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1.
Ingeniare : Revista Chilena de Ingenieria ; 30(1):180-196, 2022.
Article in Spanish | ProQuest Central | ID: covidwho-1887675

ABSTRACT

La Diabetes Mellitus es una enfermedad crónica no transmisible de origen multifactorial, cuya prevalencia en Chile es de 12,3% en la población mayor a 15 años. Dentro de las consecuencias de esta enfermedad se encuentra el pie diabético, cuyo tratamiento principal es la amputación parcial del pie. En este contexto, el objetivo de la investigación es diseñar una prótesis parcial de pie para los niveles de amputación transmetatarsal y de Chopart. La metodología empleada incluyó el establecimiento del perfil del paciente, la definición de las especificaciones de diseño y la posterior propuesta del diseño conceptual. Luego se abordó el diseño de detalle, realizando los cálculos de las fuerzas a las que está sometida la prótesis, la selección del material y el análisis de esfuerzos empleando el método de elementos finitos, para establecer el material y dimensiones definitivas. La prótesis diseñada está compuesta por una plantilla de material poliuretano-termoplástico o de polipropileno, y una cubierta estética de silicona;incluye en la misma plantilla los dos niveles de amputación parcial de pie, no restringe los grados de libertad del tobillo y es personalizada para el paciente, lo cual es relevante cuando se trabaja con pacientes con diabetes.Alternate :Diabetes Mellitus is a non-communicable chronic disease of multifactorial origin, whose prevalence in Chile is 12.3% in the population over 15 years of age. Among the consequences of this disease there is the diabetic foot, whose main treatment is the partial amputation of the foot. In this context, the objective of the research is to design a partial foot prosthesis for the transmetatarsal and Chopart levels of amputation. The used methodology included the establishment of the patient's profile, the definition of the design specifications and the subsequent proposal of the conceptual design. Then the detailed design was approached, carrying out the calculations of the forces to which the prosthesis is subjected, the material selection and the stress analysis using the finite element method to establish the final material and dimensions of the prosthesis. The designed prosthesis is composed of a polyurethane-thermoplastic or polypropylene material insole, and an aesthetic silicone cover;It includes both levels of partial foot amputation in the same template, does not restrict the degrees of freedom of the ankle, and is personalized for the patient, which is relevant when working with patients with diabetes.

2.
Ir J Med Sci ; 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1889021

ABSTRACT

BACKGROUND: In December 2019, a novel coronavirus strain, COVID-19, was identified in Wuhan, China. The first case was reported in the Republic of Ireland that month. Since then, along with many other countries worldwide, Ireland has imposed intermittent strict lockdowns to mitigate the spread of the virus. AIMS: To investigate the impact of lockdown on glycaemic control in young adult patients with type 1 diabetes mellitus. METHODS: Pre- and post-lockdown HbA1c levels were recorded for 118 patients attending the Young Adult Diabetes clinic in Beaumont Hospital, Dublin, and the results were compared. Changes in weight, insulin requirements and incidence of DKA/severe hypoglycaemia were also assessed. RESULTS: HbA1c results were 3.81 mmol/mol lower post-lockdown. Weight increased by 1.8 kg. Both of these results were statistically significant. CONCLUSIONS: Lockdown was associated with improved glycaemic control in young adult diabetic patients, and also with an increase in body weight. Changes in lifestyle factors associated with lockdown may explain this finding.

