Emotional eating in relation to gastrointestinal symptoms and burnout among young women during the pandemic

Background: The emergence of the coronavirus disease (COVID-19), created unique constraints in everyday life. Emotional eating is a known phenomenon in disasters and is markedly associated with gastrointestinal symptoms. In this study, the aim was to assess the relationship of gastrointestinal symptom severity and COVID-19 burnout with emotional eating among young women during the pandemic disaster. Methods: A cross-sectional study approach was used to allow 462 young women participants in this study. The design of the questionnaires was based on demographics, health behaviors, Gastrointestinal Symptom Severity Scale, Emotional Eating Scale and COVID-19 Burnout Scale. Data were analyzed using percentages, mean values, independent t-test, chi-squared test. The hierarchical multiple regression analysis was performed for predicting risk factors of emotional eating. Significance levels were set at the 5% level. Results: Of the women, 73.8% were emotional eaters. The level of COVID-19 burnout was moderate with mean score of 29.4+or-11.1 and emotional eating total score was 21.0+or-8.1. Increased number of meals, increased weight gain and shorter sleep time were significantly associated with emotional eating (p<0.05). Participants with more than three meals per day were more likely to be emotional eaters (Beta=4.26). The regression model showed that indigestion and COVID-19 burnout were strong risk factors of emotinal eating (p<0.05). Conclusions: This study demonstrated that indigestion and COVID-19 burnout were strong risk factors of emotinal eating. Emotional eating could pose an additional health burden to young women in the form of poor food choices.

The use of enterosorbents in the immunorehabilitation of patients who have had a new coronavirus infection COVID-19

Post-covid syndrome is characterized by a spectrum of persistent symptoms that do not disappear for many months, which may be due to an inadequate immune system response. This leads to a discussion of potentially new methods immunorehabilitation with the use of effective enterosorbents. The aim of the study was to assess the clinical effectiveness of enterosorbents and immunological parameters of patients with a long-term "post-covid syndrome" who have undergone a new coronavirus infection COVID-19. In n pilot monitored open non-randomized experimental clinical observationanl study 33 patients who had a novel coronavirus infection with COVID-19 underwent comprehensive treatment with the inclusion of azoximer bromide (Polyoxidonium) and colloidal silicon dioxide (Polisorb MP). Analysis of clinical and laboratory data showed that after immunorehabilitation, most of the indicators characterizing the state of the immune system in patients who had COVID-19 were restored to control values. And the use of enterosorbents in complex immunorehabilitation therapy is justified and confirmed by the relief of dyspeptic and asthetovegetative syndromes, which makes it possible to recommend it for use in complex treatment.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.

Medicinal bismuth: Bismuth-organic frameworks as pharmaceutically privileged compounds

Historically organometallic compounds have been used to cure certain diseases with limited applications. Although bismuth belongs to the category of heavy metals, many of its derivatives have found applications in modern drug discovery research, mainly because of its low toxicity and higher bioavailability. Being an eco-friendly mild Lewis acid, compounds having bismuth as a central atom are capable of binding several proteins in humans and other species. Bismuth complexes demonstrated antibacterial potential in syphilis, diarrhea, gastritis, and colitis. Apart from antibacterial activities, bismuth compounds exhibited anticancer, antileishmanial, and some extent of antifungal and other medicinal properties. This article discusses major synthetic methods and pharmacological potentials of bismuth complexes exhibiting in vitro activity to significant clinical performance in a systematic and timely manner.Copyright © 2022 Elsevier Ltd

