center between February and April 2020. The lipid profile and the hematological parameters were analyzed in the same group of patients before (Group before) and after clinical management (Group after). The laboratory tests results were compared between these two groups, as well as with a group of healthy subjects (Healthy controls), matched for age and sex and selected among the blood donors. Result(s): LDL-cholesterol, HDL-cholesterol, total cholesterol levels were significantly lower in COVID-19 patients (Group before) as compared with normal subjects (P<0.0001). Comparing healthy controls and the group after, statistically significant differences were observed for all parameters except for total cholesterol (P=0.9006). Total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride were found to be significantly higher after recovery than during the acute phase of infection (P<0.0001). C-reactive protein levels were found to be inversely correlated with those of LDL-cholesterol (rs =-0573, P<0.0001), total cholesterol (r=-0.732, P<0.0001), and HDL-cholesterol (r=-0.700, P<0.0001). Conclusion(s): The results of our study seemingly attest that lipids, especially cholesterol, may play an important role in viral replication, internalization and immune activation in patients with COVID-19 infection. Moreover, lipid abnormalities observed during and after this infection could be used for assessing indirectly the response to clinical treatment.Copyright © Journal of Laboratory and Precision Medicine. All rights reserved.
ABSTRACT
Biomimetic strategies can be adopted to improve biopharmaceutical aspects. Subsequently, Biomimetic reconstitutable pegylated amphiphilic lipid nanocarriers have high translational potential for systemic controlled drug delivery;however, such an improvised system for systemic aspirin delivery exploring nanotechnology is not available. Systemic administration of aspirin and its controlled delivery can significantly control blood clotting events, leading to stroke, which has immediate applications in cardiovascular diseases and Covid-19. In this work, we are developing aspirin sustained release pegylated amphiphilic self-assembling nanoparticles to develop reconstitutable aspirin injections by solvent-based co-precipitation method with phase inversion technique that leads to novel "biomimetic niosomal nanoparticles (BNNs).” DOE led optimization is done to develop Design of space for optimized particles. Upon reconstitution of solid powder, the particle size was 144.8 ± 12.90 nm with a surface charge of -29.2 ± 2.24 mV. The entrapment efficiency was found to be 49 ± 0.15%, wherein 96.99 ± 1.57% of the drug was released in 24hr showing super case II transport-based drug release mechanism. The formulation has the least hemolysis while showing significant suppression of platelet aggregation. MTT assay does not show any significant cytotoxicity. This is a potential nanoparticle that can be explored for developing aspirin injection, which is not available.
ABSTRACT
Background: Coronaviruses (SARS-CoV-2) cause COVID-19 pandemic in March, 2020, after Chinese scientists published the genome of the virus vaccine manufacturer produced several COVID-19 vaccines that aimed to induce a humoral and cellular immune response to prevent the fatality and harm caused by COVID-19. Existing study aimed to evaluate the biochemical efficiency of some of COVID-19 vaccines (Pfizer, AstraZeneca and Sinopharm) in vaccinated people of Wasit Province in Iraq by lipid profile estimation, Human SOD1 (Superoxide Dismutase 1, Soluble) and Human Malondialdehyde (MDA). Method(s): The current study sample included (55) individuals whom vaccinated with two shots of one of the three vaccines (Pfizer, AstraZeneca and Sinopharm) whom did not suffer from chronic health problems, and a control group of (35) unvaccinated individuals of both genders. Their age ranges from 18-45 years, they were divided into two age ranges (18-31 and 32-45 years) and their vaccination history was confirmed according to a special form. The blood samples were collected from fasting vaccinated individuals 2-4 weeks post the second dose of COVID-19 vaccine for the purpose of conducting lipid profile, SOD and MDA. RESULT(S): The data of serous endogenous oxidative-antioxidants balance showed a variation in the concentrations of malondialdehyde (MDA), its significant increase (P<=0.05) was observed in those vaccinated with the Pfizer vaccine for the first age range (31-18 years) and its insignificant decrease (P> 0.05) in the two Sinopharm and AstraZeneca vaccines in both age ranges and both genders comparing to the control group. Besides, the findings of estimating the serum level of enzyme Superoxide dismutase (SOD) was not significantly different (P> 0.05) between the vaccinated people of this study for all three vaccines and the control group for both age ranges and both genders. Additionally, the serum lipid profile levels (TG, LDL, HDL and VLDL) of the vaccinated individuals were not significantly changed (P>0.05) compared to the control group (unvaccinated individuals) except for the cleared variation in cholesterol level among the first age range for both genders compared to the control group. Conclusion(s): the findings of the present study showed that all the three targeted vaccines in the study (Pfizer, AstraZeneca and Sinopharm) have shown a high efficacy and safely on body oxidation balance and heart in terms of the biochemical assessment (MDA, SOD and lipid profile) of the healthy vaccinated participants. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