3.
Diabetologia ; 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1888846

ABSTRACT

AIMS/HYPOTHESIS: Diabetes has been recognised as a pejorative prognostic factor in coronavirus disease 2019 (COVID-19). Since diabetes is typically a disease of advanced age, it remains unclear whether diabetes remains a COVID-19 risk factor beyond advanced age and associated comorbidities. We designed a cohort study that considered age and comorbidities to address this question. METHODS: The Coronavirus SARS-CoV-2 and Diabetes Outcomes (CORONADO) initiative is a French, multicentric, cohort study of individuals with (exposed) and without diabetes (non-exposed) admitted to hospital with COVID-19, with a 1:1 matching on sex, age (±5 years), centre and admission date (10 March 2020 to 10 April 2020). Comorbidity burden was assessed by calculating the updated Charlson comorbidity index (uCCi). A predefined composite primary endpoint combining death and/or invasive mechanical ventilation (IMV), as well as these two components separately, was assessed within 7 and 28 days following hospital admission. We performed multivariable analyses to compare clinical outcomes between patients with and without diabetes. RESULTS: A total of 2210 pairs of participants (diabetes/no-diabetes) were matched on age (mean±SD 69.4±13.2/69.5±13.2 years) and sex (36.3% women). The uCCi was higher in individuals with diabetes. In unadjusted analysis, the primary composite endpoint occurred more frequently in the diabetes group by day 7 (29.0% vs 21.6% in the no-diabetes group; HR 1.43 [95% CI 1.19, 1.72], p<0.001). After multiple adjustments for age, BMI, uCCi, clinical (time between onset of COVID-19 symptoms and dyspnoea) and biological variables (eGFR, aspartate aminotransferase, white cell count, platelet count, C-reactive protein) on admission to hospital, diabetes remained associated with a higher risk of primary composite endpoint within 7 days (adjusted HR 1.42 [95% CI 1.17, 1.72], p<0.001) and 28 days (adjusted HR 1.30 [95% CI 1.09, 1.55], p=0.003), compared with individuals without diabetes. Using the same adjustment model, diabetes was associated with the risk of IMV, but not with risk of death, within 28 days of admission to hospital. CONCLUSIONS/INTERPRETATION: Our results demonstrate that diabetes status was associated with a deleterious COVID-19 prognosis irrespective of age and comorbidity status. TRIAL REGISTRATION: ClinicalTrials.gov NCT04324736.

4.
Int J Mol Sci ; 23(11)2022 May 27.
Article in English | MEDLINE | ID: covidwho-1888430

ABSTRACT

Platelets play a variety of roles in vascular biology and are best recognized as primary hemostasis and thrombosis mediators. Platelets have a large number of receptors and secretory molecules that are required for platelet functionality. Upon activation, platelets release multiple substances that have the ability to influence both physiological and pathophysiological processes including inflammation, tissue regeneration and repair, cancer progression, and spreading. The involvement of platelets in the progression and seriousness of a variety of disorders other than thrombosis is still being discovered, especially in the areas of inflammation and the immunological response. This review represents an integrated summary of recent advances on the function of platelets in pathophysiology that connects hemostasis, inflammation, and immunological response in health and disease and suggests that antiplatelet treatment might be used for more than only thrombosis.


Subject(s)
Hemostasis , Thrombosis , Blood Platelets/physiology , Hemostasis/physiology , Humans , Inflammation , Platelet Activation , Platelet Function Tests
5.
Medical Science ; 26(122):9, 2022.
Article in English | Web of Science | ID: covidwho-1887486

ABSTRACT

Background: The impact of severe acute respiratory syndrome corona virus (SARS-CoV-2) infection on Type 1 Diabetes Mellitus (T1DM) patients and their humoral response against the virus infection or vaccination is presently unclear, as in extant research Type 1 and Type 2 DM is rarely distinguished. Objective: we aimed to investigate the impact of SARS-CoV-2 infection, any associated risk factors for hospitalization, and the COVID-19 IgG antibody levels in T1DM patients versus those obtained from healthy individuals. Methods and subjects: 58 T1DM patients and 56 healthy adults with documented COVID-19 diagnosis and/or documented vaccination were recruited from different clinics in Al-Karak Governmental Hospital to complete a questionnaire before collecting their serum samples for measuring IgG levels. Results: Our results revealed a statistically significant decrease in SARS-CoV-2 NP IgG antibody levels in COVID-19 infected T1DM patients compared to infected healthy individuals who served as controls, while, no significant difference was noticed in the levels of SARS-CoV-2 S1/S2 IgG antibody among vaccinated T1DM patients versus controls. After adjusting for associated risk factors, the risk of hospitalization due to COVID-19 for individuals with uncontrolled T1DM was significantly increased compared to controls, and among patients with T1DM, glycosylated hemoglobin (HbA1c) correlated negatively with the IgG levels. Moreover, IgG seropositivity was significantly associated with old age and smoking. Conclusion: Our findings point towards an increased need for vaccination for patients with T1DM, and suggest that glycemic control could be a vital measure for diminishing the impact of COVID-19 on these individuals.