Impact of Covid-19 on Endoscopic Demography: A Cross Sectional Study

Background: Pandemics are never easy to deal with, especially this new covid pandemic which has exposed the vulnerability and multiple lacunae in our existing health care. In this midst of chaos and uncertainty delivering endoscopic services had become a nightmare, as endoscopy is a procedure done in the aero digestive tract and also an aerosol generating procedure. This led to a lot of enigma and skepticism in selection of patients and precautions to be taken while performing procedures. Objective(s): To Know the Feasibility and Utility of endoscopy as diagnostic and therapeutic services in Covid pandemic in the midst of chaos and uncertainties. Material(s) and Method(s): It is a retrospective study conducted from May 2020 to December 2020 in a Tertiary care Gastro hospital. Patients were screened clinically by Questionnaire highlighting the travel history, contact history, and residing history (hot spots for covid). X-Ray, HRCT and RT-PCR was done to exclude high risk cases. Clinical screening for symptoms, Vitals, Spo2 was done on all the patients. The procedures were performed using standard endoscopy equipment with appropriate COVID 19 protocols. Result(s): One thousand two hundred and eighty (1280) patients aged between 20 years to > 70 years were referred and undertake upper and lower GI endoscopy in a Tertiary Care gastro hospital. Majority of the cases who underwent endoscopy were in the age group 31-40 years 317 (24.8%). They comprised of 59.9% males and 40.1% females. Common endoscopic diagnoses were Gastric erosions 31.4% followed by Normal Upper gastrointestinal endoscopy (UGIE) / Lax Gastroesophageal (GE) Junction 17.4%. The most common symptom was dyspepsia seen in 725 (56.6%) of the patients, followed by dysphagia in 92 (7.2%), abdominal discomfort 64 (5%). Conclusion(s): This study highlights, with proper history and clinical screening and appropriate precautions it was possible to provide endoscopy service to the needy without a strict protocol and expensive pre-endoscopy work up like HRCT and RT-PCR for all patients, without compromising patient or staff safety. Patients with alarm symptoms like Dysphagia and GI Bleed benefited the most, many patients with functional GI Disorders also were reassured with negative endoscopy and counseling. As during these times, people were in panic mode with all negative things happening around;many of these functional patients with overlap anxiety disorders were scared to death. A positive diagnosis is very important while managing most of these GI disorders.Copyright © 2022 Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

Determinants and consequences of obesity - contribution of the French NutriNet-Sante cohort

Large-scale observational epidemiological studies provide essential information for the development of prevention policies for chronic diseases such as obesity. Since 2009, the French NutriNet-Sante cohort has been used as the basis for 29 empirical studies on obesity. The aim of this review is to present a summary of the findings of those studies and to deduce the contribution of NutriNet-Sante to the understanding of obesity. Among the 29 studies, 5 analyzed obesity as an exposure variable, 23 - as an outcome, and 1 - as a moderator. When modelled as a determinant (or exposure), obesity was cross-sectionally and positively associated with migraine and functional dyspepsia, respectively. In turn, when modelled as a consequence (or outcome), obesity was positively associated with different dietary factors, such as the proportion of ultra-processed foods in the diet and preference for fatty food. Other factors were inversely associated with obesity, such as following an organic diet. Some psychological factors were positively (e.g. impulsivity) or inversely associated (e.g. optimism) with obesity risk. In NutriNet-Sante, further studies on obesity are underway, dealing with its association with COVID-19 and mental disorders.Copyright © 2022 Societe francaise de nutrition

Meta-analysis: Post-COVID-19 functional dyspepsia and irritable bowel syndrome.