BACKGROUND: Indonesia faces serious challenges from a double burden disease caused by changes in people’s lifestyles. Hypertension, stroke, heart disease, and diabetes have taken up a growing share of health expenditure. These diseases are the comorbid of COVID 19 and strongly require routine health monitoring. Health monitoring will greatly develop along with the development of technology and information 4.0. AIM: This study aims to implement the healthy living community movement programs using automatic telehealth machine (ATM) for health checking and education at Politeknik Kesehatan Kemenkes Palu. METHODS: This research method is intervention research. The population were 167 employees of Poltekkes Kemenkes Palu. Sampling process used simple random sampling method with sample size consist of 96 people. The measuring instrument used are ATM device and a questionnaire that has been tested for validity and reliability. Analysis of research data using frequency distribution and bivariate test. RESULTS: The study revealed the characteristic of respondents including gender and age, physical activity was generally good, and fruits intake was also good. The variables that were significantly related to systole were gender and age category (p = 0.03). The variables which were significantly related to diastole were gender (p = 0.02) and age category (p = 0.01). The results revealed that gender, age, physical activity, and fruits intake were not associated with total cholesterol levels. CONCLUSIONS: ATMs can be implemented for health checking and education in healthy living community movement programs.
ABSTRACT
BACKGROUND: There are over 20,000 individuals imprisoned by Immigration and Customs Enforcement (ICE) daily, with nearly half a million detained annually. Numerous reports have documented human rights abuses in immigration detention, yet little is known about its health impacts. METHODS: From July 2020 - February 2021, we conducted a qualitative study of adults who had been detained by ICE in New York and New Jersey and who were clients of local legal and community-based organizations. Eligibility included: release from immigration detention in the past two years, detained for >30 days. Two interviewers conducted anonymous, individual, semi-structured interviews in English or Spanish. Interviews explored participants' experiences trying tomeet physical and mental health needs while in detention. We continued interviews until reaching thematic saturation and conducted analysis concurrently using a modified grounded theory approach. RESULTS: Of 16 participants, 13 identified as men, 5 as LGBTQ, and 4 as Black;they were from 9 countries and had spent a median of 11 months in detention. Four themes emerged from our analysis: (1) Participants attributed new medical problems or worsening of chronic conditions to inhumane treatment and poor physical conditions: “They detected I had high blood sugar and cholesterol level, but that's due to the food they give you there.” (2) Structural barriers prevented access to needed care and led to delays in medical attention: “You could literally be dying in there and it's like they need to see you dead in order for them to get you help.” (3) A pervasive sense of injustice exacerbated emotional distress. Participants felt detention was designed to break one down: “It harms you morally, psychologically, physically, what immigration officials do to you. if you didn't commit a crime that put others at risk why do they detain you there?” (4)Worsening conditions during the COVID-19 pandemic. The pandemic worsened isolation and desperation;participants feared for their lives as COVID-19 spread in their facilities and they remained unprotected: “They didn't come and ask people, ?Hey, do you feel any symptoms? Are you okay, do you want to get tested?' There was no proper tools given like hand sanitizer, Clorox. no measurements being taken, masks given out or gloves given out? we barely had toilet paper and soap.” CONCLUSIONS: These interviews demonstrate how structural features of immigration detention erode health while creating barriers to accessing needed medical care. Underlying the participants' experiences of the immigration detention enterprise is a sense of arbitrariness and injustice that further contributes to its psychological toll. Clinicians caring for immigrant communities must be cognizant of these health impacts. As COVID-19 continues to disproportionately affect incarcerated individuals, community-based alternatives to immigration detention should be urgently prioritized.