6.
Caspian Journal of Internal Medicine ; 13:211-220, 2022.
Article in English | EMBASE | ID: covidwho-1887406

ABSTRACT

Background: Despite advances in preventive measures, COVID -19 spread and mortality is continuing due to delay in timely diagnosis. This problem is partly dependent on variations in disease characteristics, distribution of risk factors particularly comorbidities and demographic characteristics of patients. This study aimed to determine the clinical presentation and associated factors of mortality in patients hospitalized with COVID -19 infection. Methods: Patients were divided into survivor and deceased groups, and clinical and laboratory findings and factors associated with mortality between the two groups were compared by calculating odds ratio (OR) with 95% confidence interval (95% CI). Results: A total of 257 patients (female 45.1%) with a mean age of 59.8+15.7 years and a mean hospital stay of 4.89+3.57 days were studied. Diabetes, hypertension, cardiovascular disease and chronic renal disease (CRD) were found in 29.6%, 37.5%, 16.3% and 3.5% of all patients, respectively. Forty-one (16%) patients died. Factors such as age >50 years, coexisting CRD, serum creatinine > 2 mg/dl;SPO2 <70% lymphocytes < 20% during hospitalization were independently associated with mortality. The adjusted ORs (95% CI) were 10.08 (1.39-73);4.51(1.15-17.61);6 (1.14-31.5);16.8(2.93-96.7);and 4.9(1.31-18.1), respectively. Most of the expected effective drugs were not associated with lower mortality. Conclusion: These results indicate a high in-hospital mortality rate in COVID -19 patients. Some mortality factors occurring during hospitalization were reversible and could be prevented by timely diagnosis and appropriate treatment.

7.
Journal of Urology ; 207(SUPPL 5):e608-e609, 2022.
Article in English | EMBASE | ID: covidwho-1886518

ABSTRACT

INTRODUCTION AND OBJECTIVE: Prostate abscess (PA) is uncommon and the diagnosis is often delayed or missed. Traditionally, PA has resulted from acute prostatitis or ascending genitourinary (GU) infection due to gram-negative bacilli but S. aureus is an emerging cause. The objective is to study the clinical features, management and outcomes of PA in COVID 19 period. METHODS: A prospective review of all adult patients admitted with a diagnosis of PA between April 2020 and July 2021(in COVID period) were conducted. Inclusion criteria included age ≥18 years, a GU infection syndrome, and imaging consistent with PA. RESULTS: Fifteen patients with PA were identified. The median age was 54 years. Four patients (22.7%) were immunosuppressed and 11 (50%) had diabetes. Fever (66.6%), dysuria (60%), and urinary retention (20%) were the most common presenting symptoms. Pelvic CT revealed PAs in all patients with 8/15 (53.3%) were >2 cm in greatest diameter. Urine cultures were positive in 13/15 (86.6%) patients with 4/13 (30.7%) growing S. aureus (MRSA). Fourteen patients (93.3%) were managed with antibiotics alone whereas 1 (6.6%) underwent abscess drainage. The median duration of antibiotic therapy was 32 days. CONCLUSIONS: PA is relatively uncommon and may be difficult to distinguish clinically from conditions like acute prostatitis. Optimal management usually requires both antibiotics and drainage. With the advancement in the field of radiology, newer antibiotics and early diagnosis, effective conservative management of PA has become possible. Noticing the trend of frequent occurrence of S. aureus as a cause, coverage for MRSA should be a component of empiric treatment for PA.