INTRODUCTION: The burden of post-COVID-19 functional dyspepsia (FD) and irritable bowel syndrome (IBS) remains unclear. The aim of this meta-analysis was to estimate the rate of post-COVID-19 FD and IBS. METHODS: MEDLINE, Scopus and Embase were searched through 17 December 2022. Studies reporting the incidence of FD and/or IBS in COVID-19 survivors and controls (without COVID-19), when available, according to the Rome criteria, were included. Estimated incidence with 95% confidence intervals (CI) was pooled. The odds ratio (OR) with 95% confidence intervals (CI) was pooled; heterogeneity was expressed as I2 . RESULTS: Ten studies met the inclusion criteria and were included in the analysis. Overall, four studies including 1199 COVID-19 patients were considered for FD. Post-COVID-19 FD was reported by 72 patients (4%, 95% CI: 3%-5% and I2 0%). The pooled OR for FD development (three studies) in post-COVID-19 patients compared to controls was 8.07 (95% CI: 0.84-77.87, p = 0.071 and I2 = 67.9%). Overall, 10 studies including 2763 COVID-19 patients were considered for IBS. Post-COVID-19 IBS was reported by 195 patients (12%, 95% CI: 8%-16%, I2 95.6% and Egger's p = 0.002 test). The pooled OR for IBS development (four studies) in COVID-19 patients compared to controls was 6.27 (95% CI: 0.88-44.76, p = 0.067 and I2 = 81.4%); considering only studies with a prospective COVID-19 cohort (three studies), the pooled OR was 12.92 (95% CI: 3.58-46.60, p < 0.001 and I2 = 0%). CONCLUSIONS: COVID-19 survivors were found to be at risk for IBS development compared to controls. No definitive data are available for FD.

Comparison of Adverse Events of SARS-CoV-2 Vaccination between Patients with Inflammatory Bowel Disease and Healthcare Workers

Background: This study aimed to investigate the adverse events (AEs) after SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD) and to compare them with healthcare workers (HCWs). Method(s): We conducted a web-based survey on the local and systemic AEs experienced within 7 days of SARS-CoV-2 vaccination (BNT162b2, mRNA-1273, or ChAdOx1 nCoV-19) in IBD patients and HCWs between October 2021 and February 2022. The frequency of all AEs was compared between IBD patients and HCWs, and propensity score matching method was used to control confounding factors. Result(s): A total of 336 IBD patients (139 Crohn's disease [CD] and 197 ulcerative colitis [UC]) and 288 HCWs who completed the questionnaire had received the same type of vaccine for their first and second doses. Common local AEs in patients with IBD were injection site pain (78.9% and 70.8% after receiving first and second vaccine doses, respectively), swelling (35.4% and 31.5%), and induration (35.1% and 26.5%), and systemic AEs were fatigue (44.6% and 42.0%), myalgia (42.6% and 37.2%), and fever or febrile sense (29.5% and 32.1%). All severe AEs were rarely observed (0-3.9%). Hospital visits or hospitalizations associated with AEs were observed in 16 (4.8%) and 18 (5.4%) patients, respectively. A small number of patients reported deterioration of bowel frequency (CD: 10.1% and 12.2%, UC: 8.1% and 11.7%), abdominal pain (CD: 5.0% and 7.9%), and rectal bleeding (UC: 5.1% and 7.6%). About 30% of IBD patients reported a worsening of their sense of well-being. After propensity score matching, there was no significant increase in the frequency of AEs in IBD patients except for diarrhea (14.5% vs 4.8%, P = 0.005) and dyspepsia (15.2% vs 5.5%, P= 0.007) after first vaccination. Conclusion(s): SARS-CoV-2 vaccination in patients with IBD was generally well-tolerated and severe AEs occurred rarely. Compared with HCWs, the frequency of AEs does not seem to increase except for diarrhea and dyspepsia.