ABSTRACT
Rationale: Individuals with COPD who develop COVID-19 are at increased risk of hospitalization, ICU admission and death. COPD is associated with increased airway epithelial expression of ACE2, the receptor mediating SARS-CoV-2 entry into cells. Hypercapnia commonly develops in advanced COPD and is associated with frequent and potentially fatal pulmonary infections. We previously reported that hypercapnia increases viral replication, lung injury and mortality in mice infected with influenza A virus. Also, global gene expression profiling of primary human bronchial epithelial (HBE) cells showed that elevated CO2 upregulates expression of cholesterol biosynthesis genes, including HMGCS1, and downregulates ATP-binding cassette (ABC) transporters that promote cholesterol efflux. Given that cellular cholesterol is important for entry of viruses into cells, in the current study we assessed the impact of hypercapnia on regulation of cellular cholesterol levels, and resultant effects on expression of ACE2 and entry of Pseudo-SARS-CoV-2 in cultured HBE, BEAS-2B and VERO cells, and airway epithelium of mice. Methods: Differentiated HBE, BEAS-2B or VERO cells were pre-incubated in normocapnia (5% CO2, PCO2 36 mmHg) or hypercapnia (15% CO2, PCO2 108 mmHg), both with normoxia, for 4 days. Expression of ACE2 and sterol regulatory element binding protein 2 (SREPB2), the master regulator of cholesterol synthesis, was assessed by immunoblot or immunofluorescence. Cholesterol was measured in cell lysates by Amplex red assay. Cells cultured in normocapnia or hypercapnia were also infected with Pseudo SARS-CoV-2, a Neon Green reporter baculovirus. For in vivo studies, C57BL/6 mice were exposed to normoxic hypercapnia (10% CO2/21% O2) for 7 days, or air as control, and airway epithelial expression of ACE2, SREBP2, ABCA1, ABCG1 and HMGCS1 was assessed by immunofluorescence. SREBP2 was blocked using the small molecules betulin or AM580, and cellular cholesterol was disrupted using MβCD. Results: Hypercapnia increased expression and activation of SREBP2 and decreased expression of ABC transporters, thereby augmenting epithelial cholesterol levels. Elevated CO2 also augmented ACE2 expression and Pseudo-SARSCoV- 2 entry into epithelial cells in vitro and in vivo. These effects were all reversed by blocking SREBP2 or disrupting cellular cholesterol. Conclusion: Hypercapnia augments cellular cholesterol levels by altering expression of cholesterol biosynthetic enzymes and efflux transporters, leading to increased epithelial expression of ACE2 and entry of Pseudo-SARS-CoV-2 into cells. These findings suggest that ventilatory support to limit hypercapnia or pharmacologic interventions to decrease cellular cholesterol might reduce viral burden and improve clinical outcomes of SARSCoV- 2 infection in advanced COPD and other severe lung diseases.