8.
Journal of Urology ; 207(SUPPL 5):e361, 2022.
Article in English | EMBASE | ID: covidwho-1886498

ABSTRACT

INTRODUCTION AND OBJECTIVE: Acute kidney injury (AKI) in coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus is much more common than previously thought and is associated with severe disease and high mortality. Despite the fact that the respiratory and immune systems are the main targets of the COVID- 19 virus, AKI is also observed, identified by the occurrence of proteinuria or hematuria, an increase in serum urea and creatinine levels. The aim of the study is to assess the pathomorphological changes in the kidneys in 100 cases of autopsy of patients with COVID-19 using light microscopy and immunohistochemical diagnostic methods in order to clarify the possible mechanism of AKI. METHODS: The study was carried out using samples obtained from 100 patients, the time interval of the onset of the disease corresponded to the 4th wave of the peak of the incidence in Russia (from June 2021). The age of patients varied from 37 to 94 years 72 (s =12.5), men - 34, women - 66. Patients with chronic kidney disease, diabetes mellitus and cancer were not included in the analysis. The cause of death in all cases was acute respiratory failure, histologically defined as diffuse alveolar injury. AKI in accordance with the KDIGO criteria was detected in 34 patients. RESULTS: On light microscopy, diffuse massive damage to the proximal tubules with loss of the brush border, degeneration of vacuoles was detected in 46 patients, massive necrosis of the tubules in 11 patients. In 65 patients, an extremely pronounced congestion of paretic dilated vessels with widespread paravasal hemorrhages was revealed. Paravasal lymphoid infiltration of the vascular endothelium was detected in 27 patients. Severe sludge syndrome in small and medium-sized vessels in 46 patients. In almost all cases, hemosiderin granules and hyaline casts were found. The quantitative and qualitative composition of tissue macrophages corresponded to the population data, without visible correlations with the disease. CONCLUSIONS: According to the study, the factors contributing to AKI include systemic hypoxia, abnormal coagulation, increased catabolism due to fever, drug-related rhabdomyolysis or hyperventilation with increased serum degradation products. Thus, our research provides evidence for AKI during the progression of COVID-10. These results contribute to a better understanding of the course and progression of SARS-CoV-2 virus infection.

9.
Human Gene ; 33, 2022.
Article in English | EMBASE | ID: covidwho-1885810

ABSTRACT

Aims: The aim of this study was to extract the signaling mediators or biological pathways that link covid-19 to other diseases such as type 1 diabetes mellitus (T1DM). Methods: Microarray data of covid-19 (GSE164805) was extracted from Gene Expression Omnibus (GEO) and analyses were performed by R package and GEO2R. Functional enrichment analysis was done to extract enriched molecular pathways (MP), biological process (BP) and molecular function (MF). Then commonly up- and down-regulated genes in covid-19 and T1DM were extracted by comparing deferentially expressed genes (DEGs) of GSE164805 and GSE9006. Results: Down-regulated DEGs in the severely progressing covid-19 patients (SPCP) had a link to T1DM. Major histocompatibility system (MHC) class II, gamma interferon (IFNγ), and IL-1B were enriched in extracted pathway that leads to T1DM. In addition, comparing extracted DEGs from GSE164805 and GSE9006 indicated that MTUS1, EGR1 and EGR3 are the genes that are up-regulated in both SPCP and T1DM. Conclusion: The findings of this study indicate that coincidence of SARS-COV-2 infection and T1DM may increase the severity of both diseases. Although covid-19 reduced the T cell mediated immune response, but increased mediators of T-cell signaling pathway such as IL-1 in both diseases. This could potentiate the inflammation response and worsens the severity of covid-19 cytokine storm or increase the resistance to insulin.