Top 20 Research Studies of 2021 for Primary Care Physicians

This article summarizes the top 20 research studies of 2021 identified as POEMs (patient-oriented evidence that matters) that did not address the COVID-19 pandemic. Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists prevent adverse cardiovascular and renal outcomes in patients with type 2 diabetes mellitus and also reduce all-cause and cardiovascular mortality. Most older adults (mean age, 75 years) with prediabetes do not progress to diabetes. Among patients in this age group with type 2 diabetes treated with medication, an A1C level of less than 7% is associated with increased risk of hospitalization for hypoglycemia, especially when using a sulfonylurea or insulin. For patients with chronic low back pain, exercise, nonsteroidal anti-inflammatory drugs, duloxetine, and opioids were shown to be more effective than control in achieving a 30% reduction in pain, but self-discontinuation of duloxetine and opioids was common. There is no clinically important difference between muscle relaxants and placebo in the treatment of nonspecific low back pain. In patients with chronic pain, low- to moderate-quality evidence supports exercise, yoga, massage, and mindfulness-based stress reduction. For acute musculoskeletal pain, acetaminophen, 1,000 mg, plus ibuprofen, 400 mg, without an opioid is a good option. Regarding screening for colorectal cancer, trial evidence supports performing fecal immunochemical testing every other year. For chronic constipation, evidence supports polyethylene glycol, senna, fiber supplements, magnesium-based products, and fruit-based products. The following abdominal symptoms carry a greater than 3% risk of cancer or inflammatory bowel disease: dysphagia or change in bowel habits in men;rectal bleeding in women;and abdominal pain, change in bowel habits, or dyspepsia in men and women older than 60 years. For secondary prevention in those with established arteriosclerotic cardiovascular disease, 81 mg of aspirin daily appears to be effective. The Framingham Risk Score and the Pooled Cohort Equations both overestimate the risk of cardiovascular events. Over 12 years, no association between egg consumption and cardiovascular events was demonstrated. Gabapentin, pregabalin, duloxetine, and venlafaxine provide clinically meaningful improvements in chronic neuropathic pain. In patients with moderate to severe depression, initial titration above the minimum starting dose of antidepressants in the first eight weeks of treatment is not more likely to increase response. In adults with iron deficiency anemia, adding vitamin C to oral iron has no effect. In children with pharyngitis, rhinosinusitis, acute bronchitis, or acute otitis media, providing education combined with a take-and-hold antibiotic prescription results in 1 in 4 of those children eventually taking an antibiotic.Copyright © 2022 American Academy of Family Physicians.

The Effect of Carriage of CYP3A5*3 and CYP3A4*22 Polymorphic Variants on the Safety of Remdesivir Therapy in Patients with COVID-19.

The aim of the study was to assess the association of polymorphic variants CYP3A5*3 6986 A>G rs776746 and CYP3A4*22 rs35599367 C>T with the safety parameters of remdesivir therapy in patients with COVID-19. Material and methods. The study included 156 patients admitted to the City Clinical Hospital No. 15 of the Moscow Health Department with COVID-19 diagnosis, who received remdesivir as an antiviral drug. The frequency of adverse reactions (bradycardia, dyspeptic disorders), as well as various laboratory parameters (ALT, AST, creatinine, ferritin, interleukin-6, and d-dimer levels) were compared between the carriers of wild-type and polymorphic variants of the studied genes. Results. Carriers of CYP3A5*3 polymorphic variants (GA+AA) had higher ALT levels after the treatment with remdesivir than carriers of the wild variant (GG). When comparing the level of interleukin-6 after therapy with remdesivir, carriers of the polymorphic variant of the CYP3A4*22 (CT) gene had a significantly higher level of this cytokine. Conclusion. An association between the carriage of polymorphic variants of CYP3A5*3 and an increase in the level of liver enzymes was found. Polymorphic variants of CYP3A4*22 were associated with higher levels of interleukin-6. Additional pharmacogenetic studies are required to assess the possibilities of personalizing antiviral therapy for COVID-19.Copyright © Team of Authors, 2022.

Post-Covid-19 Gastro-Intestinal Disturbances.