ABSTRACT
Background: Low-density lipoprotein-cholesterol (LDL-C) is a well-accepted causal risk factor for atherothrombotic cardiovascular disease. Several randomized controlled trials and meta-analyses have shown that lipid-lowering therapies reduce cardiovascular events and have a positive effect in reducing vulnerable plaques. In particular, the recommended target for LDL-C has become more and more stringent, moving to 1.4 mmol/l (55 mg/dl) for very high-risk patients. According to the 2019 ESC/EAS Guidelines, the current paradigm for lipid management favors a stepwise approach consisting of early initiation of high-intensity statin, followed by subsequent addition of ezetimibe, and ultimately a consideration of PCSK9 inhibitor treatment if LDL-C levels remain elevated. Methods: We recruited 307 patients admitted for acute coronary syndrome (ACS) during the COVID-19 pandemic from March 2020 to December 2020. Baseline LDL-C concentration and prescribed hypolipemiant treatment at hospital admission and discharge were registered. Therefore, we included all consecutive patients identified as very-high cardiovascular risk, according to 2019 ESC guidelines. We stratified our population through variables independently associated with non-attainment of LDL-cholesterol such as hypertension, diabetes, peripheral arterial disease, clinical manifestations of ACS, number of main vessels treated, and complexity of the atherosclerotic disease. Results: 274 patients were included. Mean age was 69,9 years (SD 11,4), 20,8%were women, 23,7%had diabetes, 16,4%had PAD and 32,1 % suffered from valvular disease, mainly with mitral regurgitation or aortic stenosis no more than mild or moderate. Of 25.1% with a previous history of acute myocardial infarction, the 33,3% of whom didn't have statin therapy pre-ACS index (p =0,001). At admission, medium cholesterol levels of patients that underwent previous coronary revascularization (25,5% of the total population) were 84,21 ± 31,2 mg/dL, not in range according to both 2016 and 2019 ESC guidelines. At discharge, 77,37 % of all the patients included received only statin therapy VS 22,63% with statin plus ezetimibe. In the subpopulation of patients with recurring ACS events with LDL pre-admission > 100 mg/dL,despite high dose statin, only 25% of this population were discharged adding ezetimibe (VS 75% who kept on the treatment of high dose statin without up-titration). Conclusions: Management of dyslipidemia is frequently suboptimal and the gap between guidelines and clinical practice for lipid management across Europe has been exacerbated by the 2019 guidelines. A greater utilization of non-statin lipid-lowering therapies is likely needed to reach the LDL-C optimal target. A correct stratification of the risk class would help to identify, in a personalized perspective of treatment, patients at very high risk that would take advantage of more aggressive therapy to reach the lowest target of LDL-C ('the lower is better'). (Figure Presented).
ABSTRACT
Introduction: Aims of this study were to investigate the pathological alterations in LDL-cholesterol, HDLcholesterol, total cholesterol, and triglycerides in individuals with COVID-19 infection. Methods:Between February and April 2020, a total of 80 COVID-19 patients admitted to our hospital and 80 patient recovered from COVID-19 were evaluated for their LDL- and HDL-cholesterol levels. 80 age and sex matched individual were included in the study for comparision. Lipid level were compared among the COVID-19 patient, patient recovered from COVID-19 and healthy control. Results:Over eighty percent of the covid-19 patients had cholesterol levels that were much lower than the normal person. Only total cholesterol indicated significant differences between healthy controls and COVID-19. There was a considerable increase in the levels of HDL, LDL (bad), and triglyceride levels after recovery compared to the acute stage of sickness. Low density lipoprotein (LDL) cholesterol and total cholesterol had a negative relationship with C-reactive protein (CRP). It is possible that lipids such as cholesterol are important in viral multiplication, internalisation and immunological activation in COVID-19 infected individuals, according to our data. Conclusions: In addition, it is possible to use lipid abnormalities discovered during and after infection as a proxy for assessing the effectiveness of therapeutic treatment.