10.
Laryngoscope Investigative Otolaryngology ; n/a(n/a), 2022.
Article in English | Wiley | ID: covidwho-1885422

ABSTRACT

Objective Invasive fungal sinusitis (IFS) in patients with active or recent COVID-19 have been reported throughout the world. The primary purpose of the systematic review is to describe factors associated with IFS in patients with COVID-19. The goal of the case series was to also characterize these factors in addition to evaluating the incidence of IFS at our institution after the onset of the pandemic. Methods A systematic review using the preferred reporting in systematic reviews and meta-analyses (PRISMA) framework identified publications of IFS cases associated with COVID-19 (IFSAC). Search terms were ?COVID-19,? ?invasive,? ?fungal,? and ?sinusitis.? IFS cases were evaluated for COVID-19 status, fungal etiology, comorbidities, treatment, and outcome. A case series of patients at our center with IFS between December 1, 2018 to March 31, 2020 (?pre-covid?) and April 1, 2020 to August 1, 2021 (?post-covid?) was also performed with the above parameters. Results Fourteen studies totaling 206 cases of IFSAC were identified. Most cases came from India (140/206, 68.0%), followed by Egypt (62/206, 30.1%), and North America (4/206, 1.9%). Diabetes was the most common comorbidity (151/206, 73.3%). Recent or prolonged steroid use was noted in 65.0% of cases (134/206). In our series, five pre-covid and four post-covid cases were identified. One had recent COVID-19 infection. Acute myeloid leukemia was the most common pre-covid comorbidity (3/5, 60.0%). Diabetes was the most frequent post-covid comorbidity (2/4, 50.0%). Chronic steroid usage was noted in two pre-covid and one post-covid cases. Conclusion Diabetes and steroid use are common factors in reported cases of IFSAC. IFS incidence in our case series did not change appreciably after the onset of the pandemic. Level of Evidence: 4.

11.
European Journal of Molecular and Clinical Medicine ; 9(3):5861-5865, 2022.
Article in English | EMBASE | ID: covidwho-1885214

ABSTRACT

Aim: To determine the relationship between biochemical indicators and the severity of COVID-19. Methods: Blood samples were obtained by competent doctors and nurses in accordance with ICMR guidelines. The samples were then forwarded to the central biochemistry laboratory for additional analysis. The Access-2 completely automated chemical analyzer was used to test ferritin, quantitative CRP, and IL-6, while the AU 480 analyzer was used to assess LDH. Results: We included 200 confirmed covid-19 patients in our trial. All of the patients were above the age of 18. The prevalence of HTN, diabetes, CKD, COPD, and Cardiac Disease in the study patients was 40%, 32%, and 15%, respectively. 20 and 30 percent, respectively. In the current research, the mean values of IL-6, ferritin, CRP, and LDH were shown to be higher in covid patients, with the rise being greater in patients on intubation. The mean and standard deviation of biochemical parameters in non-ICU, ICU, and intubation patients. Conclusion: Serum CRP, LDH, IL-6, and ferritin levels that are increased may be employed as laboratory indicators for a bad prognosis in COVID-19.

12.
Arch Acad Emerg Med ; 10(1): e42, 2022.
Article in English | MEDLINE | ID: covidwho-1887401

ABSTRACT

Introduction: The COVID-19 pandemic has been considered an international problem. This study aimed to survey the demographic and clinical characteristics of the deceased COVID-19 patients. Methods: The present cross-sectional study was performed on all deceased COVID-19 patients who died in Imam Reza Hospital, Mashhad, Iran, from March 20, 2020, to September 23, 2021. Their data, including age, gender, complaints, and clinical symptoms at the time of admission, as well as information at the time of death (hour, shift, holiday/non-holiday) were analyzed and reported. Results: 3364 deaths due to COVID-19 have been registered during the study period (60.46% male). The patients' mean age was 66.99±16.97 (range: 1-101) years (92.7% of them were Iranian). The mortality at night shifts was less than day shifts (1643 vs. 1721). The average amount of deaths/day on holidays and workdays was (5.63 vs. 6.24). The number of deaths varied during the various hours of the day and night. Diabetes and cardiovascular diseases were the most common confounding factors, which were observed in 22.44% and 15.36% of the cases, respectively. Conclusion: Based on the findings of this series, COVID-19 mortality was frequently observed in male patients, those with the mean age of 66.99 years, morning shifts, and workdays.