BACKGROUND: Since the end of 2019, SARS-CoV-2 has been responsible for the multisystemic hyper-inflammatory disease, namely, COVID-19, as a majorly impactful pandemic. Gastrointestinal (GI) symptoms occurring during and after disease are gaining increasing attention among experts. METHODS: We briefly review and comment on preliminary and recent evidences on prevalence, pathophysiology, and perspective treatment options for GI disturbances during and after COVID-19. RESULTS: Several reports from the literature show a significant portion of COVID-19 patients suffering from GI symptoms both at the early stages of the disease and after the end of it, sometimes for several months, namely "long-COVID-19 " patients, irrespective of vaccination. An unsolved issue regarding COVID-19 is the association between GI symptoms and the outcome of COVID-19 patients. Several studies and metanalyses suggest a worse evolution of COVID-19 in patients presenting with GI symptoms. However, these data have not been agreed. Indeed, only one uniform observation can be found in the literature: patients with chronic liver disease have a worse outcome from COVID-19 infection. Upper and lower GI symptoms have similarities with postinfectious functional dyspepsia (FD) and irritable bowel syndrome (IBS). FD and IBS following infection are recognized as a pathophysiological factor, which is a gut microbial quali- and quantitative unbalance, namely dysbiosis. Furthermore, several preliminary reports and ongoing clinical trials have shown gut microbiota modulation by pre-, pro- and post-biotics to be effective in changing and preventing COVID-19 natural course. CONCLUSION: GI symptoms characterize both long- and non-long-COVID-19 with a potentially significant impact on its natural course. Gut microbiota modulation seems to be a sensible target for disease treatment and/or prevention.

The Effect of Carriage of CYP3A5*3 and CYP3A4*22 Polymorphic Variants on the Safety of Remdesivir Therapy in Patients with COVID-19

The aim of the study was to assess the association of polymorphic variants CYP3A5*3 6986 A>G rs776746 and CYP3A4*22 rs35599367 C>T with the safety parameters of remdesivir therapy in patients with COVID-19. Material and methods. The study included 156 patients admitted to the City Clinical Hospital No. 15 of the Moscow Health Department with COVID-19 diagnosis, who received remdesivir as an antiviral drug. The frequency of adverse reactions (bradycardia, dyspeptic disorders), as well as various laboratory parameters (ALT, AST, creatinine, ferritin, interleukin-6, and d-dimer levels) were compared between the carriers of wild-type and polymorphic variants of the studied genes. Results. Carriers of CYP3A5*3 polymorphic variants (GA+AA) had higher ALT levels after the treatment with remdesivir than carriers of the wild variant (GG). When comparing the level of interleukin-6 after therapy with remdesivir, carriers of the polymorphic variant of the CYP3A4*22 (CT) gene had a significantly higher level of this cytokine. Conclusion. An association between the carriage of polymorphic variants of CYP3A5*3 and an increase in the level of liver enzymes was found. Polymorphic variants of CYP3A4*22 were associated with higher levels of interleukin-6. Additional pharmacogenetic studies are required to assess the possibilities of personalizing antiviral therapy for COVID-19.

Functional Disorders of the Gastrointestinal Tract During the Pandemic of a New Coronavirus Infection

Aim. To analyze the literature data devoted to the study of the features of functional gastrointestinal diseases (FGID) during the pandemic of a new coronavirus infection. Key findings. Measures taken in connection with the pandemic of COVID-19 infection (introduction of lockdown, social isolation) leads to an increase in the level of depression and anxiety and, as a consequence, to an increase in the frequency and prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS), as well as an increase in the severity of clinical symptoms of these diseases. In turn, the overcoming of COVID-19 infection contributes to an increase in the permeability of the mucous membrane of the gastrointestinal tract and the occurrence of its inflammatory changes, which lead to the development of postinfectious (postcovid) FD and postinfectious (postcovid) IBS. Conclusion. The problem of functional gastrointestinal diseases during the pandemic of a new coronavirus infection is very important and requires further research. © 2022 Russian Journal of Gastroenterology, Hepatology, Coloproctology

COVID-19 and the digestive system lesions in children

Initially, doctors did not pay much attention to gastrointestinal symptoms in patients with COVID-19. Fever and respiratory syndrome were monitored. A more prolonged observation period revealed gastrointestinal disorders to be an important element of the new coronavirus infection. In scientific publications, a stable term appeared - gastrointestinal coronavirus disease 2019. The tropism of the SARS-CoV-2 virus to the epitheliocytes of the gastrointestinal tract, the presence and long-term persistence of the virus in the feces were found. The frequent detection of gastrointestinal symptoms in infected patients, the frequent involvement of the liver and pancreas in the pathological process determine the importance of clinical and laboratory assessment of the state of the digestive system due to its undoubted impact on the status, course, and the overall disease prognosis. Based on the analysis of scientific publications, the article presents the results of the latest observations regarding the development of a new disease, its diagnosis, treatment options using modern drugs when combined with dyspeptic syndrome and other gastroenterological symptoms. The role of the use of standards, in particular the clinical recommendations of the Ministry of Health of Russia, is emphasized. Copyright © 2022 National Academy of Pediatric Science and Innovation. All rights reserved.