ABSTRACT
Purpose of Study Coronavirus disease (COVID-19) can range from asymptomatic infection to severe illness with multiorgan failure. Recent studies demonstrated an association between lower serum lipid levels namely high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (TC) and COVID-19 disease severity. But the results lack consistency, and the magnitude of the association is currently unknown. Methods Used We conducted a systematic review and metaanalysis on the difference in HDL, LDL, TC, and triglycerides (TG) levels between 1) COVID-19 patients and healthy controls 2) COVID-19 patients with and without severe disease 3) COVID-19 patients who died and who survived. We included articles from PubMed and Embase up to September 1, 2021. We analyzed the pooled mean differences (pMD) in lipid levels (mg/dL) for the above-mentioned groups using random effects meta-analysis and assessed publication bias using funnel plots. Summary of Results Among the 441 articles retrieved, 29 articles (26 retrospective and 3 prospective cohorts) met the inclusion criteria with an aggregate of 256,721 participants. Patients with COVID-19 had lower HDL (pMD = -6.95), and TC (pMD = -14.9) levels (table 1 and figure 1). There was no difference in LDL and TG levels among patients with and without COVID-19. Patients with severe COVID-19 had lower HDL (pMD = -4.4), LDL (pMD = -4.4), and TC (pMD = -10.4) levels compared to non-severe COVID-19 patients. Patients who died had lower HDL (pMD = -2.5), LDL (pMD = -10.6) and TC (pMD = -14.9) levels. TG levels did not differ with COVID-19 severity or mortality. None of the above analyses showed statistically significant publication bias. Conclusions Our analysis demonstrated lower lipid levels in COVID-19 patients compared to healthy controls. Among COVID-19 patients, lower HDL, LDL, and TC levels were associated with severity and mortality. We believe that reduced lipoprotein levels are secondary to systemic inflammation and hepatic dysfunction. Lipid levels could be explored as potential prognostic factors in patients with COVID-19. (Table Presented).
ABSTRACT
Introduction: The global pandemic due to Covid-19 has constituded a challenge in the follow up and monitoring of cardiac rehabilitation's programs. The State of alarm declared last year in Spain, led to strict home confinement that could have had an impact in the progress of patients Aim: To analyze the effect of home confinement on the managment of cardiovascular risk factors (CVRF) in patients included in phase III of a cardiac rehabilitation program (CRP) and also to evaluate the self-care education received during CRP. Methods and materials: Descriptive, comparative and retrospective analysis of patients in phase III of a CRP. The sample was divided into two groups: Post-Covid group (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2020 [date of end of home confinement in Spain] to 12/31/2020) and Group Pre-Covid (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2019 to 12/31/2019). Demographic and CVRF data from end of phase II consultation were compared with those from the phase III consultation (one year after the event) for both groups. The SPSS statistics v23 program was used for statistical analysis. Results: 283 patients, 137 patients from the pre-Covid group and 146 patients from the post-Covid group. No statistically significant differences were found between the two populations (Table 1). No statistically significant differences were found in the achievement of the CVRF target values: systolic blood pressure <140mmHg (94 vs 107;p=0.216), diastolic blood pressure <90mmHg (121 vs 130, p=0.276), LDL-c <70 mg/dl (86 (71.7%) vs 89 (73.6%);p=0.743), LDL-c <55 mg/dl (41 (34.2%) Vs 47 (38.8%);p=0.451), HbA1c figure <7% (106 vs 111;p=0.478), baseline fasting blood glucose <110 mg/dl (103 vs 107;p=0.970). Regarding the variation of the CVRF figures between the final consultation of phase III and that of phase II, no statistically significant differences were found between the two groups: difference in LDL-c figure for phase III consultation with respect to phase II (-0.5±20.3 mg/dl in pre- Covid group vs -5.3±24.4 mg/dl in post-Covid group;p=0.102), difference in HDL-c (4.6±26.1 mg/dl pre-Covid group vs -0.6±24.9 mg/dl post-Covid group;p=0.113), difference in total cholesterol level (4.6±26.1 mg/dl vs -0.6±24.9 mg/dl;p=0.113), difference in HbA1c (0.1±0.3% in pre-Covid group vs 0.1±0.6% in group post-Covid), Table 2. Conclusions: Home confinement has not contribute to a worsening in CVRF control in patients in a phase III of a CRP, in our study. The education given in a CRP concerning to the management of CVRF is the essential factor that grant an adequate patient control in extraordinary circumstances. (Figure Presented).