13.
Endokrynol Pol ; 73(1): 131-148, 2022.
Article in English | MEDLINE | ID: covidwho-1887303

ABSTRACT

INTRODUCTION: This review aimed to synthesize evidence on the impact of the COVID-19 lockdown on the glycaemic control, physical activity, and diet of diabetic patients. MATERIAL AND METHODS: Two electronic databases (PubMed and Scopus) were searched from January 2020 to February 2021. A total of 161 unique records were retrieved. Out of these, 25 articles met the eligibility criteria and were included in the final review. The quality of the studies was assessed by using the modified Newcastle-Ottawa Quality Assessment Scale for observational studies. RESULTS: Out of the 25 studies included in the review, 18 (72%) were cross sectional, 5 (20%) were retrospective analyses, and 2 (8%) were cohort studies. Thirteen studies included type I diabetics, 8 studies included type2 diabetics, and 4 studies included both. In the quality assessment, 17 (68%) of the studies met the criteria of satisfactory quality. Overall glycaemic parameters were improved during the lockdown. Dietary patterns were affected during the lockdown, but the direction of change- either negative or positive- could not be inferred. However, physical activity patterns were found to be deteriorated during the lockdown. CONCLUSION: The review found that lockdowns for curbing COVID-19 had no negative impact on glucose control, while there was a decline in the physical activity among diabetics. Furthermore, available studies are subject to various biases, which calls for robust studies in future with representative samples. There is also a need to promote physical activity and a healthy diet among diabetic patients, with follow-up through telemedicine during such confinement periods.


Subject(s)
COVID-19 , Diabetes Mellitus , COVID-19/prevention & control , Communicable Disease Control , Exercise , Humans , Retrospective Studies , SARS-CoV-2
14.
J Epidemiol ; 2022 Jun 11.
Article in English | MEDLINE | ID: covidwho-1887061

ABSTRACT

BackgroundRegular visits with healthcare professionals are important for preventing serious complications in patients with diabetes. The purpose of this retrospective cohort study was to clarify whether there was any suppression of physician visits among patients with diabetes during the spread of COVID-19, in Japan and to assess whether telemedicine contributed to continued visits.MethodsWe used the JMDC Claims database which contains the monthly claims reported from July 2018 to May 2020 and included 4595 (type 1) and 123,686 (type 2) patients with diabetes.Using a difference-in-differences analysis, we estimated the changes in the monthly numbers of physician visits or telemedicine per 100 patients in April and May 2020 compared with the same months in 2019.ResultsFor patients with type 1 diabetes, the estimates for total overall physician visits were -2.53 (95% CI, -4.63 to 0.44) in April and -8.80 (-10.85 to -6.74) in May; those for telemedicine visits were 0.71 (0.47 to 0.96) in April and 0.54 (0.32 to 0.76) in May. For patients with type 2 diabetes, the estimates for overall physician visits were -2.50 (-2.95 to -2.04) in April and -3.74 (-4.16 to -3.32) in May; those for telemedicine visits were 1.13 (1.07 to 1.20) in April and 0.73 (0.68 to 0.78) in May.ConclusionsThe COVID-19 pandemic was associated with suppression of physician visits and a slight increase in the utilisation of telemedicine among patients with diabetes during April and May 2020.

15.
BMJ Open Diabetes Res Care ; 10(3)2022 06.
Article in English | MEDLINE | ID: covidwho-1886720

ABSTRACT

OBJECTIVE: To identify the demographic and clinical characteristics associated with adverse COVID-19 outcomes across a 12-month period in 2020 and 2021. RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study using electronic health records from five academic health systems in Pennsylvania and Maryland, including patients with COVID-19 with type 2 diabetes or at risk of type 2 diabetes. Patients were classified based on 30-day outcomes: (1) no hospitalization; (2) hospitalization only; or (3) a composite measure including admission to the intensive care unit (ICU), intubation, or death. Analyses were conducted in patients with type 2 diabetes and patients at risk of type 2 diabetes separately. RESULTS: We included 15 725 patients with COVID-19 diagnoses between March 2020 and February 2021. Older age and higher Charlson Comorbidity Index scores were associated with higher odds of adverse outcomes, while COVID-19 diagnoses later in the study period were associated with lower odds of severe outcomes. In patients with type 2 diabetes, individuals on insulin treatment had higher odds for ICU/intubation/death (OR=1.59, 95% CI 1.27 to 1.99), whereas those on metformin had lower odds (OR=0.56, 95% CI 0.45 to 0.71). Compared with non-Hispanic White patients, Hispanic patients had higher odds of hospitalization in patients with type 2 diabetes (OR=1.73, 95% CI 1.36 to 2.19) or at risk of type 2 diabetes (OR=1.77, 95% CI 1.43 to 2.18.) CONCLUSIONS: Adults who were older, in racial minority groups, had multiple chronic conditions or were on insulin treatment had higher risks for severe COVID-19 outcomes. This study reinforced the urgency of preventing COVID-19 and its complications in vulnerable populations. TRIAL REGISTRATION NUMBER: NCT02788903.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Insulins , Adult , COVID-19/complications , COVID-19/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Hospitalization , Humans , Maryland/epidemiology , Pennsylvania/epidemiology , Retrospective Studies
16.
Pediatr Diabetes ; 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1886708