Anxiety level and functional dyspepsia incidence during COVID-19 pandemic

The adaptation process of the learning system, the hospital environment, and the high risk of COVID-19 infection can be stressors for anxiety in clinical clerkship. Through the brain-gut–axis, the interaction of psychological factors, such as anxiety, can trigger symptoms related to functional dyspepsia. This study aimed to determine the relationship between anxiety levels and functional dyspepsia during the COVID-19 pandemic among clinical clerkship students. This research was conducted on clinical clerkship students/young doctors in 2021. This was an observational analytic study with a cross-sectional approach and involved 131 respondents. The hamilton anxiety rating scale (HARS) questionnaire was utilized to quantify the level of anxiety, while functional dyspepsia was measured based on Rome IV criteria. The data were analyzed by the Lambda (λ) coefficient of correlation test. This study revealed a significant relationship between anxiety level and functional dyspepsia during the COVID-19 pandemic. © 2023, Intelektual Pustaka Media Utama. All rights reserved.

Could an Increased Percentage of Immature Granulocytes Accompanying Dyspepsia Predict COVID-19?

Background and Aim: Although vaccination practices continue at a fast pace around the world, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still threatens people's lives. In this study, we aimed to determine the presence of SARS-CoV-2 in patients who do not have the typical symptoms of the novel coronavirus disease 2019 (COVID-19), but only present with dyspepsia, and to investigate the role of immature granulocytes in the early diagnosis of these patients. Material and Methods: Adult and pediatric patients suffering from dyspepsia were included in the study. The patients were divided into two groups, ''positive'' and ''negative'', based on their SARS-CoV-2 polymerase chain reaction test results. Immature granulocyte count (IG), immature granulocyte percentage (IG%), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) values were recorded. Results: A total of 238 patients, including 25 (10.5%) pediatric and 213 (89.5%) adult patients, were included in the study. A total of 2 (8%) pediatric patients and 17 (7.9%) adult patients tested positive for SARS-CoV-2. The IG, IG%, and CRP parameters were significantly higher in the SARS-CoV-2-positive patients compared to the SARS-CoV-2-negative patients. The optimal cut-off value predictive of COVID-19 infection was determined to be ≥0.650 (sensitivity: 52.6% and specificity: 95.5%, p = 0.001) for IG%. Conclusions: It should be noted that dyspepsia may also be a COVID-19 symptom. IG% values, which can be determined with a hemogram test, a cheap and easily accessible test, may be a warning in the early detection of patients who do not have the typical symptoms of COVID-19.

Functional Gastrointestinal Disorders in Children Following Sars-Cov-2 Infection Resemble Other Post-Viral Syndromes

BACKGROUND: Post-infectious functional gastrointestinal disorders (PI-FGID) involve a broad group of well-recognized conditions such as Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) that follow an infectious illness involving the GI tract. Post-infectious IBS (PI-IBS) is the most well-known entity occurring in ~10% of patients following acute gastroenteritis due to bacteria or enteropathic viruses, and can last for several months. The SARS-CoV-2 (COVID-19) virus appears to infect the GI system as well as the respiratory tract. While respiratory signs and symptoms are generally the most prominent and life-threatening aspects of COVID-19 infection, nearly half of COVID-19 cases present with digestive symptoms such as diarrhea, anorexia, vomiting, nausea, and abdominal pain. COVID-19 infection has also been associated with autonomic dysregulation, manifesting as fatigue or dizziness. In addition, COVID-19 may infect the brain and lead to MRI changes which may alter emotions and somatic perception. The goal of this study was to determine the impact of COVID-19 on PI-FGID symptoms in children and adolescents. METHODS Recruitment: An electronic medical record (EMR) search was carried out to find all patients 8 years of age or older who were COVID-19 tested at the Ann and Robert H. Lurie Children's Hospital of Chicago between November 2020 and October 2021. Questionnaires: A COVID-19 Phenotype survey was administered to identify COVID-19 symptoms, severity, and duration in the 7 days prior to the COVID-19 test. The following questionnaires were distributed to the parent or guardian of the COVID-19 tested child with instructions to refer to the 3 months following the test (1) COMPASS-31 - assesses presence of symptoms of dysautonomia;(2) PEESS v2.0 - assesses frequency and severity of symptoms of esophageal dysfunction;(3) QPGSIV - assesses presence of functional nausea/vomiting, defecation, and pain disorders;(4) Nausea Profile (NP) - assesses severity of somatic, gastrointestinal and emotional symptoms associated with nausea;(5) Dyspepsia Symptom Survey (DSS) - novel survey to assess frequency and severity of symptoms related to gastric or duodenal dysfunction;(6) Nausea Severity Profile - assess severity of nausea (7) PedsQL General Well-Being Survey - assesses overall quality of life. An email was sent in July 2021 to patients tested November 2020-March 2021, and an email was sent in December 2021 to patients tested April-October 2021. Consent was obtained by patients agreeing to complete the surveys, and data were collected to a RedCAP database. Data analysis: A comparison of survey results was carried out for the following subgroups: COVID-19 positive, COVID-19 negative without symptoms at time of viral testing, and COVID-19 negative with symptoms at time of viral testing. Due to the small size of the COVID-19 positive group relative to the COVID-19 negative groups, a Mann-Whitney U was utilized to compare the COVID-19 positive group with the COVID-19 negative asymptomatic group and COVID-19 negative symptomatic group separately, along with the COVID-19 negative asymptomatic group versus the COVID-19 negative symptomatic group. Categorical data were compared via Fischer's Exact Test. RESULT(S): A total of 771 patients/parent(s)/guardian(s) completed the required questionnaires. The demographics for each of the comparative subpopulations were well-matched. The COVID-19 negative patients with symptoms present prior to the COVID test had significantly increased composite scores on all surveys compared to the COVID-19 negative asymptomatic group (p-values=0.014-0.0001). The COVID-19 positive group had no significant differences in composite scores compared to the COVID-19 negative symptomatic group with the exception of the NP somatic score (p-value=0.02). The COVID-19 positive group had significantly increased composite scores compared to the COVID-19 negative asymptomatic group on the DSS frequency composite and NP somatic, gastrointestinal, and emotional scores (p-value=0.03-0.0001). The COVID-19 negative symptomatic group had a significant increase in FGID prevalence detected by the QPGSIV (p-value <0.05) compared to the COVID-19 negative asymptomatic group, while the COVID-19 positive group showed no difference. CONCLUSION(S): We found an increased frequency of functional dyspepsia and nausea symptoms compared to a control population, although no differences were seen compared to a population with presumptive non-COVID-19 infection. Further, we found a significant increase in somatic and emotional symptoms in COVID-19 positive patients compared to a control population underscoring the need for a comprehensive biopsychosocial approach. Thus, Long-COVID GI disease likely exists in children. However, its manifestations do not appear worse than those following any other viral infection.

Tirzepatide (Mounjaro) for Type 2 Diabetes

The FDA has approved tirzepatide (Mounjaro - Lilly), a peptide hormone with activity at both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, to improve glycemic control in adults with type 2 diabetes. Tirzepatide, which is injected subcutaneously once weekly, is the fi rst dual GIP/GLP-1 receptor agonist to become available in the US. Selective GIP receptor agonists are not available in the US;GLP-1 receptor agonists have been available for years. Copyright © 2022, Medical Letter Inc.. All rights reserved.