ABSTRACT

BACKGROUND: There are several observations from various countries that the onset of Coronavirus 19 (COVID-19) pandemic was associated with an increase in the prevalence of DKA. However, due to heterogeneity in study designs and country-specific healthcare policies, more national-level evidence is needed to provide generalizable conclusions. OBJECTIVE: To compare the rate of diabetic ketoacidosis (DKA) in Polish children diagnosed with type 1 diabetes (T1D) between the first year of coronavirus 19 (COVID-19) pandemic (15.03.2020-15.03.2021) and the preceding year (5.03.2019-15.03-2020). METHODS: Reference centres in 13 regions (covering ~88% of Polish children) retrospectively reported all new-onset T1D cases in children from assessed periods, including DKA status at admission, administered procedures and outcomes. Secondly, we collected regions` demographic characteristics, as well as the daily-reported number of COVID-19-related deaths in each region. RESULTS: We recorded 3062 cases of new-onset T1D (53.3% boys, mean age 9.5±4.3 y.o) of which 1347 (44%) had DKA. Comparing pre- and post-COVID-19 period, we observed a significant increase in the rate of DKA (37.5% to 49.4%, p<0.0001). The fraction of moderate (+5.4%) and severe (+3.4%) DKA cases increased significantly (p=0.0089), and more episodes required assisted ventilation (+2.1%, p=0.0337). Two episodes of DKA during 2020/2021 period were fatal. By region, change in DKA frequency correlated with initial COVID-19 death toll (March/April 2020) (R=0.6, p=0.0287) and change in T1D incidence (R=0.7, p=0.0080). CONCLUSIONS: The clinical picture of new-onset children T1D in Poland deteriorated over a two-year period. The observed increase in the frequency of DKA and its severity were significantly associated with the overlapping timing of the COVID-19 epidemic. This article is protected by copyright. All rights reserved.

17.
J Diabetes Investig ; 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1886687

ABSTRACT

AIMS/INTRODUCTION: To investigate overlooked diabetes in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: In total, 462 COVID-19 inpatients were included in this retrospective study. The presence of diabetes before COVID-19 admission, and the HbA1c and blood glucose levels at admission were examined. RESULTS: Of the 462 patients, 116 had diabetes. Seventy-six patients had been diagnosed with diabetes before COVID-19 admission, and 40 patients were diagnosed for the first time. Of the patients with diabetes 72% required insulin. Patients with diabetes were significantly (P < 0.05) older, more likely to be male, heavier, and showed a lower eGFR. Patients with overlooked diabetes showed a lower HbA1c (average 7.1% vs 7.5%), a lower casual blood glucose (average 157 vs 179 mg/dL), and they used less insulin per day during hospitalization (average 16.0 units vs 34.5 units) than patients with previously diagnosed diabetes. Patients with overlooked diabetes tended to have more severe COVID-19 than those with pre-diagnosed diabetes. Multivariable logistic regression analyses showed that the increased odds ratios (ORs) of aggravation in all patients with COVID-19 were associated with age [OR 1.04], BMI [OR 1.05], and diabetes [OR 2.15]. The risk factors for aggravation in patients with COVID-19 and diabetes were age [OR 1.05] and HbA1c [OR 1.45]. CONCLUSIONS: Diabetes is a predictor of COVID-19 aggravation. Furthermore, in COVID-19 patients with diabetes, high HbA1c levels are a risk factor for severe COVID-19. A total of 8.7% of COVID-19 inpatients were diagnosed with diabetes after HbA1c was measured on admission. Therefore, it is important to measure HbA1c in COVID-19 patients.

18.
Arch Physiol Biochem ; : 1-19, 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1886327

ABSTRACT

BACKGROUND: The aim of this study was to provide a scoping and comprehensive review for the clinical outcomes from the cross-link of Type 2 diabetes mellitus (T2DM), COVID-19, and sarcopenia. METHODS: By using PRISMA guidelines and searching through different databases that could provide findings of evidence on the association of T2DM, COVID-19, and sarcopenia. RESULTS: Thirty-three studies reported a relationship between sarcopenia with T2DM, twenty-one studies reported the prognosis COVID-19 in patients with T2DM, ten studies reported the prognosis of COVID-19 in patients with sarcopenia, five studies discussed the outcomes of sarcopenia in patients with COVID-19, and one study reported sarcopenia outcomes in the presence of T2DM and COVID-19. CONCLUSION: There is an obvious multidimensional relationship between T2DM, COVID-19 and sarcopenia which can cause prejudicial effects, poor prognosis, prolonged hospitalisation, lowered quality of life and a higher mortality rate during the current COVID-19 pandemic.

19.
Behav Med ; : 1-10, 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1886301

ABSTRACT

Patients with underlying comorbidities are particularly vulnerable to poor outcomes from SARS-CoV-2 infection. Despite the context-specific nature of vaccine hesitancy, there are currently no scales that incorporate disease or treatment-related hesitancy factors. We developed a six-item scale assessing disease-related COVID-19 vaccine attitudes and concerns (The Disease Influenced COVID-19 Vaccine Acceptance Scale-Six: DIVAS-6). A survey incorporating the DIVAS-6 was completed by 4683 participants with severe and/or chronic illness (3560 cancer; 842 diabetes; 281 multiple sclerosis (MS)). The survey included the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, demographic, disease-related, and vaccination status questions. The six items loaded onto two factors (disease complacency and vaccine vulnerability) using exploratory factor analysis and exploratory structural equation modeling. The two factors were internally consistent. Measurement invariance analysis showed the two factors displayed psychometric equivalence across the patient groups. Each factor significantly correlated with the two Oxford COVID-19 Vaccine scales, showing convergent validity. The summary score showed acceptable ability to discriminate vaccination status across diseases, with the total sample providing good-to-excellent discriminative ability. The DIVAS-6 has two factors measuring COVID-19 vaccine attitudes and concerns relating to potential complications of SARS-CoV-2 infection due to underlying disease (disease complacency) and vaccine-related impact on disease progression and treatment (vaccine vulnerability). This is the first validated scale to measure disease-related COVID-19 vaccine concerns and has been validated in people with cancer, diabetes, and MS. It is quick to administer and should assist with guiding information delivery about COVID-19 vaccination in medically vulnerable populations.

20.
Diabetes Metab Syndr ; 16(7): 102537, 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1885724

ABSTRACT

BACKGROUND AND AIM: Diabetes mellitus (DM) has been a worldwide public health problem during the last two decades. To examine the effect of a smartphone application of diabetes coaching intervention on improving self-management behaviors and preventing onset diabetes complications. METHODS: A randomized control trial, two groups, pre-test, and post-test design with a non-equivalent control group was conducted. The intervention group received a 12-week smartphone application of diabetes coaching intervention to improve diabetes self-management behaviors and to prevent onset diabetes complications. While the control group received the usual care from the community health centers. The smartphone application consisted of narrative App-based coaching, a printed user guide, mindfulness-based coaching; skill-based coaching, and a small App-interaction. RESULTS: After implementation, the self-management behaviors among the experimental group were improved than the control group in terms of dietary control, physical exercise, blood glucose monitoring, medication adherence, and screening of complications. The clinical outcomes were also significantly improved among the experimental group and to the control group. CONCLUSIONS: A smartphone application-based diabetes coaching intervention was feasible to apply as a nationwide program to promote diabetes self-management (DSM) during the covid-19 pandemic.

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